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Home My WebLink About9111-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. 7.1078B. ........ Date . .~o.v. embe~..23 .................. I~1. THIS CERTIFIES that the building ................................................ Location of Property . .520..'l:~ack .Avenue ~..Cutch.o. gue~..NY. House No. Street .................. I:l~r~/ei County Tax Map No. I000 Section &OB ........ Block 3.2_ ............ Lot . .0.04 ............ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .I~lar.ch. 22 ........... , ~9.7.7. pursuant to which Building Permit No..91J. l~ .............. dated ... Had. ch. 23 ............... 19 7.7., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... The certificate is issued to B.pe~ace.n .~/,..P.e t~t;¥..III. of the aforesaid building. Suffolk County Department of Health Approval ...F.e b~'u.a~¥./.7. ~. 10.7.8 t · .?.-~S0.--32 ~. lt.,J~,. UNDERWRITERS.CERTIFICATE NO.. I~53~189.7 .................... ./ ............ Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: at premises located at ............................................................................................................................ pursuant ta application dated ........................................................ , 19..'"'.:, and approved by the Building Inspector. Fees ...... ..~.....7......-~..... TO REMOVE EXCESS FILL FROM ABOVE ~REMISES BY,~ RE(~RADING LOT ~.. DRIYEWA'f CONS'f?.UCTION -----~z;~ coNSTRUCTION / CESSPOOL ~- ,J CELLAR coNSTRUC~____/ ~ Building Inspector FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF Q~CUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certdicate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Ptaoning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property I nes, streets, buildings and unusual natural or topograph ic featu res, 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 ... Date .... .-~. ,~?~.'(....~....~ ......... New BuiMing . ./,/. ......... Old or Pre-existing Building ............ Vacant Land ............. Owner or Owners of Property ..... ~f~ ~ ~: ..... ~ ..... /. ...... ~(/ .................. County Tax Map No. 1000 Section .../.~J. ~ ...... Block .... ~ ~ ...... Lot..¢~.~ ....... Subdivision ................................. Filed Map No ........... Lot No ................ Permit No..? .~././..-~ Date of Permit .~..~.~..~..~.~.Zpplicant-,¢~/~ ~'..¢¢~'¢~j.~.-~.~... ~ .... Health Dept. Approval ..-- ........ : .~ .... Labor Dept. Approval ,~-~,/.~, .~ .. . .~ ,, \ Underwriters Approval./~'.,¢¢.4¢(¢~.~, ........... Planning Board Approval . · .~./f.~.m Request for Temporary Oert f cate ......... FinalCertificate . .~..'~.... Construction on above described building and Cr~it meets all applicab.~co~es and r/et~t..~cs Apphcan " . ........... Rev, 10-10.78 NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Southold, lq. Y. Cerfificnte O~ Occupnncy No ............. Date ............................ , 19 .... THIS CERTIFIES that the building located at .... .~ .~..0...~.~.~.(?.~....6. !/.~. Street Map No ............. Block No ........... Lot No .................................. conforms substantia~the;f~pplic~t~n for Building Permit heretofore filed in dated/ ............ ~1 t'~ t~ ' ' ~.EL~ 19.7/pursuant to which Building Permit No ......... dated ....................... , 19 ...., was issued, and conforms to all of the require- ments of th~xappl~b~$ ~p~.ision~lFq~thel:t~aw~ ,~o.~,~ccup~ykf~ ~a~his certificate is issued is --~ { .............. ................... .:_u ~'-/_' r, ~' 'Ps ..... k~/ .... ~F' "'~; '] .... The certificate is issued to ................................ :-.~ ................. (owner, lessee or tenant) of the aforesaid building. 2/, ~ /'7 £~ ~ I: '~ 7 " ~ /) ' Suffolk County Department of Health Approval .................................... UNDERWRITERS CERTI~I,~z~TE.~ ~. No ..... ~=le/~ c ~"' '~'~/'/)~ ..................... HOUSE NUMBER .............. Street .... t~ O '~' C' ~4 -o- ~'~ .~ 'E' ..... k,~'-' '~' ........ ....... ,~ ~ Building Inspector .Looo~:~~. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ' 85 JOHN STREET, NEW YORK, NEW'YORK 1OO,38 No. in the following FIXTURE SWITCHES OUTLETS DRYERS FURNACE MOTORS FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS ~IME CLOCKS UNIT HEATERS MULTI-OUTLET DIM~,~ERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: i NO' OF HI-LEO 1 This certificate must not be altered in any manner; return to the office of the Board if incorrect. may be iN ANY MANNER. TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN GLERK'$ OFFICE $OUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Dote ............. p.j J , 78 TO ~6~// ~ ~ ~ (owder or outhorized ogent of owner) ....... ................... (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance Other Applicable Laws, Ordinances'or Regulations ............................................ at premises hereinafter described in that *"f ~-I E L~ t~ E L 1. ~ ~,~ G I ~ '~ L~ (state character of violation) in violation of ..................... ~......... ..................................................................................................... (state sectioo or poroqropH of applicable Iow, ordioonce or regulation) YoU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the / '/ conditions obove mentioned forthwith on or before the ...................................................................... day of ................... {~..~...?.,..0....~.../.!~...~...., 19 The premises to which this ORDER TO REMEDY VIOLATION refers are situated at .......................................... ./. ................................ .J. y of Suffolk, New York. Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both. ..... .~: ..... .~..~....;.. Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Delmffmenf Town Clerks Office Southold, N. Yo 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, end unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings end installations, a certificate of Code compliance from the Architect or Engineer responsible for the building, 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare o certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Dote New Building ..... .~ .......... Old or Pre-existing B~lding .......................... ... Va99nt Land ............................ Permit No. ~/ZZ.~ Date Of Permit .................... Applicant ~..~.~ Underwriters Approval ............................... ""7 ...... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ~,~ c~ o Construction on above described building and,~ermit meets all applicable codes~d.,reaulatio~. ~ Applicant ........... Sworn to before me this // ................ day of ............................................ (stamp or s~al) FOEM NO. 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. ORDER TO REMEDY VIOLATION (owr~er" "or authorized agent of owner) (odd6ess of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance Other Applicable Laws, Ordinances'or Regulations ............................................ at premises hereinafter described in that ......~....~...~. ........ ?.,..~..,.~..)?..L...!.!,~!,,G.....,,!.~.,....]~..,L.~..!,!.~i~...G..~..... (state character of violation) ,.g..~.~..;~. ......... ~LZ.!~.....°...?..~ ........ ,~. ........ .C-..C.~.:~LE.!.C.~.~. ........ g..~ ....................................... ................... g.c...c...u...~..lb...~.<...Z. ............................................................................................................. in violation of ........ .~,.7,~,:,T.:.~i-~ii ....... .j...o,..O...~..,/,.~,:.~/,......,~,. ............................................................... (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned forthwith on or before the / ~ day of .................... .C.~.~.;~.u..~..r.~?...Y...., The premises to which this ORDER TO REMEDY VIOLATION refers are situated at .......................................... 7' ............... : ................ .~.~ounry of Suffolk, New York. Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both. ..... ~,.....~~,~,, ....... Building Inspector TOWN OF SOUTHOLD ~.~,t,~,~;~? ?.~.~* 'f 0~'~i ~n"e~'t . ~ TOWN CLERK S OFFICE ~ ~F~ ~ '-~ /~ ~-~ ~ ~UTHOLD, N.Y. '~/'~- ~'~ ~ . ~xami~ed ............... ~. ...... ~..~.....~......~ ? ' / // ........... .... ........................ ............................... ................................ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter ag in ink and s~mitted in triplicate to the Building~ Inspector, with 3 .set~ of plans, accurate plot plan to ~ale. Fee ~ccording to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detail~ description of layout ofproperty must be drawn on the diagram which is pa~ of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to ~he applicanL Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part ~or any purpose whatever until a Certificate of ~cupancy~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to tine Building Department for th~ issuance of a Building Permit pursuant to the~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and r~gulations, and admit , s for n~essa~ in~ections. TO REMOVE EXCESS FILL . ............ ~ /(~nature of~pp ' , , if,¢comoration) Name of owner ..