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Home My WebLink About10617-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. $.~.1.R~9 .......... Date ....... 0~ .b.o.l~q ~,. ?.~ .............. 19 .~ THIS CERTIFIES that the building ................................................ Location of Property . .~'0fl. .............. ~.r~..g.o~.d. ............... .lqAb. ~.~.qq.k ..... House No. Street Hamlet County Tax Map No. 1000 Section . .1.2.2. ....... Block . .0.7. ........... Lot..0.0.~ ~ .0.0.~ ....... Subdivision...~. ........................... Filed Map No. ~( ....... Lot No... ~( .......... conforms substantially to the Application for Building Permit heretofore fi]ed in th~ office dated ·...~P?.~,Z..~ .......... ,19 ~.0. pursuant to which Building Permit No..1. Q~.1.?..~ ............ dated ... ~. P r.J~,. 3 ................. 19 ~ ~)., was issued, and conforms to all of the requiremonts of the applicab]a provisions of the ]aw. The occupancy for which this certificate is issued is ......... ....~. ?.o.o..~..t.a.c..~.~.e..~..~.~.~..p..or.~.~.c..o.. ............................................. T~e certificate is issued to ........... ~'re~k. ~r.l~b¥ .................................. (owner, ,~m*e,e~ of the aforesaid building. Suffolk County Department of Health Approval .... n / a ................................... UNDERWRITERS CERTIFICATE NO ............ n/. a ................................... ·. ....... Rw.l~l FOlh~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERtv~IT (THIS PERMIT MUST BE KEPT ON THE PP. EMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N? ~0617 Z Permission is hereby granted to: ...... ~.4~..c.:i~.....~.~ ~./....~. .......... ..~..o. ........ ~.~,~.~. ....... ~ ..................... ...~,~ c ~.=..~..~.: .......... _. ~o ...~~.~.c.~....~~~....~~...o~...~z~ ~~., ....... ~~ ....... ~.~.z~ ....................................................... f Ct premises ,ocoted o~~ ....... ~~....~~.."~~"~ ~, Building Inspector. .ee*.~..~ ..... ~t - · I~uilding inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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 lines, streets, and unusual natural or topographic features. 2. Finat 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 o'r Enqineer responsible for the building. 5.Submit Planning Board approval of completed site plan requiremer~ts where applicable. B. For existing buildings (prior to April 1957), Non-conform ng uses, or buildings and "pre-existing" land uses: 1, Accurate survey of peoperty 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 braidings or prem/ises, 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../ , .. New Building ............. Old or Pre-ex st ng Bu ding(X) /Vacant Land House No. ' ...................... ~ Street Ham/et / County Tax Ma No 1000Se /~-~'~'~"' ' P · ctlon .............. Block...~. '7 ...... Lot .d~..(~.l~ ....'~.. .... Subd~vlsron .......... -~' · -- ~ Filed Map .................... No. .Lot No ............. Perm't N°-/~-(~. ~.' ~...~. Date of Permit ~ .'/~.~./~)..App licant .~.. ¢~. ,~,~.~'..//~. ~. ~,~.//~ ~. ....... Health Dept. Approval ... '~ .Labor Dept. Approval ... ' .......... ,,. Underwriters Approval Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ...../~...- ......... Fee Submitted $ Construction bu ild,ng an~tS~~es and regu lations. on above described Rev, 10-10-78 FOU~DATION ( ~ _s ~)~ FOUNDATION 2. ROUGH~RAME & PLUMBING INSULATION PER N.Y. STATE ENERGY CODE FINAL ~' ~ ~ ADDITIONAL FO~M NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL FiFe No ................................................................. Date ...... .~,../.4.~....~.. ......................... , 19....~..Q To .h.".~,~.~.cr.~..... ~~ ~ ............... ,. ............... ...~.~.~-=..~..:~ ........ /.~/~~ ~:~ ,~,v e ~op I~.X...L.~.~. ..... Block ........ .~. ......................Lot ........ ~.~.:.~ .................. is r~ disapproved on the follow, ng grounds ~..~.~.~....f%z~L.q.~.~ ~6Z.(z ~. ~.... ~:~.~ ~z~.... ~z~.~x~....~a~a ~ ~....~.~... ~ ~/~..../~ ~.....~.~....~.... ~..~K~.... I~ ....... ~. ~......~... ............ ~~ .......... FOBM NO, ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTfiOLD, N. Y. ORDER TO REMEDY VIOLATION 19..~'.C)' Date... ~. :,/. ,C~ .ca..f. 4.-.~¢, ./. ........ .?,. .................. (owner or authorized agent of ~wner) · ~address o{ owner or auirhorixed agent of owner) PLEA$£ TAle, Ii NOTICe: there exists o violation' of: Zoning Ordinance Other Applicable Laws, Ordinances'or Regu ations at premises hereinafter described in that .,..,....,~,~,.:, ....................................... , ....................... .