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Home My WebLink About179-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFF[CE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ........ Z"9% ...... Date ....................... Al:~I1,....28 ............. 19%~... THIS CERTIFII:S that the building located at .]~l~?,jl..&..~r...~l~ .......................... Street Map ixlo ..................................... Block No ..................................... , Lot No ....... conforms substantiaJly to the Application for Building Permit heretofore flied in this office dated .............. .~o~el~be~.....~.~.. ............ 19..~'~..., pursuant to which Building Permit No ...... ~..~..~. ......... , dated ........................ NOVetl~.b~.~...~-.....19.~.~...., was issued, and conforms to ali of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ............ .............................................. ~R .t.V.A.T-E...DI~DLi~N~ ............................................................................ This certificate is issued to .,,.~tl.~,~-&B.,.,~e~.~, ......... ,(.-.O~t,e~-) .................................................. (owner, lessee or tenant) of the aforesaid building. .......... fk: ................ .... Building Inspector FOP,~I NO. 4 TOWN OF $OUTHOLD BUILD~NG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ~[~e&a~..&....~,~,~..~.(1, ........................ Street Map No ..................................... Block No ..................................... , Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................. ~o.~.eltll~e~...,~..19...~8., pursuant to which Building Permit No .Z...].~O ............... , dated .................. ~O.¥~e.~-.,~-~ ........... 19.~..., was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ............ .............................................. ~RI~fATE.... DWELLL~,~G .......................................................................... This certificate is issued to ....,~.~[$a~..F. ied.]Le~,.....(....e~,e~)...-.: ................................................. (owner, lessee or tenant) of the aforesaid building. Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF O(~CUPANCY THIS CERTIFIES that the building located at .]~/.~..]~.~O~'.f,'..I~OD, C~ .............. ~ ......... Street conforms substantially to the Application for Building Permit heretofore filed in this office dated dated ................... ~.'~e~e~......~. ........ 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 ............ .................................. PR IYATE .. ]]WELI,I ~I ....................................................................................... (owner, ~essee or tenant) of the aforesaid building. FORM ~0. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PER/rUT (THIS PERMIT MUST BE KEPT ON THE PREMISES ~P~).y$~.I~,/~N~,.S~.~,~I.~.UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Dote ............. INTo,v, embe~.....2.~ ................ 19..~... Permission is hereby granted to: Thom~.~....~ .~.~ .~..n..~.~. ..................................................... ........ Kez~.~n...Bl. vd., ............................................ atpremiseslocatedat.~/~....~ve~..p~ ........................................................................... ...................................................... ~r~enport.,.....~.~, ........................................... i..: ..................... pursuant to appNcation dated ..............NovemBer ....... ~..~ ................... 1~.~....., and ~pproved by the Building Inspector. ~ Fee $..10..00 ......... Building InspectOr:.: ,, '~ FOEi~ NO. ! TOW~ OF $OOTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~×omineo ....... ~-,..(:~...: ......... {.. ......... 19.Z...~.. Approved ........................................ 19 ........ Permit No ...... ~.../...~ .............. Disopproved o/c ............................................................................................ (Building inspector) Application No ...... ..~.~....../.~ ..... APPLICATION FOR BUILDING PERMIT Date . ::; Z..C ............. (.\ ...................... 19...¢../.... INSTRUCTIONS o. This opplicotion must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plon showing Iocotion of lot ond of buildings on premises, relotionship to adjoining premises or public streets or areos, ond giving a detoiled description of layout of property must be drown on the diogrom which is port of this Iocotion. c. The work covered by this applicotion moy not be commenced before issuonce of Building Permit. d. Up,on opprovol of this applicotion, the Building Inspector will issue o Building Permit to the app[icont. Such permit shall be kept on the premises ovoileble for inspection throughout the progress of the work. e. No building sholl be occupied or used in whole or in part for any purpose whotever until a Certificote of Occuponcy sholl hove been gronted 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, end other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or or r removal or demolition, as herein described. The applicant agrees to comply with oil applicable laws, ordinances an ~tions. (Sig or name, if ¢ corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer generat contractor, electrican, plumber or builder. (?.. :d'~: ~ Name of owner of premises ............... ::~':./. . .~/.(-.~:-::~ .............................................................................. If applicant is a corporate, signature of duly a~horized officer· (Name and title of corporate officer) 1. Location of Iond on wh,:b proposed work w,U be dene. gap No::.~.~..',.::..¢..,,:,~:/.,:,.. -: ~oc~. :..~. ............ Street and Number ............... :.(-."'.:'./././': .......................... ./~-. ........................................................................ 2. State existing use and occupancy of premieses and intended use and occupancy of prOposed construction: a. £x,st.na use and occuoancv......~....¢~.../'.~..~.(~..../:~.~./?..4'.~//~.~/..~..:~ J//.?.Z'~,Z:,~_.~'. ~ 7,",~:,,,..,?~ J - . . .,: ........................ ,.: ............................................ 3. Nature of work (check which/applicable): New Building .................... Addition ......... ...... Alteration 7 Repair ................... Removal ...... .......... Demo t on. ............. Other Work ¢Describe).~.~.~. 4. Estimated Cost ...... '.....