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Home My WebLink About9169-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. Z10295 Date December 10, 19 80 THIS CERTIFIES that the building ................................................ ~80 Middleton Road, Greenport, N.Y. Location of Property ............................................................... House No. Street Ham/et County Tax Map No, 1000 Section /40 .Block 05 .Lot 003 Subdivision Fleetf£eld .Filed Map No. 11551 .Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 6 ' 19 .7.Tpursuant to which Building Permit No. 9 69 Z dated ...A?.r.l.l..-.6.~ ................ 19. 77,.-. 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 ......... Accessory Structure James E. Chute & Catherine A. Chute The certificate is issued to ..................... [o~'n'o),' ........................... of the aforesaid building. Suffolk County Department of Health Approval ....N./.R, ................................... UNDERWRITERS CERTIFICATE NO.. ,~/~. .................................. Building Inspector Rev 4/79 FO~M NO. ~' 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) 9169 Z Permission is hereby granted to: ...~..~....gk~.~ ................................................... ................... .~.e..e.~.o..~.~. ...................................... to ... ~.~t.~, ~,.d.... ~.~ 1,Z.. ~..0..e. e,. ~ ~.O.~.y... ~.t o.~. fkCe,...bt~ ld~ ~ .................................................................. at premises located at ,.,T~,Q.~..,2.~..,]]L],O.~.tI'...~..,,.~e.~f~~:j ........................................................... ........................................ ~,~.O......,~lO,~ ~ !.~n..~a~.. ~r~e~po~.t; .................................................. pursuant to application dated ........................... ~'.....~. .............., 19.~.~:.., and approved by the Building Inspector. FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 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 survev of peoperty showing all property )ines, 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 informa- tion required to prepare a 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 Date.. / ~..-.../.O...'7. ~¢~. .... New Building ~ ........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property C~..../~..I../~.../~..L./.~ .?.~...,~.' .... ~. ~.... ~.~ ~.~.~.~./~: .~... House No. Street ~Hamlet O~ne~ o~ O~ o~ P~o~..~ ,~ .~. 5 ~..~ .... ~ ~iZq~ .... ~ ff.~.~ ...... co,,t~ ~,~ M~, ~o. ~000 ?t~o... ~ ........ ,~oc~ ~..E~14,~?~2. ~ ....... .............. ......... ,e~mi~ ~o.~/.~.~, ~. O~te o~ ,~,~i,~r.~.t ?.?.~,,,ca,t '~ ~....~ .~.~ ..... Health Dept. Approval ........................ Labor Dept. Approval ...................... Unde~riters Approval .. 77'.'. .................. Planning Board Approval .... ~ .......... Request for Temporary Certificate ..................... Final Certificate ....................... ,,, s~i~,~ ~..5-. ~.~ .................... Construction on above de~ribed buiMing and ~ all ~~d regulations, b ~,~,~c~~~. C~~~..:.. ......... ¢... FORM NO. 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. ORDER TO REMEDY VIOLATION (owner or authorized agent of owner) 480 Middleton Road ................. G~.e~z~p~ ~.~ ... N ~Y. ............................. (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance ART. XIV Other Applicable Laws, Ordinances'or Regulations ............................................ at premises hereinafter described in that .......... .~.~.z...1.~.z,..~.g..,~,e.,.-~....z..t....~.,,_.cJ,,.,6,.?.~ ........................... (state character of violation) ....................................................................................................................................... in violation of .......... ................................................................................................. (State section ~r 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 12th day of ......... .D...e..a...e..~..b...e.~ ......................... , '19...~..0... The pre, raises to which this. OxO~DER TO REMEDY VIOLATION refers ore situated at . .~./'z~/~'J.,~.'.'..6C.~'~..Z4~/.'~,, .~.L.~,,',~',.7/..~.c'.-~--~,~'....Caunty 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 I~OR,~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, No ¥, Approved .................. ~. .......... ~ ...... , 19...~.ff. Permit No..~l ............................ (Building Inspector) Application No ................................ APPLICATION FOR ~IJILDING PERMIT Date .......................... .~.., '?,'.l~. ...... ~, 19.'..7...~..., ,.'~~ INSTRUCTIONS a. This application must be completely filled in by typewriter ox in ink and submitted in triplicate to the BuildingN Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets az areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. c. The work covered by this application may nat be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. 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 for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the 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 app icant agrees to comply with al app icab eaws, ordinances, bui ding code, housing code, and regulations, and to~ admit authorized inspectors on premises and in, buildings for necessary inspections. ~ ~'n-~a't,~u~e of appl i~~l~r,~tion)"'- ~,~..~, ........ ....... ff.~._.C¢ '._~. ........................ ~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..~.~A .~.;..~.~...~-..~..~ If applicant is a corporate, ~gnoture of duly authorized officer. (Name and title of corporate officer) Builder's License No....~.'.....,~.~....~.~ Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... l. Location of land anwl~ch,,, ~--~ , ~ / r~ ~.~- ~u ~ ~ ~ ,/pr°p?edw°rkwill,bed°ne~ M, gp Nf~.:,~.,~.?.. ............................ ]~ot No..~'.~.~... ................ Street arid Number .~,L...--~**~.~.~.~:~.7~,..~*~..>..***~'~L..-,~*~~)..../~.,/..~,., .................................. ~ / Municipality 2. State existing use and occupancy of premi~'s'~and i~ended use and occupancy of proposed construction: o Exstn use andoccu anc . . g P Y ......................................... ~ ..................................................................................... b. Intended use and occupancy ~.~..4L,~'~- ' ~..4~_.~ ....................................................................... 3. Nature of work (check which applicable): New Building....~ ...... Addition .................. Alteration ................ Repair .................. Removal .................. Demolitior ..................... Other Work ..................................................... ~, ~ / ~ (Description) 4. Estimated Cost .~)..~. ...... : ............................................ Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...~'.~ ................... Number of dwelling units on each floor ....T,~ 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 ............................ ~N'umber of Stories ................ ~ .............. 8. Dimensions at_entire new construction: Front .r..~ ................. Rear ....~ ........... Depth ~ .......... Height ..~:~ z~,__ .... Number of Sto~q~ ....... L ........ ~ ........................................... ~ ................................. ~ ................ Size of Iot~ront ........................... ~..Z ..................... Rear .......................................... Depth ...... ~...~..?. ............. Date of Purchase ........................................................ Name of Former Owner ........................................................ Zone or use district in which premises are situated ..................................................................................................... Does proposed construction violate any zoning law, ordinance or regulation: ..~ ............................................ Will lot be regraded ~ ................ Will excess fill be removed from premises: ~ ( premises~.~..~ ~ Addre~~~one ' 7'~-' ~ ' .......... ....... Name of Owner of /I Name of ~rchitect ......... ~.. ................................................ Addre~ ................................ Phone No Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate cleaHy and distinct[y ~[J.bui[dings, whether existing or proposed, and indicate all set-~ck dimensions fram property lines. Give street and block number or description according to deed, an~ str~qd in~ icate ~hether interior ar corner lot. --10. _11. 12. 13. 14. STATE OF NEW YORK, COUNTY OF ..................~-~....~.~..~. [ "'" ................................................................................................. being duly sworn, depases and says that he is the applicam (Name of individua~ signing contract) above named. He is the (Contractor, agent, corporate officer, etc.) of said 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 con¢oined in this application are true to the best of his knowledge and belief; and ~har the work will be performed in the manner set fo~h in the application filed therewith, Sworn to befor~ me this ..................... JUDITH No~a~ P~siic ~No,