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Home My WebLink About60-zFO,~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. GERTIFICATE OF OCCUPANCY Z 764 ~ JUly ~1 ~0 ~ No ......................... Date ........................................... THIS CERTIFIES that the building located af M&SOll Drive~ CIl~chogtl~ .................................................. ~,.\ ............... Street Map No ....................... Block No ..................... Lot No .... '\ .. , conforms substantially to the Application for Building Permit heretofore filed it~ this office dated July R5 57 ~ ~ 60 · ........ ; ..................................... 19 ........ pursuant to which Building Permit No ......................... July 25 19.~.?.., was issued, and conforms to all of the requirements slated ................................................. of the applicable provisions of the law. The occupancy for which this certificate is issued is This certificate is issued to . carl & L~ona Jantzen, ownars (owner, lessee or tenant) of :the aforesaid building. ......... ............................. 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 A~[~e,~I~E~-.i~Ti~I~ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No ........ Z.....{]0 ..... Date ........................... ~'U~'~'....- ~5 ........... 19...~.. Permission is hereby granted to: A o G. F....~La~-.. A/.~.....C e.t~l...Je.n~.z er, ..................... . z~Z.5...~.~e& m.. 8.~., .................................................. ... ~.~i ~..~ rZe. 1~ ,..... ~.,.~.~ ................................. to D.uild.....~ew...d.~,~l li~?, .............................................................................................................. at premises located at ..S/g....l~asot~..Dzti.v.e .................................................................................... ................................................ ~,~ .¢.~.q~c~.e. ~..... ~.~ ~.~ .......................................................................... pursuant to application dated ............................... J.~_-l~.-...~..~ ............. 19....~.., and approved by the Building Inspector. Fee Building Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDIING D[PARTMEHT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved - ' ' 19 Permit" ~ ~''- Disapproved a/c .................. ..<':';:~'. .............. ~:':,~ ............... >,..~:-r. .......... ~..~ ........... (Building Inspector) Application No ............................ APPLICATION FOR BUILDING PERMIT Date ........................................................ 19 ............ INSTRUCTIONS o. 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 givin9 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,an approval of this application, the Building Inspector will issue a Buildin9 P~rmit 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 a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEP, EBY MADE to the Building Deportment for the issuance of o Buildin9 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 applicantagreestocomplywithall applicable lows, ordinances o~ regulations. 2~,~ ~/(~~ ...................................................... Y* ...... 7/* ......... / .............. (Signature of applicant, or name, if~g/corporotion) ........ ,*/: (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. ........................................................................................ ' ....................................................................... Name of owner of premises ~'~ ~ ~'.."~....~, ' .~/.....~,.,"9/..~....~:...~.....~.....~' If applicant is~orporate, signature of~uly,authorized officer. ....... .............. 1. Location of land on which proposed work wiil be done. Mop No ................................... Block .................................. r ............ ...... Street and Nu/nbf ~!~;~:,r.:~,..~: .................................... 2. State e~i§tin,,g us~ anA, o~cu~ancy of p~re~%i~ses and intended use and occupancy of proposed construction' a. Existing use aAd occupancy......,~. ................................................................... b ntended use and occupancy ~)/~z~'~ ~./,x~' ./..,TZ~/,~ / ~ r~ ............ 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal ................... Demolition .................... Other Work (Describe) .................... ............................................................... 4. Estimated Cost ............................................................ Fee ./..0... ~ (to be paid on filing this application) FEES: f~'6 5. If dwelling, number of dwelling units .......... / ............... Number of dwelling units on each floor ...... Z .................. If garoge, number of (:ers ...... ,/~'...o....-~.. ..................................................................................................................... 6. If business, commerical or mixed OccupQncy~ specify noture 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 .......... : .......... T ........ Number of Stories 8. Dimensions of entire new construction: Front.....~...~.~' ................ Rear ~ ...... ~,.~,.~, .............. Depth .,~.,.8'....4-,.,.~-:.....~,. ........ Height ..~.....~....,Z....'..~....~.....-Number of Stories ..... ,(.. .................... 9. Size of lot: Front ..... ..~....~.. ............... Rear ....... .~...~.. .............. Depth ....~...~.. ,~,,,~. ............. 10. Zane or use district in which premises are situated....~. ...... ~.~ ........................................................................... 1 1. Does proposed construcdo,n violate any zoning law, ordinance or regu ar on ..................................................... 12. Name of Owner of prermses ........................................ Address ............................................ Phone NO.~..?..Z';.°..?,~.