~.~.~.D.J,L.~ .......................... :.Fee ......................................................................................... (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 .................................................................................... If business, commerical or mixed occupancy, specify nature and extent of each type of use ................................ Dimensions of existing structures, if any: Front ....... ,,~...~/..~.. ........ Rear ...... ~...~.,..'~...../.-~..... Depth ~ /~ 7' 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 ..... 5~J Rear ......... ~...~..". ............ Depth . .'.~....~...~,.~..~._./...)...~ 10. Zone or use district in which premises are situated ................... ..~......~ ............................. _~..~ 11. Does proposed construction violate any zoning /aw, ordinance or regulation? ...... .~_~....~.~..- ................................... 12. Name of Owner of premises.~./.7.C.~...~'!~.~./.~..~..Jz'..~. ...... Address ..~..'~.?.;.LJ'~;/~'uJ.'~'~ Ph e '.xT..~./.. ......................................... on NO, Name of Architect ...................................................... Address ............................................ Phone NO ..................... Name of Contractor ......................... !..~. ....................... Address ............................................ Phone NO .................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposedl, 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. .J (N~e of i,ffdividual signing application) 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 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 filet) therewith. ,ri-- IX,, Sworn to before me this ........ ~ ........... day of .....· .' .................. of ~plicant) Notary Public,.~ ........................................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. F×amined ................... 19. . Approved ........................................ 19 ........ Permit No ................... D~sapproved o/c ............................................................................................ (Building Inspector) Application rqo ............................ 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 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 ony purpose whatever until a Certificate of Occupor~cy 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 Yet and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or I or demolition, as herein described. The applicont agrees to comply with all applicable laws, ordinances an name, if g/corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, e]ectricon, plumber or builder. Name of owner of ' / ¢,~ ~ r , . ~ ¢,.,/ r, , premises ............ ./:...M.~ ...... ~. ......... ~...~ ......... ~ .......................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and tide of corporate officer) 1. Location of land on which pr~o?o~ed work will be done. Map No,,. ~ ............ ~>*~'/'/~'-'~/;V/?~:-....:./.: ......... Block .......... ./ ....................... Street and Number ................. : ........... ~: ............... :~./.....,...~ ........................................................................................ State existing use and occupancy of premieses and intended use and occupancy of proposed construction: o. occupancy Ex~stlng use and ........ ~ .................................................................................................. ~ ............... b. Intended use and occupancy ....... 3. Nature of work (check which/applicable): New Building .................... Addition .................... Alterati/on.t ......... ~ ......... , ~J .... Repmr .................... Removal .................... Demoht~on ............. ~.u...Other Work (Describe)...~.'.~.~.g...r:.. .... - 4. Estimated Cost ~.~/0~-,- Fee lo (to be paid on ~ilipg this application) FEES: 5. If dwelling, number of dwelling units ............................ Number of dwelling units o.n ~ach 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.....:Z.~?i~'.(.~...... Rear ....... .~..~...W.../.~Z ..... Depth ....... a~...97. ............ Height ...... ./..,..~/..~.../-~'.: ...... Number of Stories ................. '.?...~/..f~ ................................................................................ Dimensions of same structure with alterations or additions: Front ...... ..~...,~...~.~...~:.i ........ Rear ....... ~ .~.L~./..'~. ........ Depth ............ .~,~.Z.....~..'..~... Height .......... .//,.~...'...~.:..~.....Number of Stories .......... .~i~...'~...(~.. .......... 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ..........2 ................ Rear ............................ ) ~ Depth ..... .~..~.('.~...'~'..q..~....?..5 10. Zone or use district in which premises are s~tuated' ................ ~ ........................................................................ 11. Does proposed constructi~ violate any zoning law, ordinance or regulation? .......... ~. ................................. 12. Name of Owner of premises.'.~.4(.fL¢...~s.K~.~(~/~... Address ~ZeF4Z~z~(4d'X4 .............. Phone NO. Name of Architect ...................................................... Address ............................................ Phone NO ..................... Name of Contractor .............................. ; ..................... Address ............................................ 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 corner lot. STATE OF NEW~ORK, . ) S S ~ .................... ~ ............... e,n. sworn, o,d ,ho, ,s above named. He is the .................. /~9.¢h~ ........ (.f¢~.~..~[~ ............................................................ (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; the application filed herewith. and__that the work will be performed~. ~in' the manner sera,forth in Y .-~,~tded ~1/,.~.~'~ Sworn to before me this . ~- .~ ~ .,- Not~ry ~ublic. ............................................................. County FOEL~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam ned /'~/"~--~ ~'~ 5' ~ Approved ........................................ 19 ........ Perm t ~no ................................. Disapproved a/c ................................... ~ ................ (Buildin0 Inspector) APPLICATION FOR BUILDING PERMIT ............................... .