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Home My WebLink About44-zFORM[ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CL~RK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPAHCY No ........ ~_,...~.~ ....... Date .................. 0etobe~'"' '~' '~' ............. 19. THIS CERTIFIES that the building located at ...POq~tas.~l.-Ave.&..~lwoo~..l~d~... Street Map No ................... '~X~' .......... Block No ........ ~ ................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......................... ~.~1~.~.....~.0 ........... 19.~.~,..., pursuant to which Building Permit No ..... ~...11~' ............. , dated .................. ,]~U~ ......... .~. .............. 19..~.~..., 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. RI'VATE..DWE~,L.I. NG .................................................................................... This certificate is issued to '~//l~]:'i~"]B~S;~l~e~"7""('O~D.~")"[~ ................................................. Lowner, ~essee or tenant) of the aforesaid building. Building Inspector FOl~l~l NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLFRK'S OFFICE SOUTHOLD, N. Y. BUILDIh~G 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: pursuant to application dated .............................. ~],~...]~ ....... 19.~..., and approved by the Building Inspector. Fee FORM NO. I A g' '' P ...... pprove ........................................ 1 9....4... ermit Disapproved a/c ............... ,,<i74' ................. ,,.x. ............... .~.M ............. .r:x ........... --- (Building Inspector) Application N o..~...~/...¢~.. ......... APPLICATION FOR BUILDING PERMIT £ c£ Dote ........ ~.~,M.. 10~b.,..;I,.9..E..~: .............. 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building , Ir~spector. , · k b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets ~r areas, and giving o detailed description of,layout of property must be drawn qn 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 Bui'lding 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 dntil 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 P~rmit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as here~p described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or nome, if a corporation) s/s~ Stmrtse Highway - 500' w/o. Lincoln Avenue, S~.M~..flle . New York° Sayv~lle 4~ $332 (Address of app{ic~nt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electricon, plumber or builder. ................ q~neral..~m~rao~e~ ............................................................................................................................................ Name of owner of premises...j~.:L~`~..~.*.J~R~.e..~.~r..?..~.~.~..~.~.[...i..~.g~...~.9~..~.~..~&.~.~`t .............................. If applicant is a corporate, signature of duly author~zed,~,fi~er. ~ e o~ ~ o ..........'"'"'""'(N;'~e"" ...... and' ........... title of' .............. cor~,;,-/.~-~}~icer)l~/~ ~1~~-''~'0''''*~''*'* ....... ~ ,.* r t , · rr 0 "~A ' C Roy S. Mac Donald - Zreas. Location of land on which proposed work will be done. Map No ................................... Block .................................. State existing use and occupancy of premieses and intended use and occupancy oF proposed construction: a. Existing use and occupancy undeveloped lez~l b. Intended use and occupancy oma £e~til~.. dwellt,.n~ ~bo be occur, led b~. owner 3. Nature of work (check which applicable): New Building x · . .................... Add t;0n ' ", .................... Alt r0t 0n ................. Repair .................... Removal .................... Demollt~ort .................... Other Work (Describe) .................... 4. Estimated Cost ....~;1,~,.8.5.0,.0f) .................................... Fee ../...~. ...................................... (to be paid on filing this application) FEES: 5. If dwelling, number of dwelling units ......... .o..~..~ ............. Number of dwelling units on each o~e floor ............................ If garage, number of cars ....... ¢~1~...-...~,.~t~1~1~ ..................................................................................................... 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 ....... .§.8.-.fi ............. Rear ....,5.8...6 ................ Depth ...~i....aA..6..~.~ ........ Height ....~,~ .................... Number of Stories ..... .X. ..................... ' I , , r .... O(k.T,,~ ................ Depth / ,~ ~'~ 9. Size of lot: F~ont ............ /~...0:?...0. ....... Rear ............................ I0. Zone or use district in which premises are stuated ................................................................................. 1 1. Does proposed construction violate any zoning Iow, ordinance or regulation? ............. /.~...~ .............................. 12. Nome of Owner of premises.~;l,J.~k:km.~.,...l~.o.~.O/~..Address .~...~...K.~..~;~..~.o..u...~...':..~......B.~b.~hone NO...~.0.:...~.......O.~$g Name of Architect ...................................................... Address ............................................ Phone NO ..................... Name of Controctor.....J>.O.I1..$.'hl~,~l'.~...~l~.~ .............. Address .B..o.~.....~,.-.~g.~...t..~.l..~ ............ Phone NO.~.gt.:..'...~....~.S..S..g. 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, ) COUNTY OF ........ :...:.....f......