HomeMy WebLinkAbout417-zFO~M ~0.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUI'ANCY
No....~,..39t] .......... Date .......................... .~1{~.~....~.~. .......... , 19.~)...
THIS CERTIFIES that the building located at.~.~'{~..Ro~c]..,,..~.S..03,c]..Hart~o~r..Rd ........... Street
Map No...x:~:~ ............... Block No ...... ~ ............. Lot Narc ........ ~ft~/..ffl~£O]]f~....~.~.~, .....................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
............................. A~UB.~...2~, ...... , 19~...., pursuant to which Building Permit No..~.Y~? ...................
dated ............... ,. .......... Au~.st,...,2,Z ....... , 1959...., was issued, and conforms to all of the requirements
of the applicable provisions of the {aw. The occupancy for which this certificate is issued is ..............
........................ ~.~Lwt~e...~.ue..~.~,~...ft~v~3,~8 .................................................................................
This certificate is issued to ~.~f{~.....~0g~ ...........(~..O.'~.~). .................................................................
(owner, lessee or tenant)
of the aforesaid building.
FOI~M NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
417
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Dote .~.~.....~...(.. ................... ,~.--.
Permission is hereby grgoted to: _ j ~
./.~'-I,
L~.....,.~
~...~..~.,....
~o ...... ~~~ .....................................
.... ~ ......... ~,..~,.. ........ ~~..,.~...~ .............................................
~...~..J~.~....~" "''~ ..................................... ~... .........
Building Inspector
i.~-
F~ $...~ ...................
FOR~ NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, H. Y.
NOTICE OF DISAPPROVAL
E,e No ...Z....~..Z.7 ................................................... ~ate .......................... ~...~ .......... l~...~.
To .... 1~,..~..~.,, ..~. ~,.%. ,~.~ ...........................................
.... 01d..,Ha~.b,o:~..~oad ..................................
.... ~ew..E~.~o~,...Ne~..~0~c ...................
PLEASE TAKE NOTICE that your application dated ..................... .~...~.~.1~..S...~..,..~..~.. ........... 19~...~....
for permit to constructd~,~l:L~[;~g ........................ at the premises located at ..~./.$....0~.d.....~.,~...~..O..?....~O~,¢~
.. * ~.eW · ~ .~. ~01~ ,,f..Ne.~....~.oZ'~ ................ Street
Mop ........... .?. ~..~. ..................... Block ........ ..~.?~ ............................ Lot ....??..?. ................................. is
disapproved on the following grounds .,i~k...o:~..J~.~.~ .........................
.......... ~.'ow~ ....,aw..2~OA ......................................................................................................................
Building Inspector
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N, Y.
Examined ................. 19. ,,
Approved ........................................ 19 ........ Permit No ...............................
........ .................
(Building Inspector)
Application No......~.-./..~..~.. ...........
APPLICATION FOR BUILDING PERMIT
Date ............. .~....~ ........ ~........!. ....... 19...)~'...~....
INSTRUCTIONS
a. This application must be completely Filled in by typewriter or in ink and su0mitted 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 l~ept on the premises available for inspection throughout the progress of the work.
e. No building shah 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 issuanc,e of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Sou'thold, 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)
........ .................................................
(Address of applicant)
State whether applicant is owner, lessee, agar, architect, engineer, general contractor, electrician, plumber or builder.
........................................
Name of owner of prem.ses....~....(~ .......... ....~.. · ...... ~.....~..4,¢(k,~. ....................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
1. Location of land on which propos,~ ~(or~- wi, Il,be done. Map No: ................................ ~ ........ Lot No: ....,.. ...............
Street and Number.,J~' '~-~/) //l,/ f/ ~ ~/, P ~ //..~.....~..~....~..,...~..../~....~.~.~........~....~.....o?.f~.~.~..~._~...~..~~.~....~m7... ......
Municipality
2. State existing use and occupancy of p~emises and~intended use and occu~cy of~ proposed construction:
a. ~xisting use aha occupancy ......................... ~ ..........................................................................................................
b. Intended use and occupancy .......................... ~.,,~. ...............................................................
3. Nature of work (check which applicable): New Building .................... Add'tion .................... Alteration
Repeir .................... Removal ...... v ........... Demolition .................... Other Work (Describe) ....................
~O -~ /..
Estimated Cost. ~x.~..~..l~ ........................................ Fee .......................................................................................
4.
(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 ............................ 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......,~v.~'. .............. Rear ,..~..,~.. ................. Depth ..c~,',,~:..J~l,~,..~.../..~,~.~
Height ............................ Number ¢~f Stories ../.i~ ...........
