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Home My WebLink About22-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. .....Z.2........... Date ........................... uly..3�. .a...........19-57. THIS CERTIFIES that the building located atEfB..Parsd1Be..point..road*......... Street Map No. ......NA...................... Block No. ..........i!##.................... Lot No. .............:k#l1............... conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................julinR..8........1957..., pursuant to which Building Permit No ......Z...2' ............. dated .............................J..Me.....8.*........19.5�. ..... 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 ............ ...........................pri!st,a..d31r9].1 ing.............................................................................................. This certificate is issued to ....2billipt-BabCCI.$..........C..Mme !)............................................... (owner, lessee or tenant)- of the aforesaid building. t�>..L....... ....... ...... ................... Building Inspector.... FORM NO. 2 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: ........ ~.~,h ¢.&~4e. ........................ ; ............................. to ...l~l¢,....~........~.~.t.~.t.~.~...~..~.e.~..~e.~.z.~..~ ........................................................................... at premises located at ..... .]~4~,&~.¢l~l~..~tCt~l, .................................................................................. pursuant to application dated ...................................... .~3..~...e....8.¢. ............ 19..~.?..., and approved by the Building Inspector. Fee $.5~.0¢ ........ ~,~ ea~ FOI~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~/ " '9~ '? No,....~:~' ..~~ F....'"'- App rove d .................................... u .... 19....~..C. Perm i t Disapproved a/c -~--~ .......... - ................... ."7'''ct: .......... ~L~'''~'~ ......... i' L';-: ::-'-" .................... (Building Inspector) Application No ........................... APPLICATION FOR BUILDING PERMIT Date .~....~ ..¢.~,... 19~.~.,~...' 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 o 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 until o 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 oll applicable laws, ordinances and regulations. (Signature of applicant, or name, if o corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. ............... ...................................................................................................... Nome of owner of premises ................................................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1, Location of land on which proposed work will be done, Mop No ................................... Block .................................. State existing use and occupancy of premieses and intended use and occupancy of proposed construction: a. Bxisting use end occuponcy ........................ ........ ~ ...... ~ ............................. b. Intended use end occupancy .......... ................. ' ............ : ................................ f Aitera~io ~ 3. Nature of work (check which a[~plicable): New Building .................... Addition .................... n .................... Repair .................... Removal ..,, ................ Demolition .................... Other Work (D~cribe) .................... 4 Est mated Cost ........... ~.....'~...~...: Fee ..~..;..~... ........................................................ (to be paid on filing this application) If dwelling, number of dwelling units .......... .~. ............... Number of dwelling units on each floor ............................ 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 ..... .,~..~.~..f. ............. Depth Dimensions of same structure with alterations or additions: Front ............ ..~...~.. ............ Rear ....... ~.:.~.~....~ ............. Depth ........... .~ff'~ .............. Height .............................. Number of Stories ....... ./f. ...................... / 8. Dimensions of entire new construction: Front .......... Z'.~ ............. Rear ........ /.~.../. .......... Depth ......~.X(..z. ............ Height .......... .~.. .............. Number of Stories ........../. ................. 9. S ze of lot: Front ........ /..f.L) .............. Rear ........... ~.¢: ...... Depth .....~...C~.....:..-~....4.'...: 10. Zone or use distr ct in wh ch prem ses are s tuated ~" ~. 11. Does proposed constructiot~ violate any zoning law, ordinance or regulation? ..................... ~.."k'~ .......................... 12. Name of Owner of premises.~.~~.. Address ..,~./.~.~.,~.c~.~...Phone NO.~/2.~..~....~...P..~ Name of Architect......7~......~~,~.... Address .................................... i"'"Ph°ne NO ..................... Name of Contractor...L,f'izcZ~..~...~i:~'-,c~,-,~,~ZF~C ...... Address .~~, .~.r.~..~.,.~...Phone 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 numbers or description according to deed, and show street names and indicate whether interior or corner lot. ~¢~-__~ STATE OF NEW YORK, -~ _ SS.' ~y ...... COUNTY OF ............................ .. ~ ..................................... bemo duly swom~ deposos ond soys thor he is the ~ppHcont (~ome of individuol siOnin~ ~pplicotion) obove named. He is the ........................................... ~~ ............................................................... (ControctoG ~ont, corporote officer, etc.) o~ said ownor or owners, ond is duly outhorized to ~erform or hovo performed the soid work ond to moke ond file this opplicotion~ thor oll stotements contoined in this ~pplic~tion ~re true to the best o{ h~s knowledge and ond thor the work will be performed in the m~nner set forth in the oppHcofion fi[od therewffh. Sworn to.b~efore me this ...... ...... ................. Notary Public,.. .~ ....... County (Singature of applicant) RAYMOND E. TUrH~LL Notary Public in the b~a~e of N*W York Residing in Suffolk County SUffolK Co. Clerk's No. 5'29402000 C~mrnission Expires March 30, 195~ 3. Nature of work (check which applicable): New Building ....................Addition .........Alteration.... .............. Repair ....................Removal .. ................Demolition ....................Other Work (Describe).................... 4. Estimated Cost ...........a2.✓`.W,o-d............................Fee ........................ .° ......................................................... (to be paid on filing this application) FEES: 4%__� 01 5. If dwelling, number of dwelling units..........Z...............Number of dwelling units on each floor............................ Ifgarage, 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 .....4./!.'................. Depth .....�................. Height ..........?...............Number of Stories ............... ............................................................................................. / i Dimensions of some structure with alterations or additions: Front ............f/�............ Rear .......,3.6................. Depth ..........!le.............. Height .............1n................Number of Stories ......./...................... S. Dimensions of entire new construction: Front........../.a -1.......... Rear ......../..02./........... Depth ......a l.............. Height ..........14..1............ Number of Stories ........!�................. fi I �•/el /i 9. Size of lot: Front ........r..qt.............. Rear .........../...E............ Depth ....,�. ........ . R �. 10. Zone or use district in which premises are situated............. .. ....... .................................... 11. Does proposed construction /violate any zoning law, ordinance or regulation?. .................... .......................... 12. Name of Owner of premises.il� ..Address ..�.�d. falpl..Phone NO. AA1.2290 Name of Architect......./.�......�r/JPjr.� Address ...... ......... ....................)......Phone NO. .................... Name of Contractor...AALccltsi.L .� ....Address .�� `�� Ai.Z�.PhoneNO./�::�t/-1a 5.0..7 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 numbers or description according to deed, and show street names and indicate whether interior or corner lot. T� /S - Al y a ti x AIOTf — C 0 EATS i WC, - DLUe C PRO AOS EO-fiED It SNORE LfNL STATE OF NEW YORK, ) SS.. '�A Y COUNTY OF /............................) ....&OA....... ........ ....................................being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the........... ................................(� .....................................................I...................... ...... (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 contained in this application are 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 bgfore me this ....r......... day of ..L%( ��................. 19.. ... ( / 't� //( (Singature of applicant) Notary Public...... . .......County RAYMOND E. TUTHILL Notary Public in the State of New York ' Residing in Suffolk County SuttolH Co. Clerk's No.5.29402000 Commission Expires March 30, 1958