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Home My WebLink About165-z _ r FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. .....T.....125.... Date ............................June...5...............19...58. THIS CERTIFIES that the building located at .W,/g.....Rr;1498...j,p............................... Street Map No. .............X.X..X................ Block No. .....=........................, conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................$OU.C>IDti ".....5..........19.5.... pursuant to which Building Permit No ......7,165..........1 dated .................XQV.P. ber.•1r ...............19.57.... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ............ ...................................................PRIu.AT.V,.-J WPa1JT;f....................................................................... This certificate is issued to ..FAWflyd...EA...Lally.............................................................................. owner, lessee or tenant) of the aforesaid building. 1{ riZ.lc'— oV1 ...................................................................... ....... Building Inspector NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. I~UILD~NG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES ~/~l~$(~.O~f, ,~,f,~/~.g~e.~%.¥~,~J~,C,~T,I~,~.UNT~L FULL ¢OMPCET~ON OF THE WORK AUTHORIZED) Permission is hereby granted to: Date .................... ["~'ove~'be, r'... '6 ........... ] 9. :~.. at premises located at ...... ~/8.....Br.~dge-.-La~ae .................... , .............. .............................................. .................................................. (East..Cuteho§.ue..). ......................................... ; ........................... pursuant to application dated ................... ttevembe~..~ ..................... 19.~.., and approved by the Building Inspector. Fee $...~..00. ........... FORM NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ......~..~..~'. ..............19..~...~ ~ Approved .................... Disapproved a/c ................... : .......................................................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT t ,~ ,.S'- Da e .............. .L..~...~<,. ...................................... lC? ...... ~... INSTRUCTtONS o. This application must be completely filled in by tvpewriter 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 odjolning premises or public streets or areas, and giving a detailed description of layout of property must be drown on the dlogram 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 port for any purpose whatever until o Certificate of Occupancv shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment 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 Lows, Ordinances or Regulations, for the construction of buildings, additions or a Iterations, 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) ( g .... - (A~dress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .......... ~(~,.~4~...'~.....~......;~/..~..';..'r.7 ............................................................................... If applicant is a corporate, signature of duly authorized o~ficer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map~,No: ................. ~ ........................ Lot No: .:.~. ............... Street and Number ~..~¢.~./(LJL....;q...~'~;:~ ...... :~,......G;~:'~T~.~..~...~...~..:.L..~...f ................................. 0 Municipality ~ d / 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ~./..~.¢.-~k~.%~,~ ............................................................. , ......... ../) ............................. b. Intended use and occupancy....(~,.~.~,~.:f..,'~.:~..,~...~(~..~w~ ................ 3. Nature of work (check which applicable): New Building .................... Addition ....... .~, .......... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ........ ~../.....¢:Z~. .................................... Fee (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, commercial or mixed occupancy, specify nature and extent of each type of use .............................. 7. Dimensions of existing structures, if any: Front..~...~....z...~ ......... Rear ..... ~....~:..(~ ......... Depth .....~...(~ .................. Height ....~...,~...~. ............ Number of Stories ...... ~:~ ................................................................................................... _ , ,, ......... Dimensions of same structure with alterations or additions: Front ...:-~,..(~...=.~ ............ Rear Depth ........ ~..(,...r. ............ Height ..~.,2 ....................... Number of Stories ..... 2. ....................... 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ........~..~ ............. Rear ......... ~,~..Q ............ Depth ....... ./i..?...~...-~.. ...... 10. Date of Purchase ,~.~v:..~../...~.....'.3..:~. .......... Nome of Former Owner ......~..~...~.....~ ............. 11. Zone or use d~str~ct ~n which premises are s~tuoted,...~..-~. ........... ~ .................... 