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Home My WebLink About9923-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy Date ................... .~/.~..~.~.-....~., 19 7.~. THIS CERTIFIES that the building .... A.]' .......................................... Location of Property / ~ ~C tl~l~*'7'*v &/ ,~ il,l:~ ~4 /~ TVI*'FU~x County Tax Map NO. 1000 Section .... /.~./...Block ....... ..~. .... Lot .... ~ .......... ~.. Lot No Subdivision ............. ~ ............... Filed Map No .................... conforms substantially to the Application for Building Permit heretofore fried in this office dated u .. .......... ~... ~;....~.l, 19 ursuant to which Buildins Permit No ................... ?.. dated .......... .~ Y.(..'...~.~ ....... 19 was issued, and conforms to all of the req ents of the applicable provisions of the law. The occupancy for which this certificate is issued/is~ ......... ,~, . _-~_. ] ~/,~'-/E 0~f-- Fp~f'q ~L '; Thecerfificateisissuedto ~ AT~OLb I4~/~IA I:t N of the aforesaid building. Suffolk County Department of Health Approval A./, /~ . UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector FO~ NO. 2 TOWN OF $OUTHOLD BUILDING Di~PART/~HT TOWN GLERK'S oFFIGE S~UTH'O~D, N~ Y. No. ' BUILDING PERMIT (THIS PERMILr MUST BE KEPT O~ THE PREMIgE$ UNTIL FULI:- COMPI.ETION OF THE WORK AUTHORIZED) ; Permission is hereby granted to: TOWN OF $OUTHOLD , Building Department Town Clerks Office South, old, H. 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 Inspector 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 installations, a certificate of Code complience 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: I. 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, o~cupancy 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 a certificate. C. Fees: 1. Certi{icate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Rte ..... ........... ............. New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property .......... ~./~..~. ...... ~ ___ ,, ~~'~"~/z-~"~)'""~" .................. ;...............................................' Subdivisi,~r ................................................................ Lot No ............. Block No ............. House No.......z~z.. Permit I~o..~...~...~.~..... Date Of Permit .~.~./.~....~plicant ~.~,~.....~.~../~/.~..~..~.~:~'.~...~....~....~... ' Health Dept. Approval ......... ~..,...~.... ..................... Labor Dept. Approval ................................................ Underwriters Approval ........... ~./~ ................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fin~ Certificate ~. .............. ~ ...................... Fee Submitted $ .0.'~.....~.. ....................... Construction on above described building and,,j~ermit meets all applicable codes and regulations. .... ( ~pp~canr ........~ ................................................................................... Sworn to before me this . ................ day oF ~',~"r ...................... Notory ...... (stamp or seal) qualm Suffolk Cou,lt¥ ~'o. 52'467594~ ~¢~ ~ ~1~ Gommissio~ Expires ~arcfl 30, TOWN OF SOUTHOLD OFFICE OF BUILDING INSPEC'WOR TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765-1802 February 26, 1979 Mr. Harold Hanna£in 1290 Horton Ave Mattituck, New York 11952 Re: B.P. # 9923 Dear Sir: It appears that construction under this permit has been completed. Please make application for a Certificate of Occupancy and arrange for final inspection. We are enclosing application forms herewith. Yours truly, EDWARD HINDERMANN Building Inspector Eno. EH/Pis CARL'S MOBILE HOMES Route 58, ]Box 523 -:- Riverhead, New York 11901 AC 516 - Ph. 727-7745 June 14, 1979 Town of Southold Building Dept. Town Clerks Office P,O. Box 728 Southold, N.Y. 11971 ~entlemen: In accordance w~th the telephone conversation w~th George Fisher of yOUr office on this date, ! am enclosing the "State- me.t of Responsibility" signed by Harold Hannafin (permit ~9923) to complete the requirements for the issuance of the Certificate of Occupancy. Please send the original C.O. to Mr. Hannafin, 1920 f l often Ave., Mattituck, N.Y. 11952, and a photocopy to Carl's Mobile Homes, Inc., at the address above. Your cooperation in this matter is appreciated. Carl's Mobile Homes, Inc. l~:ds FORM NO. $ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Date ................... ................. , ,9...7.? (o~ner or..~uthorized agent ot~ow~erJ PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance Other Applicable Laws, Ordinances'or Regulations ............................................ at premises hereinafter described in that ('~'~'~'~'~-'~'"~'~;t~te character of violation) ............................. (State section or paragraph or applicable law, ord' a~ce o g 'o ) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned forthwith on or before the ...................................................................... 19. ~,~,. day of · ~¢/~, ........ , The pr.err)is, es to which this ORDER TO REMEDY VIOLATION refers ore situated at ./~,~:~'~..~/~..,~...?