~'.,~ Name of Architect ...................................................... Address ...................................... >.....Phone NO ..................... Nome of Contractor../~.-..~'_..~.-../.~....-~..~...~..,:': .................. Address ..,'~,.?,,~,..~..~...<'~.~....~,..~.....A?.,~.,~..Phone NO..~..."~'....~..-.?..,,~.,'<'.~ 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 corne~ STATE OF NE'v~ YORK, ~, ) couNw S S., ......... ..~..6...~:.. ........ ~........~../~.../..~....~;J~......'~.....'~,,,,'~.. ....... ~ ................ be ng duly sworn, deposes and says that he is he applic, (Name of individual signing application) (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 :lie this application; that all statements contained in this application are true to the best of his knowledge and and that the work will be performed in the manner set forth in the applic,m~n filed therewith. , belief; Sworn to before me this ' ' X L ~i (~// / ,~x, ,~ ~,1, ,/~ / /~Singature of aplK[icant) FORM[ lgO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. App oved ......................~. ................. 19 ........ Permit mo ................................. Disapproved a/c (Building Inspector) Application No ~ ~C) APPLICATION FOR BUILDING PERMIT oo, ................. ............ INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing Iocotlon of lot and of buildings on premises, relationship to adjoining premises or public streets or orees, and giving o detailed description of layout of property must be drown on the diagram which is port of this location. c. The work covered by this opDlicotion may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue o Building Permit to the oppliconL 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 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, es 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, architect, engineer, general contractor, electrican, plumber or builder. ............................................................................................................................. Name of owner of premises......~...~......~'.. ............ .~. ....... ~ ~ .~.....'~....."~... .......... ·...~....~....~.../..~..~ ~C=~ ~:... .................... if applicant is o corporate, signatu[e of duly authorized officer. ..... ~>J'ame and title ~'of corporate officer) Location of land on which proposed woa'k will be done. Map No ................................... Block .................................. Street and N~mber .....~/...,~...~'.~..~.,.~.. ,....~....~.....-z. ................................................................................................ *-St-at~-e~dsHn~use.~q.~d!(~cc"upo~c.~ o~es and intended use and occupancy of proposed construction: o. Existinguse and occuponcy.....~.~(........~..., .......................................... b. Intended use and ~ , ~ ........... ~ 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... I~emolition .................... Other Work (Describe) .................... 4. Estimated Cost ..... ..cr¢...~. ................................................. Fee ../..0..: .................................................................................. (to be paid on filing this application) 5. 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 ...... ~.O.. ............... 7. Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth ............................ Height ................ ..~..~ ....... Number of Stories ........ -m. ..................................................................................................... Dimensions of same structure with alterations or additions: Front ......... ..'Z7...:.. ............... Rear .........."---7 ..................... Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front.......~..~.~ ...............Rear .....~...~ .................. Depth ................... Height ...~........¢Z..7. ......... Number of Stories ..../. ...................... / 9. Size of lot: Front ......~.....O.. ............... Rear ....... . .~.....~.......'7 ..... Depth ....~.....~. .................. 10. Zone or use district in which premises are s~tuated....~7 .......................................................................................... 11. Does proposed construction violate any zoning law, ordinance or regulation?......~...¢)....~. ..................................... 12. Nome of Owner of ~remis~es~..~.~...Z..~..~..4~...~...~...~..~..~...~.z...~....~..~Addre/s/s~././.~.~.~.~..~.~¢~..~h~N~Z~..e.~z~ Name of Architect ...................................................... Address .................. ~ .......... .~,...f.....Phone NO ..................... Name of Contractor....~..'.~.... ........ ..~...4~..¢...~...z ....... Address .~'.,Z..d.~.4.~'..'~'../..'¢../....~... ...... ~..C...Phone NO ..................... Locate clearly and distinctly all property lines. Give street and block whether interior or corner lot. PLOT DIAGRAM buildings, whether existing or proposed, and indicate all set-back dimensions from numbers or description according to deed, and show street names and indicate S S.' COUNTY O~......), ~....~.~..~....~..~.~..~..~...~...~.....~..~..~(..~.~..~...`~...~..~...`~.....4~.. ...................... being duly sworn, deposes and says that e is the pplicant (Name of individual signing application) above named. He is the~...C~..e~.C4~..`..;~..~.~..~...~...~..~.~.~..~.~.~./.~..c~....~.../~ ............................................................................. (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 tru%to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the applj~"gfion~,/filed therewith.~ Sworn to before me this ')l/ ~ ...... -.~..~. ........... day of .....~ ........~. ................. 1 9..-). ........ /~'-- ~ I_/I ~3 ~ /~_~ ////~ j'" ~(Singature o~' applicant) Notary P u b i i c, · .~{~..(~..t~.~¢ .g~,~/.~.~..~..~J~,,~' ............. County