~,..) S,S.' ~. ¢ Ro~ M'~O Do~r~Id t,o~,,,~ ..................................................................................................... ~ duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the......~¢~.~.eX'...~¢..D.gA.~.~A.&.~..~ .]:.A9.,.~...9.9.~,~.~,9~.o.~ ................................................................. (Contractor, agent, corporate officer~ etc.) o of said owner or owners, and is duly authorized to perform or have peYformed ~he-said work ahd to make and file this application; that all statements contained in this application ore 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 _~e this ..... /, ............ 19~..'.....,'~.,. ........................ day o '~~f'~"'/~~~_.~.~.~-. ~,~--~- , .,, . ,~ 7-' '~'z ~z' ~ > F ' (Singature of applicant) Notary Public,. ............... ~ ,...... ~.~./~.'~.~/.....k~.... ·..(~ou nt y FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19 ........ Permit Disapproved a/c ............. ~..u..'J ............................. :: ........... y,., ....... .; ................ ............... ........... ............... __ (Building Inspector) Application N o.~.~Jf/ ........... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled Jn by typewriter or in ink and submitted in duplicate to the Building inspector. b. Plot plan showJn'g 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. Th~ work covered by this application may not be commenced b~fore 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. h~o building shah be occupied or used Jn 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 and regulations. (Signature of op~alicant, or name, f o corporat on) e/a. ~une/.~e l~ir, hw~r - ~00' w/o. L~ncoln Avenue, ., ..s.~r~.~...-... ~..~.o. ~.: ............ ~.~!.z.~..~..~!~ ........ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer~ general contractor, electrican, plumber or builder. ................. ~ene~,aJ...eoa/;r~ ........................................ i ................................................................................................. Name of owner of premises..~..W~z~ir~.F`..~es~rm~..~...~.~`i~P4~j~..g.~.W~L.?...~..~..~t~? ............................. If applicant is a corporate, signature of duly authorized office~...~, DON S~A~, Zne. ~ ~ ~ ~J [ J ~ ......................................................... (Name and title of corporate~officer) ~ R~ S. ~o ~o~d - Tre~. Ir. Location of land on which proposed work will be done. Map No ................................... Block .................................. Street and Number ~, oor~eF Pe2~ash (Flee~le ~eek) ~ad ~ Mi~ood ~ad, Ou~oho~ State existing use and occupancy of premieses and intended use and occupancy of proposed construction: a. Existing use and occupancy ~ertte],o~e~ "1~ b. Intended use and occupancy.......o.~f~ ~.~..;J.~,~. ~t!/e].]....~. ~'o bo oocu~ie~ l~t OW'~.~ 3. Nature of work (check which applicable): New Building ........ ~ ......... Addition .................... Alteration.,.,,...,.,,,, Repair .................... Removal .................... Demolition .................... Other Work ~Descrlbe) .................... / Fe 4. Estimated Cost ....~1,1.~-~8~e00 ...... ; ............................. e .......................................................................................... (to be paid on filing this application) FEES: 5. If dwelling, number of dwelling units ......... ~1~ ............. Number of dwelling units on each floor ....... ~. .............. If garage, number of cars ...... ~l~.,.&'l~l~l~, ..................................................................................................... 6. If business, commerical or mixed occupancy, specify nature and extent of each type of use...~,,~ ....................... 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 ....~8.,1~ ................ Depth .~2...~l~,~..'l& ........ Height ..,~J~. .................... Number of Stories ..... ~ ..................... 9. Size of lot: Front ...*...../..~ ..........Rear ~.-.~'. ........... Depth..~...'.~.....~.~.. ............ 10. Zone or use district in which premises are s~tuated .............. ./..:....~)...: ................................................................ ] 1. Does proposed construction violote ony zoning law, ordinonce or re ulotion? ......................................... 12. Name of Owner of premises.W~lliJ~.~.,,..B~ll~l~...Address~&.~[~Lll~lL.~l~t~,~.,~.]~,~l~one NO. Name of Architect ...................................................... Address ................ '.,¢ ...................... :...Phone NO ..................... Name of Contractor.....~D~.8~u~,~..[l~, ............... Address~..~l~.~l,e ............ Phone NO~,m.~...J~ 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, ) COUNTY OF ........ ~...~ ............... ) .......... .~.~...~...~.~..~. ......................................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the....~l~eaJll~ltl~el'..~.,,~)eT~.J[~,l~ie.l'~..$.lte.~..~.¢l~l~.~ ................................................................... (Contractor, agent, corporate officer, etc,) of said owner or owners, and is duly authorized to perform or have performed the said work dnd to make and file this application; that all statements contained in this application ore true to the best of his knowledge and beli~; and that the work wil.I be performed in the manner set fo~th in the application flied therewith. ~' Sworn to befo~ this~~ . ~t~J~k~ ,J , J / ............ .... ................... , .... / (Singature of applicant) Notary Publ,~~.. ~.~Z~..Cou ~