~... / If applicant is a corporate, signature of duly authorized officer. (Name ap. fi title of corporate officer) Builder's Lice~'~b No ..................................................... Pi LiCense No Electrician's, License No ............................................. Other Trade's' License No ............................................... Location of land on which proposed work will be done. Mop No.: ..... .Z ................................. Lot No....: .................... Street and Number ............................ ~.,~.4.~./~.. ....... ~...~..~/~.~ ................. C.,,4~.[~'~.4.~..:~../~..1~....,.~,.~.~.~ /)~unicipallty / State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .............................................. ., ................................................................................. b. Intended useand occupancy ...... / ...... ..~/~..~..~.J...~..t~..' 3. Nature of work (check which applicable): New Building........~.... ...... Addition .................. Alteration ............... Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) 4. Estimated Cost ............. ~.~. ....................................... ee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .............. /... .......... Number of dwelling units on each floor ............................ if garage, number of cars ............/.. .............................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Num~ber,~,_~,/at Stories ................................ 8. Dimensions of ej~tire new construction: Front ............. .~..~...~. .......... Rear ......... ',~...¢?...." ..... Depth ..... ..(~.....E?., .......... Height .....J.~....' ..... Number of Stories ....... Z .................................................................................................... Size of lot: Front ....................................................... Rear ........................... Depth ................................ Date of Purchase ,...' ................................................... Name of Former Owner ...~.~.~.~2.,/);'....~......~4r/~.~..z/L)....., Zone or use district in which premises are situated .................................................................................................... Does proposed constructj~ violate any zoning Iow, ordinance or regulation: ..... /~..~. .......................................... Will lot be regroded '"'"'~" '~'"'~"z~ ........ Will exc~ess, fi, J~ .b¢ re~zloved troD3 prem, Jfes;/~:~ Yes ( ) No 14. Name of Owner of premises ..~...°..~..(....~.~.~ddress ~~..~.. Phon* No. 2~..2'~',~...~..~? Nome o~' Architect ............................. i ................... ....~....... Address ................................ Phone No Name of Contractor /{ / Address /t Phone No. ?/ PLOT DIAGRAM Locate cleaHy and distinctly al.I buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and it~dic~te whether interior or corner lot, ~' 1. 12. STA-I-E OF NEW '¢ORl~d ,¢ ,~ l S c COUNTY OF .~.....f '~ / , ................................................................................................z ~,// )~eing duly sworn, deposes and says that he is the applicam (Name of individual signing contract) above named· ,He is the ...................................................................................................................................................................... (Contractor, agent, corporate officer, etc.) ¢¢c~f s~id owner or owners, and is duly authorized to perform or have performed the said work and to make and file = this application; that all statements contained in this application ore true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this -~ ,/'/ ~ . .... ................. JUDITH T. TERRY Notary PuNic, State of New York No. §2-03~4933 Suffolk County Commission Expires March 30~ ItlE~IIRE.~I' PUBLIC I'F4TER #~1111 -' ~ IWILE$ +_ FI4 T£R $E,'~'1¢£ = PRIV4TE THE LOCATION OF WELL~ AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND/OR FROM DATA OBTAINED FROM OTHERS ........ - .... SUFFO~ COU~ DEPARTMENT OF H~LTH ~CES FOR ~PROV~ OF CONSTRU~ION ONLY ~EOVED~ ,, ~ ...,,4 THIS SURVEY 15 A VIOLATION OF SECTION LA~.72 9 OF THE NEW YOR~ STATE EDUCATION REVISIONS SURVEY FOR: SPENCEt~ PETTY, 177' oF NEI~v AT CUTCHOGUE SOU THOtD SUFFOLK CO., N.Y. / ~u · DATE: = 50 11~.4R. 17, 1,977' 12GA YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN ~N'. YOUNG HOWARD W. YOUNG · -- MOI~UMEIVT ligAmEnT PIIBLI¢ WATER MAIN: 4~ ¥1lE$ +- WATER SER¥1CE-- P~IVA~E THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM F~ELD · O~SERVATIONS ARO/OR FROM DATA OBTAINED FROM OTHERS THE WATER SUPPEY AND SEWAOE DISPOSAL SYSTEMS FOR THIS RESIFENCE WILL C(~IFORM TO THE STANDARDS OF THE SUFFOLK COUNTY ~PARTMEJqT g~' HEALTH APPLICANT: -- ADDRESS .$ .EWS~O.S YOUNG & YOUNG SEPT. /, /9?? 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK SURVEY FOR: SPENCE/? PETTY, 777 CUTCHOGUE ~ 17TLE eu,~R,~ur~E co. SOUTHO£D ~UFFOLK CO., N.Y. SCALE: ,, - , DATE: