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Home My WebLink About10420-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the bufldmg ................................................ Location of Property 845 Yennecott Drive~ Southold, N.Y. House No. Street Ham/et County Tax Map No, 1000 Section ,,, ,0,~,~, ..... Block .... .~, ......... Lot .... .1.~..&.. Subdivision. ?.ep.~.e.o..O.t.~..P..a.l".k. ............ Filed Map No..~..1.8.7...Lot No. 9.9..&...6.0. .... conforms substantially to the Application for Building Permit, heretofore filed in this office dated ·. St~,.9t.. ~ ............ 19.7.9 pursuant to which Building Permit No ...... '1.0/~20. Z ........ dated .... Oa~;obelt ./~, ............ 19.7.9 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 ......... ......... P.v. iva~:.e .0ne.-.EamiZy. Dw~llin~ ...................................... The certificate is issued to ...Stephen. Cal?.r. & .Elizabetl~ .Hanson ................... of the aforesaid building. Suffolk County Department of Health Approval ..... 9--S0,~86. · Robel~.t .l~ ,..Vii]. a .7/'~ .$/80 UNDERWRITERS CERTIFICATE NO ........ l~l. b~90~013 ................................ Rev 4/79 Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFF)CE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N? 10420 Z Permission is hereby granted to: ......... ~.~.,.,... .~~....~~ ...... :.~. .... ...... ~..~..5~:....~,~~..~z: .......... ........... ~~,.....~ ......... ....................... ~: ..... _ ~ &~~ ~. ._~~'~ ............................................. pursuant to appdca ion aatea ...~~-.~.~...,.: ............ , . ../.., pp d by e Building Inspector. Fee $..~.~ .... ....... Bui~din 765-1802 BUILDING D'EPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2N'D [ ] INSULATION FRAMING FINAL ~Ot~ ~ I--I FI~AIVXF--- A i~t D I T ~ C3 NI /~. L ' i . THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK NEW ~ORK 10038 T~I~ O~TI~I~ was examined on ~ ~ ~, ~980 a.d found to be in compliance with the requirements of this Board. FIXTURE OUTLETS 17 RECEPTACLE~ SWITCHES 35 19 DRYERS FURNACE FIXTURES RANGES ' OVENS EXHAUST FLUORESCENT VAFOR 17 FUTURE APPLIANCE FEEDERS UNIT HEATERS MULTI-OUTLE1 SYSTEMS NO OF FEET DIMMERS SERVICE DISCONNECT S E R ~ I OTHER APPARATUS. Elec. room i~atera 4~GFCI 1-~ 1-4.~ H~WAL AWG OF CC COND NO OF HI4EG C E AWG OF HI LEG NO OF ~EUTRALS AWG OF NEUTRAL X/O i~75 Y~!;s Ave. Soutt~ld,N.Y~ 11971 11 FOR FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This apphcation 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 !ines, 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 ~nstallation from Board of Fire Underwriters. ,' 4. Commercial buildings, Industrial buildings, Multiple Res de~nces 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing ail property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, oecupancy 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 ~and use 3. Copy of certificate of occupancy $1.00 $5.00 Date ........................ New Building .... ..V/. ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .~'.~/.- ......... : ........................................ House No, Street Hamlet Owner or Owners of Property ~.~9.~, p.n...C.O~..~..rT. .... .~.,.. ,~. l.~.~..~.= .~.%~../3 . .['.~. ~. ¢).:~ ~ ~ County Tax Map No. 1000 Section ...~.~.~. ....... Block ..... ~ ........ Lot,,, ]~, .-~, ~ ~ .... Subdivision.. ,~.o~ .~ y~¢.~.o.-.~....~.C~,C .~ ....... Filed Map No...,~ ~, .~..~...Lot No...~ .~ ?...~..~.. Health Dept. Approval ,.. ~ .'.~3.. :...,~, .. ,Labor Dept. Approval ........................ Underwriters Approval . .~, ~ ~ (,).J. ~..~. ........ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $...~ · P.O. ..................... Construction on above described building and permit meets all applicable codes and regulations. Applicant ....................... Rev. lO-10-7a FORM NO, 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Yo ORDER TO REMEDY VIOLATION (owner or authorized agent of owner) ../...f:..Z~7......~..~..~s.Z')~.a, ....... .~..er...~. o z~ - ,o . y . (eddress of/owner o/outhorized agent of owner) PLEASE TAKE NOTICE there exists o violation of: Zoning Ordinance ....... . ,~7~.. ..................... Other Applicable Laws, Ordinances'or Regulations ............................................ at.premises hereinafter described in that -~..o.r~-,o/~,E[ ~r'7--~'~- ¢':,-~/~,~ (state character of violation) ~..~:.~.....~.~.....~.~.~./.:~.~:...e.~.~.....~.~.~.~.~..~...~...~ c~.~:~..~7 ...... ~~../.~ ............ .~.~...~./~....