~,. ..... (state character of violation) in violation of~-...~C~.....~ ........................................................................................................ (State section or paragraph of apphcabte law, ordinance or regulation) /' YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy thc conditions above mentioned forthwith on or before the .... ~?.~.~.(,..,.~Z~2~,~.....J~?~(~&..C~ ............ The premises to which this ORDER TO REMEDY VIOLATION refers are situated at ........ .......... y of uffol , Yor . ~')'(~' " ~ ,~,~/~4,(~ ~'~"~ . Count 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. / FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180~ Examined~...tr~//-.....ff..., 19.~.~. Approved~.../~. f.~.-~., f .... 1 .~.. Permit No../..~.~. r. :.~..~2_ Disapproved a/c ....... -7-7 '~' '~ ......... ~ ........ /~ (Building Inspector) Application No../.q.6. !.'7 ........ APPLICATION FOR BUILDING PERMIT Date ..... . ,~.~..~.~ ....... , 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 apphcation 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 inspecL~ms~. ~'-)~ · ../~..~ ~'2 ~.: ....... . ....~. · .: ...... ~a~u ~o~ ~p~ll~tr; or name, if a co poratlon) f...o... ?.o.x..s?.: ........... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. OWNER Francis J MurRhy Name of owner of premises (as on the tax roll or latest deed) If applicant is a corporation, signature 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 .................... 1. Location of land on which proposed work will be done· .East .inte~:~e~ticm .of .the .01d Main ·Road .......... and Route 25, Laurel, N.Y. House Number ~ 7c~--~ Street Hamlet County Tax Map No. t 000 Section . .lag .7..6...a ....... Block 5L36.41 ............ Lot ................... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction' a. Existing use and occupancy . .R.e.t.a,i.L .S.t. qre..-...P~s,~Q~, .S. hrwb~, .S. tlDD15,e.~, .Etc. ........................ b. Intended use and occupancy .I]etail .atqre .-..P. lan,s ~ .V. egetall!s~, .F.l:~.l£t ~ .Etiq...'' '~' '__.....~.o.~.'.; .~ .... 3. Nature of work (check which appliCable): New Building .......... Addition .......... Alteration . .X ........ Repair .............. Removal .............. Demolition .............. Other Work ............... ~-/Z (Description) 4. Estimated Cost .... $5,009,00 ......................... Fee . ~ ........................... , (to be paid on filing this application) 5. If dwelling, number of dwellingiunits ............... Number of dwelling units on each floor ................ If garage, number of cars .... , ................................................................... 6. lfbusiness, commerciai or mixed occupancy, specify nature and extent of each type of use ..~$~- ............. 7. Dimensions of existing structures, if any: Front... {39.~ ......... Rear ...8.0~ ......... Depth . .25: ........... Height . 1£! ........... Number of Stories ... ~. .................................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... i · · Heig~ht ...................... Number of Stories ...................... 8. Dimensions of entire new constFuction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase .......... t .................. Name of Former Owner ............................. 11. Zone or use district in which pr~mises are situated.. ~.al~a~rg~40- .... '.':~...~:/. ............................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...Np ......................... 13. Will lot be regraded ..... .N.O. i ................... Will excess fill be removed from premises: Yes ~-NoJ 14. Name of Owner of premises .. ,~.a43.e .............. Address ................... Phone No ................ ~ Name of Architect ...... ,. · · i ................. Address ................... Phone No ................ Name of Contractor .... .S.e?'.~i ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctl,y ail buildings, whether existing or proposed, and, indicate all set-back dimensions from interior or Corner lot. STATE OF' NEW~ /~ S S ........ .ff. :~..n.: ....... *...t .L/Y-. ¢ .,/).#. ~. ...... being duly sworn, deposes and says that he is the applicant (Name of individual signing contraci) / above named. (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 coniained in this application are true ~o 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 No, 52.812§8§0, Sdlfolk Coune/ /~ ~ Ta*m E~p~r~s ~larr. h 30~ ~