~...~'~;..., ./..~..'....County of Suffolk, New York. Failure to remedy the conditions aforesaid and to comply with the applicable provisions of Iow may constitute on offense punishable by fine or imprisonment or both. ,/~ ~f'~-~, .'//-'~f~' ..... ,~i d~n~ ~ector April 13, 1979 STATEMENT OF RESPONSIBILITY To Whom It May Concern, I, Harold Hannafin, state on this date that I accepted full responsibility for the removal of a section (approximate- ly eight to ten feet in length) of the side supporting wall, when I dismantled it, where it adjoins my 1973 Holly Park mobile home (#6020676), and that I will continue to accept the re- sponsibility for the removal of the above described wall section. State of New YorY~ County of Suffolk Sworn to before me this 21st NDtary P~ub 1 lc ~ day of June 1979. Disapproved a/c ........................... ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, Permit No, .~~ .......... Application No ............................. 6LIfling Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building 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 not 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 t~ntil 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 Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as here n descr bed The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (~.~ature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, genera~ contractor, electrician, plumber or builder. ................................................ .................................. Name of owner of premises /~z~ZoLO lf~pplicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... 4~.'.~'....~.. .................................. Plumber's License No ...... ~.Ct{ ................................. Electrician's License No....~...~...~ ................................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: ........................................ Lot No ......................... Street and Number ../'...~....~..((.........~...~.~..~......./~....~...~.~'. ........ ~/~...~...'.7'....7~.~...7~.~..~.~.. ......................................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ~'P~ b. Intended use and occupancy ~ ?.~..... .............................................................. / property lines· Give street and block number or whether interior or corner lot. 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ................ Repair .............. ,;... Removal .................. Demo to-. ............. Other Work ................................................ .... ' ~. ~./ ~ (Descript on) 4. Estimated Cast ............................................~ ............... Fee .~./..c~ ................................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Nurnbcr 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: Fro~,t ........................... Rear ................................Depth .................... Height ........................ Number of Stories ......................................... ).~. ......................................... .~.~? ................... Dimensions/of,,o ,same structure with olt~o, tions or additions: Front .................................... Rear ............................ Depth ................................Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ................... , ............... Rear ............................ Depth ........................ I-[eight ....................Number. of Stories ........................ '. ....................................................................................... 9. Size of lot: Front ........................................................ Rem .......................................... Depth ................................ 10. Date of Purchase ........................................................Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded ............. ., .............. Will excess fill be removed from premises:,( ) Yes ( ) No . ,//z'~ ~ c. lC 14. Name of Owner af premises .................................................... Address '<~"~"W'~."~'~'I ........ Phone No ....................... Name o~- Arch tect ......................................................... Address .,~ ....... x....,~'c,t..r.~*,~.:/-Phone No ....................... _('",/,,/~, ,~1 4/I /x ,/ , Name of Contractor ........................................................ Address....?~...;...'..~.~....';..~.... Phone No. .... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from names and indicate being duly sworn, deposes and says STATE OF NEW Y~K./ / , /H2cc ....... ................ he is the opplicam above named. He is the .............. (Contractor, ag'~"'~",~';~';~'~<~[;',~'~"'~f~'.'f~..., ~.~.~.~._ ~_-.~-_, ~.~, ............................................................... 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 ali statements contained in this opplicetion 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 befc~r~mne this ./.7.~/ ( ...... ...~.../.! 19 Notary Public, County (Signature of applicant)