~..o.../.~..& .................................. ,D-..~...r. czc,..'z.¢...~/.....~ in violation of ...... ............. ,,-~,. ,~,,~...~,,~,,~, .~'./,..?~,. ........................... (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 ...................................................... , 19 ........ The premises to which this ORDER TO REMEDY VIOLATION refers ore situated at :l/.~:/~e'..~.~.-~...&:..~.~..eZ..~.~.~.~...Coun,y'' of suffo,~. New ¥or~. 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. d .d. · FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved .~..'.~..~ ......... 1~.7. me~mit No. ZO.~ ~ Application No...~..~.dO ....... Disapproved a/c ............ '.- ........... .22',f ........ '/ , APPLICATION FOR BUILDING PERMIT Date ~.~e¥..% ......... 19!~. ~ 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 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 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 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. ('Ivlaiting a-~dress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ~.v~..~.<. ...... G e. ,~.~ .~ .L...Q.~,-.,..~:<o~.~..~ .~ ....................................... Name of owner of premises 5'..~..~...~hx....Q....VxC~..~. ....... ~.t~..7~,/d~..~..~..~ ..... ~..~.~x~l(..~ ........... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer2 Builder's License No .................. ~.. Plumber's License No.../..d~....~.~:.. Electrician's License No. Other Trade's License No ...................... ::~ ~qZS- 1. Location of land on which proposed work will be done.., y.~ ~.~..~-~.(~...~.....~..~ ..................... :~..o~.. itt..~..~.. ..................................................................... House Number Street Hamlet County Tax Map No. 1000 Section . . ~.~.',~..~. ....... Block ..... ~ ........... Lot. ~.~..~t.~. j. ~. ........ Subdivision.. ~. ?.~ ~;~[ ~' /~' Filed Map No. 5'~ / b> ~.... Lot ~'q. W I~ g? 'Y' .......... (iq'a~) ....................................... 2. State existing use and occupancy of premises and igllanded use and occupancy of proposed construction: a. Existing use and occupancy ... ~ ...... .t~...~d~.....~,~dd~ ...................... b. Intended use and occupancy .................................................................... 3. Nature of work(check which applicable): New Building ..... Addition .......... Alteration Remoyat .............. Demolition .............. Other Work ............... Repair .............. ,' ~p(~) ~ (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 ................ . If garage, number of cars ..... i ' · '~ ..................................................... 6. If business, commercial or mixecI occupancy, specify nature and ~xtent of each ty, p,e of use ..................... 7. Dimensions of existing structure~, if any: Front .... '7 {.) .... Rear '7 ~,. Depth . . ..~. ~.. ...... Height ................ Number of Stories ..... / .................................................. Dimensions of same structure with alterations or additions: Front ................. Rear .. ................. Depth ' Height Number of Stories 8. DimenSions of entire new construcfion: Front ..... .~f--). ......Rear ...... .~...~ ..... Depth .... .~. ~. ...... Height ............... Number of Stories ........ ·/. } ............................................. 9. Size oflot: Front ....................... Rear ...................... Depth ...................... 10. Date of Purchase ........... i .................. 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 ...~..-~i ................... Will excess fill be removed from premises: Q'e~J No 14. Name of Owner of premises ... i ................. Address ................... Phone No ......... -- ....... Name of Architect .......... . ................. Address ................... Phone No ................ 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 property lines. Give street and block: mmber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF..S"..~../.,,ff.~ .~-,..c- ..... ......... ~.'~..~.'~t....Z~...~."7 ............... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the..~. P..'~..--~..~..~..~/..'~... ................................................................... (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;lthat all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manne? set forth in the application filed therewith. Sworn to before me this OTARY PO L a f ................ No, 52 ~ 4658322 . Suffolk County (Signature of applicant) reml Expires March SO,