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Home My WebLink About12799-z FOB~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT Cf'HIS PERMIT MUST BE KEVT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12799 Z Permission is hereby granted to: ..~...~.~...~.~::..~...-, ~- . _ ~--~,;~. ...~.~. ....... ~.z. .......... ~~...~ - .... ~.z.,.z~....~..~...~ ........ ~ ,o ...... .~~.~.=Z:.....~.~...~.~.~.....~.~.~:z~.~.~ ............................. at premises I~ated at ........................... .Z~:~:.~....~~ ............................ ~./.....~ ................................... co..~ ~ Mo, ,o. ~0oo s,~,~o. .... /~2~ ........ ~ ..~. ......... ~o~ ,o...~.~ ........ Building Inspector. Fee $. · ~.{ · ~.. ~- · · .. -~.~-.'~. · .~ Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD 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-iS-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 survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic 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 requ ired to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2, Certificate of occupancy on pre-existing dwelling $15,0 0 3. Copy of certificate of occupancy $1.00 New Building ........... Old or Pre-exi~ting Building ............ Vacant Land ............. Location of PropertY.Ho.u.se j'No. ' '~' '~' '~'' ' ' '' '~~' ' '~'~Street ........ '~'~"~ Owner or Owners of Property ...~...~.~....~..~ .~.~..R~...~.~ ....... County Tax Map No. 1000 Section ../. ~.. ~. ...... Block .... .~ ......... Lot ..... ( .......... ....... F,,ed Map ?...Lot ..... Permit No.,/. 5..?..~'~.ZDate of Permit/' ~/~ ~/.~-~.Applicant. ~-a~. Health Dept. Approval ./~..':~'..~o'./. ~..~2. ........ Labor Dept. Approval ........................ Underwriters Approval.!.~.. ~.' .~. ~. . .~./'. 8. .... ....Planning Board Approval .. ................. · .. Request for Temporary Certificate ..................... Final Certificate ...... ~ .......... Fee Submitted $... ~... ~...~. .................. //~ Construction on above described building and~m)~meets~al~'pl~ble codes and regulations. ~0~_~"~('~ '~.~.(b ~ ~ t.O Applicant ~~ ',~, ' ' ' '~-~;-;~-'~' ...... x .............. Rev. 10-10-78 iON DATE COMMENTS (2nd) _ / ~' , ADDiTiONAL COMM~S~ " /~' : . . .,~~~~--~. ,-~ FIELD INSPECTION 1. FOUNDATION FOUNDATION 2. ROUGH FRAME & PLUMBING $. INSULATION PER STATE EN ?DE FINAL l~OB~ NO, ~ 'rOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTNOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12772 Z Permission is hereby granted to: ...... ~..~...~ .¢c ./.~../...~.~... J/~-/r, ...... z.o..~ ......... ~,c.5.~.~ ....... '.~./...: .............. ....... ~~.F~ .~...,....z.~....:.. :./... ................ ,o ....... .~ .~..~ ~.~.~..... c~z,z~m...~.~,..~. ~... ~ .~. ~.~.~.~d'~..~ .~ ................................. at premises located at ................................................ ? .................. ? ..... County Tax Map No. 1000 Section ...(~..~.~...~.. ........ Block ....~../. ........... Lot No...~..J./...~....: ..... pursuant to application doted ..... ,Z~.~-,)~/.~/~..~-,~ ...... .~... ...... , 19..~..~., and approved by the Building inspector. Fee $../~'~...~/.... ~.. ~. .... "'~' ' Building Inspector Rev. 6/30/80 FORM NO. 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. ORDER TO REMEDY V~OLATION Dote .P..e.~; ~.~D.e.~.. ~ ................................ 19.8.(~... (owner or authorized agent of owner) 1930 Leeward Dr±ve~ Southold~N.Y, 11971 (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance .... .O.'JP' .'- '-' J..(~. '0' ....................... Other Applicable Laws, Ordinances'or Regulations ............................................ Swimm£ng pool--no permit, no fence around ,. ~ 9,.o,.z,. ~,...~ ~.,~,.e. ~... ~!..q....g..o. p,.,z..~,..~ ..°... g. :.,0..: ............................................. : ............................................... i~ violation of .?.',.z..v....!..°..g,r..!.!LL(..z:.~.:..z,..,!..°,.9. r,,3...°...,c..:,~.l.~.l../,,x,,,z.y....!.~.9'z'!'~'~!'f''L!'l ............................ (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 .....D...e..c...e..rg..b..e.?. ............................... , 1¢...4. .... The premises to which this ORDER TO REMEDY VIOLATION refers are situated at .~.~.~.2~.~.~`~`~.e~?~?`~?`~`v`~?~`~`~`u`~?`~`~`~``~`u`?`~`~`N`~.`~:~unty of Suffolk, New York. 11935 Failure to remedy the conditions aforesaid and to comply with the applicable provisions of low may constitute on offense punishable by fine or imprisonment or both, Building Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ............... .2 Approved. Y'..~-~..//~/. 7' ........ 1~.'.~. Permit No...