HomeMy WebLinkAbout11-zNO, 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES that the building located at ..~/5..~.~dleV,~..~.~'~ ....................... Street
Map No ..................................... Block No ..................................... , L~*~i.~ ....G~.e~n~or.t,?...~,~',
conforms substantially to the Application for Building Permit heretofore filed in this office dated
................................ }/~/?. .. 2,1, .......... 19..~.~..., pursuant to which Building Permit No ......... ~..~3.. ......... ,
dated ........................ ~....2.~. ................. 19.~'..., was issued, and conforms to all o~F the requirements
of the applicable provisions of the [aw. The occupancy for which this certificate' is issued is ............
,/
............................................ ~ ~ .?.&~.~k. ~.~(~ .......... ..................................... i..... ..........................
This certificate is issued to ....... .~h~.~L~s..~O.~.t~ ..........(...G¥~e~.....) ............. i..~i ..............................
(owner, lessee or tenant) ~'
of the aforesaid building.
Building Inspector
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF
APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION
OF THE WORK AUTHORIZED)
Permission is hereby granted to:
..~..e..o.~.....R~..~.r.~o..~..t..o.n..flc~r~. ...............
.......... 69.... t~.t~..Cher...L~n~ ...............................
......... Ri.v. erhead.....}~:..~.. ...................................
to ...... ~Uild...n~w.. ~lwetl.i.r~ ..........................................................................................................
......................... F..qr...q.h.e. rle s..... No.vi.~ ...........................................................................................
ot premises located at ........~iddle~.....L~ne .....................................................................................
......................................... ~ ~'ee~l~O~.~.~/.....N-~:~.~ ................................................................................
pursuant to application dated ....................................... ~a-~.-...~;L ........ 19....~.~, and approved by the
Building Inspector.
Fee $...~0. o.0.0. ....... ~0~ ~1 d
Building Inspector
FORH NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
NOTICE OF DISAPPROVAL
PLEASE TAKE NOTICE that your application dated ............................
for permit to construct .......................................... at the premises located at
Map ~ Block ........................ : ................... Lot .................. ~ ................... is
Building Inspector
TOWN ElF SnUTHDLD
DFFICE DF BUILDING INSPECTOR
TOWN CLERK'S DFFICE
SOUTHOLD, N. Y.
June 13, 1957
The appeal board granted a variance to Chae ~vit to eet his huuse (permit
~Zll) ~SFt'£rom road instead o3 35 as required in ordinance
Building InspeCt or~
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
E×om~ned ........ ~....~.? ....... ~.~.~.~
Approved ........................................ 19.,.,.!..Permit No .................................
............ ./.: ........... / ......... y...,/ .......................
......... ...... ................................
(Building Inspector)
^pp,ca.o. No~../.( ...........
APPLICATION FOR BUILDING PERMIT
ate .................. ~... .......... : ........................... I S~ ............
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building
inspector. ,. ~
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 location.
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 progress of the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever untii 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 and regulations.
(Signature of applicant, or name, if a corporation)
.E.?....A~..~....L.'..~.!.~...~....(-.~.,~.....(.~.,..~.~..?..:~.~..~
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder.
Name of owner of premises ......... ..~......~....O.~..t~,~...Z-.....L.?~'. .......... '..').~...~....~'..~.'.../..~ ..................................................................
If applicant is a corporate, signature of duly authorized officer.
....... ....... ...........................
(Name anti'title of corporate' officer)
1. Location of land on which proposed work will be done. Map No ................................... Block ..................................
....................................................f r Oot,, L= 4~ o ~.~ ~. ......................................... o .'z L
Street and Number ~..~..
2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..................................................................................................................................
b. Intended use end occupancy ................. .~ ::.~..~. ...............................................................................
3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ....................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....................
4. Estimated Cost .~...~.~..~..O. ............................................ Fee.~...0...~..O....~. ..................................................
(to be paid on filing this application)
FEES:
5. If dwelling, number of dwelling units ............. l ............. Number of dwelling units on each
f Ioor...?.~..~...~.~...
if garage, number of cars ........................................................................................................................................
6. If business, commerical 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 .............................. Number of Stories ................................
8. Dimensions of entire new construction: Front.....'~ .................. Rear ~ ~ /
................................. Depth ............................
r
Height .....(..~ .................... Number of Stories ............................
9. Size of lot: Front ~Or Rear ~ O r' [ OO f
........................................................ Depth ............................
10. Zone or use district in which premises are situated ............... /~.....~....~ ...............................................
