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Home My WebLink About49-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. .....$................ Date .......................Rt Bust.....22..2v........1911j�... THIS CERTIFIES that the building located at W/.S..Nr..04zkwood...Road..................... Street Mop No. ..Laurel..Park....... Block No. .....oat*Xt*0A............... 11MON0. La 1ji.....I+WYIW..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................................•..Uly.......1319.57.... pursuant to which Building Permit No ....Z..�..............I dated .............................U2,V.....15..........1957..., was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ............ ...................................PrIvate...dwellin*....._................................................................................ This certificate is issued to .....Edvar&Y tzpatrl.ck•••.••(...omner••• ........................••••••............ (owner, lessee or tenant) of the aforesaid building. /W6MJC e G... Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. ...Z.. ........... Date ............................... Permission is hereby granted to: 3tan1eg..gePk&-- ►{tt.....FAyrs..Fltrr'"rlek........ ..80%ad..AVe r...................................................... ......Tbattitucky.....NIX,................................... to ...ElU1.1d...ark--6AF11•don.•to••eadet4.ng...drre3firsE............................................................. ...................................................................................,............................................................................. at premises located at ... /g.. iflT`�iR 4A�CwOO$ ROaQ.................................................................... ..............................................Laurel .....N.*YW.................................................................................. ................................................................................ ................................................................................ pursuant to application dated .............................July-..1..51...............1957.... and approved by the Building Inspector. Fee $..5.00.....paid ................................................................. ............ Building Inspector FORH NO. 1 TOWN OF $OUTHOLD BUILDING D£PARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined. ,/ ~ 19~ ' ' ~/ 1" " '" ~/- No.....~........~...Z ......... ,~pprovea ........................................ / '/ ........ Perm it Disapproved a/c ....... . ' .......... ......... ........... .......... (Building Inspector) '""f' Application No...~....~..' .~'.. ........ APPLICATION FOR BUILDING PERMIT Date .............. ./. ~. .................. 19...'~.i~ .... 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. Up,on 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 gurpose whatever until a Certificate of Occuponcy 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. Zheapplicantagreestocomplywithollopplicablelaws, ordinancesandregulat(~~~o 1'~ ~~.~. (A dress of applicant) (I State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. ........................... .......................... ................................................................................................. Name of owner of premises...,..~'~~.,.~...~..~~"--'"'] .................................................................... If applicant is a corporate, signature of duly~ [ ]~aut~drized oLN~cer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No ................................... Block .................................. Street and Number ...~".~..~/~'k,~...~.,~.'<'~...'~....,~~ ....................................... 2. State existing use and occupancy of premieses and Jntend~J use and occupancy of proposed construction: a. Existing use and occupancy.~~~ .......................... b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition ................... )¢,lteration .................... Removal Demolition Other Work, (Describe)(~~ Repair ............................................................ 4. Estimated Cost ............................................................ Fee ~.j..O..?. .............................................................................. Y /-) (to be paid on filing this application) FEES: 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......~.~.....O.. ............ Rear ....~...O.. .............. Depth ...~.....~... ................ Height .../.~-~'- ' ...... Number of Stories ..../.~'--~" .................................................................................. Dimensions/of same' structure with alterations or~addition~ Front ....~......~.. ................. Rear ~...~.'. ..................... Depth ..~%,~..~....I ............... Height Z~..~ ...... Number of Stories ....~ ............ 8. ~ ~ '' ~'''' Rear Dimensions of entire new construction: Front ........................................................ Depth ....¢~.. .................... Heightd~....~.. Number of Stories ....~.....~ / 9. Size of lot: Front ...... ~..~. ............... Rear ..... ZI~. ......... ,...._Depth . .~..~....~.....O.. ........... /¢l ~'~ '~ 10. Zone or use district in which premises are situated....~....~~ ............ ..~...~.~'..~..i ...... 11. Does proposed construction violate any zoning law, ordinance or regulation? ........... /~,::..q). ................................ 12. Name of Owner of premises~.~.....'.~.~...Address ............................................ Phone NO ..................... i Name of Arch tect........./.,..........,..... ........ z ................. Address .....,~ .................................... Phone NO................--- Name of Contractor~..~...'~Address:~..0L,~.,./..~one-- "~ ' NO PLOT DIAGRAM Locate clearly and distinctly oll 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' COUNTY OF ........................... ) 2 ' I, . ....... ~'~~~i~n~': ............ being duly sworn, deposes and soys that he is the applicant above named. He is thee .........~ ...................................................................................................................... (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 before me this ,,- ...... ~...?.....~.~... .... da~~ · ','~.' :': ' ':: ~'L~'~ '~'~''''~.,,)~,_~ ~ ~,~,~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N^ Y^ Exo,nineJ..... ........lq;F��.7 . Application No.. ,... °��/ �� /\pproved.........,.^........—....l9�.....Pern"it ��n��°��.��........ Disapproved a/c .... ^/~, '^^, /^~~ ~+,^' —........~.....~........'~^..^........,..—....~^.��~—^', ^^^^r^—`'—~~^—~^^^^^^^^^^^^^^`^`^^^�^^^..—^. (Building Inspector) ' APPLICATION FOR BUILDING PERMIT ��l /� _— Dote...—' —.~��--.....l9��.'(,. v |kSJ�lU[T|<]NS n. This application must be completely filled in by typewriter or in ink and submitted induplicate tn 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 tnthe applicant. Such permit shall 6okept onthe premises available for inspection throughout the progress ofthe work. e. Nobuilding shall 6eoccupied orused inwhole orinpart for any purpose whatever until oCertificate ofOccupancy shall have been granted 6ythe Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of Building Permit pursuant |othe 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 tocomply with all applicable laws, ordinances and regy � ,`,'.,,, (Scorporation) , (Address nfapplicant) Y /� State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electricon, plumber or builder. .................................. ......... . ^.........~....~—..^.....—...~.,. Name nfowner uf premises.... .......—....—.,..~.`,,,_,^~^,_,,, ter. |f applicantis o corporate, signatureof duly ��r�� ~~^--^~~^'—`^—`~--^^~^^^^^`^^~^~^`^^^^^~~ (Non�eon61h|eofcorpnroieoff�*� l. Location o[ land onwhich proposed work will bedone. Map No. .................................. B|ock ...^~,..~^^~_,, Street and Number ...o _.,,_,,_,~^,_,,,_^,,,,,^^,,.. 2. State existing use ou4 occupancy of premieses and intended use and occupancy of proposed construction: o. Existing use and occupancy. ............................................. b. Intended use and occupancy................................................................................................................................ 3. Nature of work (check which applicable): New Building ....................Addition .....1.:.•.c. ..p.....;Alltteration...............I..... Repair ....................Removal ....................Demolition ....................Other Work (Describe)�. a . Muuoq��0.0*��{a1tAu a o (J 4. Estimated Cost .............................:..............................Fee ............................................................................. (to be paid on filing this application) / FEES: 5. If dwelling, number of dwelling units..........!................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 ........�. V........... Depth ..... .............. ,._, Height ..�`'�...... ... .Number of Stories ..........1. :............... ......................................... Dimensions of sam structure with alterations or additions: Frorft ......... ...fa.............. Rear ......n;?..A................ Depth ....�...(w................ Height .....d7t,�"-.^.......Number of Stories ................................ r i 8. Dimensions of entire new construction: Front.........�.'............... Rear ........ A'"Z . �.......... Depth ......... ............... Height . .. . . . .. Number of Stories ..... . ............. 9. Size of lot: Front ......fir. ............. Rear .....s� ............. Depth :2 '.. °, ' ..... 10. Zone or use district in which premises are situated......k.c.::f 4 Q.... !. 11. Does proposed construction violate any zoning low, ordinance or regulation?........•�. "—........................... 12. Name of Owner of premises ..7 Address ............................................Phone Name of Architect......... ................... ��.. ..... Address ...... ............... ...................Phone NO. ...................... Nome of Contractor Address ::. :+..;/4..l!�:........Phone NO. J....`.C.`?'' 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. cot 7 i R STATE OF NEW YORK, ) SS.. COUNTY OF ..... ................ r.... . . ........... .. .............being duly sworn, deposes and says that he is the applicant (Name of in vi al signs 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 before me this ........�0... day of .... .... ........ .............. 191 N ngatu e f appli ) Notary Public................... .......U........... . County ALUM x Nat" PON k of New Yd! #62-986 00 BaRem (yam