~.. ~.~. ~ ~]~.. Disapproved a/c ........... ] ~~...'~/...~..~ (Building Inspector) APPLICATION FOR BUiLDiNG PERMIT Received../ .. ,19 INSTRUCTIONS a. This apphcation must be completely tilled in by typewriter or in ink and submitted 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 or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued 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 applicant agrees to comply with all apphcable laws, ordinances, building code, housing code, and regt~latiqn~, and to admit authorized inspectors on premises and in building for necessary inspections. ~ ~ '5 . . E' ?.¢,: :., . : . Co . ;?.... (Signature of applicant, or name, if a corporation) (Mailing address of applicant) l { q'X-Z~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... ............................................................................ Name of owner of premises (as on the tax roll or latest deed) If applicant is a corporation, sign,.ature of duly authorized officer. ...... .............. (Name and title of corporate officer) Builder's License No ...... / ~ ............... Plumber's License No, ...~..zZ~,.../.~...~(..~: . . . Electrician's License No.~..~. ~:~. ~.~/~ ..... Other Trade's License No ...................... 1. Location of land on which proposed work will be do~e ................... '..' ...., ......................... .............. ............ ................ House Number Street County Tax Map No. 1000 Section ..... [.~ J~. ........ Block .... -.~. ............ Lot ..... .~ ............. Subdivision...../~.??.~.x~.....~. :~ ................ Filed Map No... ff..~.~.~. ..... Lot...~.,ff. ......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy.. ~.1. '~ :'5'9..'.~.,,. \..' .~.,, %"rcSx. x.~x,~. ~:~.~5~.~.. ¢ .c .Of_,~,\.~ ¥~, ~,~ ./.'~ ,qyg.C ~! .' ........ b. lntended use and occupancy ...~..5; .k~..~k .... ~. 'X~'-'m k k,,~ X~,,,~ '~coe t'\',v,o ~,,~-c la 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. RemoVal ............ Demolition .............. Other Work ............... , ..~/7~7 dd/~- (Description) 4. Estimated Cost ......... ~d.~.~. -- ............. Fee ~.. ....... ~ ....................... (to be paid on filing this application) ' {~/.Y.~ mb fd Iii f il! rd ·g u' 5. I dwe ng, numbero welhn mtn .......... Nu ere we ng units on each floor ........... If garage, number of cars .... ~ ............................. 6. If busmess, commercial or mixedI occupancy, specify, n~a[ure?p~l extent of each l[ype of use ..................... 7. Dimensions of existing stmctureg, if any Front .~(.tC..U./Af..S~y~ ~ l~oar B~nth Height ............... Number of Stories ........................................................ Dimensions of same structure wiih alterations or additions: Front ................. Rear Depth .................... .'.. Height .......... · · ./ ........... Number 9f Stories ................ t ..... 8. Dimensions of entire new construction Front ~'.'~, Rear ~("/( De,,th 5..-f~-.~ Height ...~ .......... Number of Stones .... /~.~.. ' .... t ' 9. Size of lot' Front ,/'t2d Rear . ' '2~'.'"i ....... }' 'h .... '¢ 'd '~L ........... .......................... t ........ Dpt . ~3,)[. .. . 10. Date 0fPurc)ase ..... ~4,Ar2~. j..t4...' [.~.~._3. .... nN_ame of Fon3~ er O~vn;r . ~'z...6!'.~.~.. 1 1. Zone o~ use uistrict in which premises are situated...t~'~$ a 0/( b( .F).,~ .C. .... ...... i .............. ........ 12. Does proposed construction violoJe any zoning law, ordinance or regulation: ...... ~/~. ~.... ................. .~. 13. Will lot be regraded ........ .~...z~.~,~. ................~ill. exce~fill be removed from premises: Yes 14. Name of Owner of premisesd(.0g[~, .P~.~ ~0.~g/)'..~c~r~e~'r ~.~,~ 5' .................. / ....... Phone No ................ Name of Architect ti'~;.14dZ -~7~ ~g - ~Addreso ~1~- /F ~I~ Name ~f Contracto~/~v'gfA-~h.'f~F,490/~/6. -~. AddreSS: ................. Phone No .............. PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block lumber or description according to deed, and show street names and indicate whether interior or corner lot. ST^T OF / S COUNTY OF~ALr/-dd~.' ...... j ' (Name of individual sig~ing contract) above named· ·.. being duly sworn, deposes agd says that he is the applicant He is the ................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duiy authorized to perform or have performed the said work and to make and file this application; that all statements con/ained in this application am 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~ ........ :../~--f..~ ....... dayo? ..... ,~Q~.. p ....... , 19 ~.._.~ /,~ · ........ .., .... ///7 < 80~~' ~.,~i ~ ~ / t~i~gna~ure et appucanr)