11. Does proposed construction violate ony zoning law, ordinance or regulation? ......... ~....~.. .............................
12. Name of Owner of premises ...... : ................................. Address ............................................ Phone ....................
Name of Architect.......~.....~ ................. Address ....~'....~L~...~.~..'~...~.....~....~:../.~.. ....... PhoneNO.~ .................
Name of Contractor.../..~....~..~...~..~.~..~......~.....'~.~Address ...... ~f.~..u...~..;L...~....~'...~....~.......Phone NO./~...~,?....~..~....~..~
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate ali set-back dimensions from
property lines. Give street and block numbers or description according to deed, and show street names and indicate
whether interior or corner lot.
Sworn to before me this
day of .......
(Singature of applicant)
.................. ~'~.. .~....'~......~.. ................................................ being duly sworn, deposes and says that he is the applicant
(Name of individu~ signing opplication)
(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 oil statements contained in this application are true to the best of his knowledge and belief;
and that the work will be performed Jn the manner set forth in the application filed therew.t~'h.
FORH NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
Approved ................................................ No ......... ~......f. ..........
Disapproved a/c ..............~/~ ............................................
......... ..........................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building
Inspector.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, an(~ giving a detailed d~scription of layout of property must be drawn on the diagram which is part of this location.
c. The ,~ork 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 P~rmit to the applicant. Such
permit shall 5e kept on the premises available for inspection throughout the progress of 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 6r demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances and regulations.
'
(Signature of applicant, or name, if a corporation)
........
(Address of applicant)
State whether applicant is owner, lessee, agent, architec.,t, engineer, general contracto'.r, electrican, plumber or builder.
Name of owner of prem ses "~/ ~ O ~' ! /
If applicant is a corporate, signature of duly authorized officer.
(Name and -title of fzorporate officer).
1. Location of land on which proposed work will be done. Map No ................................... Block ..................................
umber E'
Street and N ...................................................................... ..~.% .p..
2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..................................................................................................................................
b. Intended use and nccunnnrv
3. Nature of work (check which applicable): New Building ....... ~ .......Addition .................... Alteration ....................
Repair .................... Removal ........... :~ ....... Demolition .................. ..~Other Work (Describe) ....................
4. Estimated Cost ....... .~.i,...Z'~....'?....~...:....~... ........................ Fee~.~..:...O..~ ............................................................................
(to be paid on filing this application)
FEES: dJJ'~"~-Z- c'c
/
If dwelling, number of dwelling units ............................ Number of dwelling units on each floor.....!_...~Z~....¥:._',,':1.ff..~:~
If garage, number of cars ........................................................................................................................................
6. If business, commericaJ 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 .............................. Number of Stories ................................
8. Dimensions of entire new construction: Front ~S ~ ! ~ /
............................ Rear '~ ~' Depth 2--
Height / ~ ~ /
............................ Number of Stories ............................
9. Size of lot: Front ~ O ! . Rear ~ ~:~ /
....................................................... Depth! o ~:) (
10. Zone or use district in which premises are situated ........................... ~ ..........................................
11. Does proposed constructian violate any zoning law, ordinonce or regulotion? ............ ....~.......~.. ..........................
cz. L
12. Nome of Owner of premises .......................... l ............ Address ............................................ Phone NO .................
Name of Architect........~..f,...%..e.~ ............. Address ..~T:...~ ......... Phone NO.
Name of Contractor....~....~.?.~...,~qr.'..... Address., ',...~..!~...V'...~.-.?....'...~...,~..~--, ......Phone NO..~.?..?-T.}.~...¥.?
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from
property lines. Give street end black numbers ar description according to deed, and show street names and indicate
whether interior or corner lot.
STATE OF NEV~ YO~K, ,/~_ ) bO~ ~-'./DO~,/:.i~ L, A/VJ~
s s.,
COUNTY
OF.~.....)
................... ~ ......................................................... beino du¥ swom~ deposes end soys thor he is the opollc~nt
(Name of indiw~ual signing application)
obove homed. He is tho ........................ ~ ..........................................................................
(Controctor, o~ont, cor~orote officor~ otc.)
of s~id owner or owners, ~nd is duly outhorized to perform ~r have performed the sold work end to m~ke end file
this opplicotion; thor oll statements contained in this ~ppHc~tion are true to the best of his knowledge and belief~
end thor tho work will be performed in the monner sot {orth M the appHcotion filed therewith.
Sworn to before me this
. .~... ~...6.'.~.. .......... day of ..... ~].....~ ................. 1 9..~...~....
/
(Singoture of applicant)