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Home My WebLink About453-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFIGATE OF OCCUPANCY THIS CERTIFIES that the building located at....B./..~..,W..e.~...A...~.. ....................................... Street Map No~.,J~.~Y.e.L~L~ ....... Block No ........ ~ ......... Lot No..~, ........~.~Q]k~l.~....~.t.~.~. ...................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......................... ~p~e~.~2'.....~9. ..... 19~§...., pursuant to which Building Permit No....~...~.~ ................ dated .......................... .~f~..~.l.~.~...~...., 19~.8....., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy forwhich this certificate is issued is .............. ............................... ~i~a .re.. one..£~mily...~.~.~lling ........................................................................... This certificate is issued to ..... ~,i.]~.J~.~...~..~.'~.~.~A'l ...~g ..................................................................... (owner, lessee or tenont) 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 UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N° 453 Z Date ...........Bep%onber.....19................ 19.5$... Permission is hereby granted to: Willies.E.;...11"t................................................... ..........345..W..58th .F'.t....................................... ..................Now••Y.Q rlcv...A.• .V.............................. to ........................$tztld••aew••dwell Ing........................................................................................ ................................................................................ ................................................................................ at premises located at ..L04-4..7x1.... map..#..859..................................................... ..........................................delle••Are-t........Southald................................................................... ................................................................................................................................................................. pursuant to application dated .......................Se-ptMb......19.........19.54.., and approved by the Building Inspector Fee $,10.4)0........... �.G.w:. ...... .� .L.............. Building fnsp8ctor FORM NO. 1 TOWN OF SOUTHOLD BUILD~NG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... ~.....?. ........ 19...~.~.. Approved ........................................ 19 ........ Permit No ............................... .............. .......... (Building Inspector) Application No. ~'/~'~ APPLICATION FOR BUILDING PERMIT Date ............... ..... 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 any purpose whatever until .o Certificate of Occupqncy 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 alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ..... .~...~.....~ ....... ,~'~ ............ ~.~....?.,. b./. ...................................... (Signature of applicant, or nome, if a corporation) · ........ ........... ................. (Address of applicant) State wheth,er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of prem~ses.·...~ ............. ~.~....~,..~.~.:¢~..';~:.z...: ..................................... ~ ......................................................... If applicant is a corporate, signature of duly authorized o~ficer. (Name and title of corporate officer) 1. kocot on of and on which proposed work wi be done. Map N,_o: ...k~.M~...k~.-~.:bx'~....~Z...~...~../Lot No: ............. Street and Number ..~,::,:.:~.,~:.~:.:'~ ........... :...~:. ...... ' ...................... ::~..:: .................r ....... :.~. ...................... .~ .................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................................................................................... b. Intended use and occupancy ............................. F~ ............... : .......... ~ ..................................................................... 3. Nature of work (check which applJca'ble): New Building ....... ~."_........AddJtion .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost..£.~ ................. ..-Z.. ................................. Fee .......................................................................................... (to be paid on filing this application) units ................... : ............ Number of dwelling units on each floor ............................ 5. If dwelling, number of dwelling O't'~'-~ If garage, number of cars ................... ~-m.. ................................................................................................................ 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.....~....O... ..............Rear ............................ Depth ...~..~ ...... ~ .......... Height ....... ./...Z..'...~ ...... Number of Stories ..... .(.~..~ ....... ............. ............ " 9. Size of lot: Front ..... ~.~..'....(':: .......... Rear t ~ v,, ~ ) Depth ..... ~, ......... / ............ 10. Date of Purchase ........../..~..'?.....~.~.. ............................. Name of Former Owner ... ~ .... ?.:':'::7:; ........ !]. Zone or use district in which premises are situated .............. : .....:~.:~..':.';..~..!~.M. :......' ................................... ]2. Does proposed construction violate any/Z~jq, ing law, ordinance or regulation? ......... ./........o.. ................................. 13. Name of Owner of premises..,.~'::; ......... .N.J..;:.....:...l~......Address ............................................ Phone NO ..................... Name of ArcMtect~'.:.:. ................ ~ .......7' ................. 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. STAT[! OF NEW('~ORK~,~ S S V~ r'"~ '~'"" % .... be nn duly sworn, deposes .and says that he is the applicant ................ ~'~ ~ ~ ' ~¥ "i'~ ividu~" --'~'i' ~f~'~'~'~' ' ~ii~'~i~'~ ............... 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 th s a)p cat on; that al statements contained in thi~pp~,~ation are true to the best of his knowledge and belief; and that the work wdl be performed ~n the manner se~,~o~ ~the apphc~on filed therewith. , Sworn to before me th.s , ~.. ;~'/~ ,~ ~ z//, /{~. ,' . ,~ ~, ~ ,, ",:,-, ~, 7~,~.~of~.· c.~..~,_-.<~c~7-' / '1 ~,, of ....... ~"~'~;~, 19 ~ '~ '(~r;~ ~',~ ~., (S gnature of app cant) 7 ................. r'""~. , .~ ..Z r~,~. ~ . ~,~?~,~ ~,~ / FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. I ~ Exo mined.......~......(~... ........ .~. ............ 19...~....~. Approved ................ : ....................... Ig.:.~.....Permt No...~........~./~.'~-.~. .......... (Building Inspector) ~ Application No.......~.'..~.7.~.. ............. APPLICATION FOR BUILDING PERMIT Date ............... .~~.~.~.~..... !.. ~...., 9..~....~.. .... 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 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 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 applioable laws, ordinances and regulations. ..... ...... .......... .................................. (Signature of applicant, or name, if a corporation) .......... ................. bi ......................................................... (Address of applicant) State wheth,er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises....~...~.. ............. ~.~....~..'...~. ............. ~ .............. "~ ......................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on w.~~d ~l_l~b~.~e done. Map ~~...~....~...~.~9~o:, JV~,"i'/'''( ............. Street and Number ............................................................... .............................. .~.-. ................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. l~xisting use and occupancy .................... ,~ ............................................................................................................... b. Intended use and occupancy ............................. ~.?..~.] ..................................................................... 3. Nature of work (check wh?ch applicable): New Building ....... ..~....,......AddffJon .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ........................ ...':TZ. ................................. Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .........i~ ...... 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.....-.~...~ ............... Rear ............................ Depth ...~..~ .................. I0. Date of Purchase ......... ./....?...5..~..~... ............................. Name of Former Owner . .~...~.~.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. STATE! OF NEV~YOP, JK~ n ~ ) S S COUNT* OF '"),t~ t'~ ~,, _,, be n deposes ,and says that he is the applicant ................................ .V_.~.. ................................. ~ ............ g duly sworn, (Name of individual signing applicati~) above named. He is the .................................... ~..v...-....-~.,~ ......................................................................................... (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 th s application; that all statements contained i~ ~bis~?prEp. lication are true to the best of his knowledge and belief; end that the work will be performed in the mani~f~,,~'.~tlgOl~,,,~the application filed therewith. , ,,~ Sworn to before me this ~ ~ , '-' ,~,,~ ~ ~t~ of ~, /.,j ,1/,/. ., /[ ~7~'~ ~ _ ......... ~...~. ........ da~ of ......~;~T~..~ .................... 1~.~°~.~ '~00 ~' (S.gna[~L~ar~t) ~ Notary I~ubJic, ~...~.....--'~..~-~'.~....~;~ ~'''e~ ~' 's~"~ '7 /