12. Does proposed construction violate any zoning law, ordinance or reaulation?(])'~'"-].~ ............................ 13. Name of Owner of premises..~.:..~.:.../.,t .... Address. ~../...~. ...Phone NO.~.A,..~..~..~.. ... -- ~ Ph Name of Architect .......................... ;: ............................ Address ............................................ one 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 NEWt YOgI~, COUNTY OF .,~._~....) ,. ~ .................................. being duly sworn, deposes and says that he is the epplicont (Name of individual signing/g~plica_tio?_oL____~_..___._ 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 oil 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 appel,cation filed_therewith. Sworn to before me this .......... ~. ........... ,d, ay of[ ....... '~..' ................. ~ ,. £LmSI~ I~gj~ ature of app icant) Notary Public, ....~.~ ............. ~ount'y ~°t~i~P~'iC'n~ ,, Sta~es~ff01~o~ C0unty~v Y0r~ FO~V~ ~NO. 1 #.~ TOWN OF SOUTHOLD BUILDING DEPART/V~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19 ........ Perm t No ............................... Application No ............................. APPLICATION FOR BUILDING PERMIT Date ......... ~.:..?~.~ ................................ 19..~.Z.. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in dupJicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to <~djoining premises or punic 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 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 issuanoe 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ...... ..C..., ........ ........................... (Signature of applicant, or name, if a corporation) .............................. ............................ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises ....... .,_,,,.c~,~,:.~ .z.~...'%.-.........:::-..: ....... ~.'.;...(',k<~ ....................................................................... / 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: .................. ~'L...'-. ................... Lot No: ......'-Z. ............. .............. ' '"'"'"" ~.==~ ~ kh ~h~r ~ ~A .~1~'~~ ~ ~ '/~ ~ ~ 3 .................... r ...................... State existing use and occupancy of ~remises and intended use and occupancy of proposed construction: ~. Existing use and occupancy ........... L~Z~..,......~ ........................................................................................... b. Intend*d uso ond occuponcy......¢~2~'~5~}:~...~. .. ~ .... ~ .............. 3. Nature of work (check which applicable): New Building .................... Addition ............... ,/~ Alteration .................... Repair .................... R~moval .................... Demolition ................ :~.Other Work (Describe) .................... 4. Estimated Cost .......... ]r~../.......~... .................................. Fee ........... ~*~...t ...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, commercial or mixed occupancy, specify nature and extent of each type of use .............................. 7. Dimensions of existing structures, if any: Front....'.~....~...7.....~. ........ Rear .....?...~..~.....~. ........ Depth ......~...~ ................. Height ....~.~....~ ................ Number of Stories ....... ..e~. .................................................................................................. Dimensions of same structure with alterations or additions: Front ....'~.....;T..(~. ...............Rear ...~...~..~..&...~. ............ Depth ....3...~,..~ .................. Height ..~.....~.'. ................. Number of Stories ..... ..~. ....................... 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front .......... ~...L). ........... Rear ........ ~ .............. Depth ......./~..'Z...~ ............ 10. Date of Purchase ~..n..~....~....~. ...........Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated....~~--.....~...~..,~<~.~~. 12. Does proposed construction violate any zonJnfl law, ordinance or regulation? ........ (Jl_~t,~zz......m. ............................. 13. Name of Owner of premises.~'~. .... Addre s ~..:.. hone NO.~.A~ ........... · ..... Name of Architect .............................................. ~ ...... Address ............................................ Phone NO ..................... Name of Contractor~...~.....Address . ~./~.;..~:..Phone NO.?~,:.~...-..¢.~..?..z~- 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. COUNTY OF ,,~~ ...... ) ' ..~..~~.. ........................................ being duly sworn, deposes .and says that he is the applicant (Name of individual sign~,~applic~a~j~n)_~ · above named. He ~s the ................... ~~..: ............................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, end 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 ., tEL0~ ~L.~-"~z~.., /'~,%~,,(-~) ~ . [~Z:---~-~ ~-- - ~ ,,~.r~,~.~-,~ ..................... ~ ....... i~ ~'t~(~t~'~e of applicant) Residing in S~ffol~ County .......... No. 52-0367800 Notary Public, : ~ My Commiss,o. Expires M:rch 30, 19