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Home My WebLink About68-zTOWN OF ~OUTHOLD BUILDING ~)EPt~RTMENT TOWN CLERK'S OFF:~CE SOUTHOLD~ N, Y, C~:'t~"i'~'FICAT~- OF OCCUPANCY TH~S CERTIFIES that the building located at .~.~CJ..~.~..~....D..~..:.., ..~.~..~ ..... Street Map No ............. ~**... Block No ....... ,~, .......... Lot No ...... ,~,. ....................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............... ~...~ ................. 19...~ pursuant to which Building Permit No ........ ~..~... dated ~ ~ 19..~ was issued, and conforms to all of the require- ments of 1he applicable provisions of the law. The occupancy for which this certificate is issued This certificate is issued to (owner, lessee or tenant) of the aforesaid building. FOR~I ~0. 2 TOWN OF SOUTHOLD' BUILDING DEPARTMENT TOWhi CLERK'S OFFICE SOUTHOLD, hi. Y. BUILDING PERMIT (THIS PERMIT MUST BE IKEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMP. LETION OF THE WORK AUTHORIZED) No ...... 2/6.. f~.~ ......... Date ....................... Permission is hereby granted to: ~:~ ~:¢~¢,,~..t ~ ....... I~ ......... , ...................................... .............. Nc..~g;~e~ .. ~l.~j:e ................................... ............... ~ '~ e~4',t~ -~L.t~ e! ~ ~.-....N.,..Y.'., .......................... to ........ F¢~..e ~.~.. ~e~.. ~.t o.z*.~,~e...t a~.~u..~i~uh...~e ~.e ~ ~z~... i~tz~]~,~ti f~.. ~e,.~:t ~ e~ ........ at premises located at ...~,~...%~.c~.~f~OD...~:$.Y.C,.....f~Z~..t.C.~D.%t.O,~-;~.....~],L*:.~.,. ..................................... pursuant to application dated ....................~}~9~.~..J.'C~,y.s...~.,~...19...5.~.., and approved by the Building Inspector. Fee $..1.0.,.O(.). .......... Building inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. Approved ........................................ 19 ........ Permit Application ~o ............................ 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, 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 thais (~ppli~ation may not be co~nmenced 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 a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o 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) Naugles Drzve, Mattztuck, New York (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. owner Name of owner of prem ses ASPHALTS ~ ZNC. If apglicant ~ o corporate, sig~Ura~e of duly authorized ,officer. V (Nome and title or corporate officer) 1. Location of land on which proposed work will be done. Mop No. ~ Block - ' Street and Number .... ~.8.g~.e. ~....~.?. ~.¥.e. .............................................. ~/.~.~.~. :~...C~;:~7.: .... 2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction: a. Existing use and occupancy s..t..o, rag.e. 9.?..A..~s~...h..alt road '~te,r.i~ls u sa~le b. Intended use and occ pancy , , ,. ................... 3. Nature of work (check which applicable): New Building .................... Addition .................... Alterc~tl ....................... erection of new Repair .................... Removal .................... Demolition. ................... Other Work (Describe)...s,~;.Q~..a.g..e.. tank / ~ o o ~ $10 o O0 4. Estimated Cost ...... .~.,, .L .-~. ............................................ Fee .......................................................................................... (to be paid on filing this application) FEES: 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 7. Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth ............................ Height ............................ Number of Stories .............................................................................................................. Dimensions of some structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of [et: Front ....... ~0.0 ............... Rear ............ ~.QQ ......... Depth ..... ..~....~..Z ........... 10. Zone or use district in which premises are situated.....;.. .... ~ .':..'~-. ................................................. 11. Does proposed construction violate any zoning, law, ordinance or regulation? ............................. D.Q .................. 12. Name of Owner ..... ~ ........................................................................ .FF~ne NO ~ .9.-41.0.0 of premises A PHALTS~ IN0, AddressNaU.~les D~. Mat~it ................... Name of Architect ...................................................... Address ............................................ Phone NO ..................... _ Chicago BridgeI'"Alee~.z'uz~"r--- .'~u'~" ..B.r.q.~.'..d..~.~..~'.~....~..:..Y..? ......... Phone Name of Contractor .................................................... ',~ddress 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 corner lot. STA'I"E OF NEW YORK, ) COUNTY OF ....~..'q,.~.~..o..~.~. ......... ) S S.' H. M. Brush ................................................................................................ being duly sworn, deposes,and says that he is the c~ppllcant (Name of individual signing application) president . above named. He is the .......................................................................................................................................................... (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 ............ ~? ........ day of .............. ~ .~..]r.~. ................ 19....~.~ ..... FOR~I NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c ..... " ..... ' ......... ....................... (Building Inspector) Application No...~..~.~ ....?.. .... APPLICATIGN FOR BUILDING PERMIT Oate ............................ ................ .... 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~3n 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 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. ABPIfAL~ INO ~ (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 nrem ses If apl~lican,t~s o corpora~sl~ure of duly authorized officer. V (Name and title of corporate officer) Location of land on which proposed work will be done. Map No ............. '~7~.]~].,-~. .......... Block .................................. Street and Number .....,N,.a..,~.~..1,9.~.....D,.zT.l,.Y.e. ....................................................... State existing use and occupancy of premieses and intended use and occupancy of proposed construction: a. Existing use and occupancy.....~...~..O.?...~.~.9...O..~..A.~.Y?.~..~.. b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition. ................... Other Work (Describe)...8..~..O.~'...~.~.~... t~nk ~/~ ~ $10,00 ........................................ 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 ............................ if garage, number of cars ........................................................................................................................................ 6. If business, commerical or mixed occupancy, specify nature and extent of each type of use..~.~.~...'rm~:.'-..~..~.::':.~.;.. 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 ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ...... 20.0. .............. Rear ............ ~.O.Q ......... Depth ........................... 10. Zone or use district in which premises are .~tuated ....................................................................................... 11. Does proposed construction violate any zoning law, ordinance or regulation? ............................. 1'~.O. .................. 12. Name of Owner of premises..A.~..I.~..~..~...~.N...~..~.....AddressN...~..~.~.9.~.....~..~......~...~.~..~.q~ne NO. I~ ..... ...............c)'b'100 Name of Architect ...................................................... Address ............................................ Phone NO ..................... '~ t Ohica~o ]~x. idge & Ix'on CJ- ...]}.~.o.~.d.W~'.~....N..:..~..: ......... Phone NO ..................... Name of uon racror ....... : ........................................... gA'ddress PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from prop~;rty lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. ' ST,~T'E OF NEW YORK, ) COUNTY OF ....~..t.l.~.~..o.l~ ........ ) S S.' ................................................................................................ being duly sworn, deposes and says that he is the applicant (Name of individual signing application) p~e~Iden~ above named. He is the .......................................................................................................................................................... (Contractor, agent, cat,rate 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 Jn the application filed therewith. Sworn to before me this .......... .'~'..~. ....... day of ....... .~[..~...g..~ ..................... 19....~.2 .... iNC. Tov~N oF ~c