9. Size of lot: Front ..~..../...~..:.....)~.....~.....~Rear ..W'...~........~...~.¢.~'.. Depth ...~...~./..'.~.~..../..~....~../~
10. Date of Purchase ...~.~.~....../..~....~-~...~.: ............. Name of Former Owner ........................................................
'Z4.'
] ]. 7one or use district in which premises are situated ................... ~. ............................................................
]2. Does proposed construction v2olate any zoning Iow, ordinance ok re0ulatian? ........... ,~..,,~.,~.t ..............................
,3. Name of Owner of ...... NO .....................
Nome of Architect..t.h:...~~..~..h'"~ / ~ ................. Address ....... Phone NO .....................
Name of Contractor/~.-.:..°~...~.c~.[,..~....~',,J~'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 NE~,~. Y~I~/4,~ ~( ) S S
COUNT~Y,~'~''~''''''')
............ ~..:.~~.c~.... ....................... being duly sworn, deposes and says that he is the applicant
(Nome of ,ndividua' sign~n~)appli~
above named. He is the ................... ~~.../vk....r~'~'~... ........................................................................................
(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 s~ fort~,!~n the applicat~n filed therewith. ,~ ,
Sworn to before me this
N ic, ....
TOWN OF SOUTHOLD
BUILDING DEPARTMEHT
TOWN CLERK'S OFFICE
SOUTHOLD~ N. Y.
.........
Approved ........ ~......I ..............19 ........ Permit No ...............................
............................ ~ ................................... Y~' ...... ~7 .........................................
,:~.~:5~¥:¢.................~
(Building Inspector)
Application No ............... /. ............
APPLICATION FOR BUILDING PERMIT
Date .............. k~¢'...~'. _~ ./ ......... ~ .............. 19.~..~) ......
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and su6mitted in duplicate to the Building
Inspector.
b. Plot plan showing location of lot and of buildings on premises, relationship to adioining 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 any purpose whatever until .a Certificat, e 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 Sou'thold, 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.
(Signature of applicant, or name, if a corporation)
(Address of ~pli~t)
State wheth,er applicant is owner, lessee, agar, architec~tf engin,eer, general contractor, electrician, plumber or builder.
............................................................. ..........................................................................
Name of owner of prem~ses....E.~'.' ......................... .NJ. ................... ~.~ .....................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
1. Location of land on which proposp,,d ~or~ wiJl~)e done. Map No: ................................ ~,,.....'.... Lot No: ....~ ...............
Street and Number ..~..~ ........... ............. ~ .............................................. Municipality ~ ....... '~ ........................ ,,?"~ ........................
2. State existing use and occupancy of premises anti, intended use and occug~Dcy or, proposed construction:
a. ~x~st~ng use aha occupancy ........................................
b. Intended use and occupancy .......................... ~;;'; ~...t, ...............................................................
3. Nature of work (check which applicable): New Building ...... .../~..... ...... Addition .................... Alteration ....................
Repair .................... ~,'% Removal ......:.~ .......... Demolition .................... Other Work (Describe) ....................
4. '0 --' ./....0.
Estimated Cost..,-~..~j....~...). ........................................ Fee ...................................................................................
(to be paid on filing this application)
5. kf 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...,.'.i ......... ~ ............
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 .................. Reor ...x.
..~ .................. Depth ............................
Height ............................ Number ¢Stories ..~..T~ ........... ¢
/ ~ ,, . -~"~ /~ I~"*1¢1~)~ >/7 5/ // ~ ~
· ~tO' ~ '~ ' ~1 '
9, S~ze of lot: Front ............................ Rear ............................ Depth ........... ~,.,/,~ .....
............ ........................................................
] ]. ~ono or use district in which premlsos oro situated ................................................................................................
]2. Does proposed construction v~l~t~ ~nv xonin~ Iow, ordinonc~or~O~l~tion?, ........... ~./.~.~ .............................
13. ~ame ot uwner or ~s ............................ ............ ~aa s .: ......................................... , ~ ,~ .....................
Name of Architect ......................................................... Address ............................................ Phone NO .....................
Name of Contractor. X>,cz;......';.....:....:: ............ :..: ........ .~ddress ............................................ 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 ..NJ~_.¥~[~,.~. ) S S
................................................................................................. being duly sworn, deposes and says that he is the applicant
(Name of individual signigg~pplic~
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 t~is ap.,p_lication are true to the best of his knowledge, and belief;
and that the work will be performed in the manne~,~t~ in the opplicatig.~filed ~herewith. U .
Swan to be, fore me this ~' ~_ ~. ' ~,~f~e~ "~,.~ ~-~,~,~-'~
day of ~ [~?~:!,~ :~z~,~u,~ Yo~ (S gnature of app cant)
~ot~ Public, ..~ ......................