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the BuiIding Inspector. b. Plot plan showing location of [at and of bui{dings 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 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. (Signatur~r~,~f 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 ....... .~d ............ .':~,.~, ....... .....~.~. ........................... ; ......... A...-'...'r~_z..f';z~...~.k.....~c:.. .................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work will be done. Mop No ................................... Block Number c~/~ r~ ~ ~,-~ Street and .................................................................................. ~ ~ ~;~ ~,~_/ ~^~ ~),~ ~jf,,~,,L~.,~.~ ....................... State existing use and occupancy of premieses and intended use and occupancy of proposed construction: o, 'sting use and occupancy .................................................................................................................................. occu anc b, Intended use and p y ........................................................ ~. ..................................................................... 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe)..~._~O/)~'~"~ 1~ 4. Estimated Cost ............................................................ Fee ...J...O..~.....~.~...%...~- "'~ ~' -- ...................~ ~'/'~'J~""~'" .:..'~......'..~....'~..-...'~...~- (to be paid on filing this application) FEES: If dwelling, number of dwelling units ......... ../.i ............... 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 ................................ 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 .......... --~'.~....~.... ....... Rear ....... "-'~..~....~..... ......... Depth /~..~.~ ............ 10. Zone or use district in which premises are situated 1 1. Does proposed constructio~ violate any zoning law, ordinance or regulation?......~ .................................... 12. Name of Owner of premises...~~~.'~..Address ...~~ ............... Phone NO ..................... Name of Architect......,~.,j.,..~ .............................. Address ............................................ Phone NO ..................... Name of Contractor....~..'rz..~ ............. ~ .......... Address ............................................ 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 corner lot. STATE OF NEW~')YORI~, .~ ) COUNTY OF-~)~ S S.. ................. ,~/'~..~....~..~...~.. .................................... being duly sworn, deposes and says that he is the applicant (Na~/6f indi~dual signing application) 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 ........... ~...' ............... J9...~..-~..~'.... Notary Public, .. ELOISE BOWDEfl Notary Public, State of New York Residing m Suffolk County No. 52 0367800 __~ My Commission Expires March $0, ~.~ pplicant) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ,, ,~ s~ ~-~ ~ 7 Approved ........................................ ] g ........ Permit No ...................... i .......... Disapproved a/c .~~.~.:..:.:~:z.:;:~:i ............... (Building Inspector) App'ication No .......... !.2., .g ......... 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 gi~;ing a detailed description of layout of property must be drawn on the diagram which is port of ~his 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 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, os 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 .............................................................................................................................................. . If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work will be done. Map No ................................... Block .................................. Street and Number .................................................... : ........... T ........................................... id'..~,T2~.,::;,':7~. ................ State existing use and occupancy of premieses and intended use ¢0d occupancy of proposed construction: o Ex stn .se ondoccu anc 4Zo, .... 'C g P Y ...................................................................................... , ....... b. Intended use and P Y ........................................ ................. t ..................................................................... 3. Nature of work (check which applicable): New Building .................... Addition ....................Alteration ....................· Repair .................... Removal ............. Demol,t,on .................... Other War< (Descr be)...~,4~ .~ ' '1 - ,~ I 4. Est mated Cost Fee / 0. ~ (to be paid on filing this opplication) 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 ................................ 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 .......... ~.....-.~.... ....... Rear ......................Depth .................... 10. Zone or use district in which premises are situated ,,. Does proposed construction vioJpte any zoning 'aw, ord,nance or regulat,on?......~ f . ¥4, . - 12. Name o Owner of prem ses .................. ~.~......Address ............................................ Phone NO ..................... Name of Architect......~x ............................................ Address ............................................ Phone NO ..................... Name of Contractor.......~..~........~'....4~..ZZ~ .......... Address ............................................ 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 ,~rior or corner lot. STATE F NEW~Y.OR~K; . ·/~) S S COUNTy. OF~) " ............... ; .......... ~ ....... :..,~..: ......... :....; ...................................... be ng du y sworn, deposes and says that he ~s the apphcant (Na~ of in~vidual signing applicatio~ e ' e the ~.....~ ........................ above nam d. H 's ........................................................................................................................................................ (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; ~nd that the work wilt be performed in the manner set forth in the application flied therewith, Sworn to before me this ....... ~' .~ ...~.."~. ..... day of ....i...~...: .............. 19..~....~... M No. 52-0367800 (.,~,,.- ~ (Singature of applicant)