HomeMy WebLinkAbout489-zFO,R~ N:O. 4
TOWN OF 5OUTHOLD
BUILDII~G DEPAI~TMIgNT
?OWI~I CLEItK'$ OFFI¢t~
SOUI'HOLD. N. Y,
GEtlTIFICA'I'E OF OCCUPANCY
No .......... 1i...71t2.. Date .............................. July.. 2.1 ........... , 19.6.0'
THIS CERTIFIES that the building located al .Silel~li. ri!~..Rei~cl,..'C~l~cho~tle ........ Street
Map No. 'NagtS&U'""' Block No ......... **......Lot No .... Pa~t:."t40 ......................................................
conforms su~atntially to the Application for Building Permit heretofore filed in this office
dated OC!:oloel: 14 19~.~... pursuant to which Building Permit No ....... .~....~.8...~. .....
-lated .............. {~9~.o...b.~....~.~ ......... 19.~.0..., was issued, and conforms to ail of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is
................................................................. PR.IVA~'' .01~!...-PI~ Zt~¥ · · 1~ 'I2I~'0 .......................................
This eertifmaie is issued to .............J.~lll0. iL.l~i.~.D.0.1~.lilCt,....O.lgrlf~ ......................................................
(owner, lessee or tenant)
of the aforesaid building.
FORM NO. 8
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° 489 , Z Date ...........afatOblT.....I4................... 1918....
Permission is hereby granted to:
mid`1y ortan,.,,,�✓�.....James„1laDox al ................
........CdT�'AMM4...:::............................................
N*i•
..................................................................................
1.1.14 nsr,r D+rolling.........................................
................................................................................ ................................................................................
at premises located at ......11:tlra.ift-RONA..... .................................................
........................................................autaboU44....male..................................................................
.................................................................................................................................................................
pursuant to application dated .................( Ct.4lCP..:.. 1....:...............19`5..8..., and approved by the
Building Inspector
Fee $4.0*0.0..........
.............................' ....
Building Inspector
FORM NO. 1
TOWN OF $OUTHOLO
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
...... I9...,.?
Approved ........................................ 19 ........ Permit No. ~..?.:...o....../.. ......
Disapproved a/c ........... ~.~., ,-.~';:':~ ....................... :'::'~ ~.~ ................ ~..~) ............. ~..:~-,~,~
............................ ......... :: 'i..' .i ........ i
(Building Inspector) (
Application No......z~..i...~...? ..........
APPLICATION FOR BUILDING PERMIT
Date ............................................................ 1~ ...... ~ ....
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 p art for any pukpose 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 alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances and regulations.
(Signatu~ of dppllcant, or nome, if o corporation)
(Address of opplicant)
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 aut~horized officer.
........
(Nome and title of corporate o~rt~cery
1. Location of land on 'qhich propose(c~ work will be done. Map ~o: ...c ........................................ bat lxlo: ....................
Street end Number ... ................ ,~..~ ....................................................................................................
/ Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
Existing use and occupancy ........... ~, .........................................................................................................................
Intended use and occupancy....!..~-?..~.'..'~-~.~, ..................................................................................................
3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ....................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....................
4. Estimated Cost.....(../...'.~...?...~.'~ .......................................... 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 ............................ Rear ............................ Depth ............................
Height ............................ Number of Stories .............................................................................................................
Dimensions of same structure with alterations or additions: Front ................................ Rear ................................
Depth .............................. Height .............................. Number of Stories ................................
' ' ' ..~.,.~.~ ................... Depth ~ /~
B. Dimensions of entire new construction: Front..:....l;...~' ................ Rear ............................
Height ..../...~.~i ................. Number of Stories ..... ! ......................
~ o De th 7 (~
9. Size of lot: Front .... /..fl .................. Rear ..../..~. .................... p "'/' ............ ~ .......... . z; ,
10. Date of Purchase'~.......,.~..., ................................ Name of Former Owne .... .~....,...~ ...................
11. Zone or use district in which premises are situated...:~.~,~..xm;.~~ .........................................................
\
12. Does proposed construction violate any zo~ning law, ordinance or regulation? ......) ..............................................
13. Name of Owner of premise .~...v~..~. ress .J..~.l.. . :~Phone NO.~.~..r..~..'.9...~..
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 YORK, ) S S
TY F . /~ o ~
COUN o ........................ ..,)'
....... ..~....~ n .............................. being duly sworn, deposes and says that he is the applicant
(Name of indivic[uol~ign~ng apl~!ication)
above named. He is the...g.'.~1...~.~;-~'...~......~.(./'....,~...~..~...~',~.'~.~.:.(~ ...... ...................................................................
~' (~o~t'ractor, 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 ap~licgtion filed t,~erewith.,~
Sworn to before me thisx/n ..~", ,t,~/ //.
Notary Pu ' , ................. ,;.~:: .............................. Y ~t~ti~:~
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Approved ........................................ 19 ........ Perm t No ..............................
Application No....~.~..~....~ .............
APPLICATION FOR BUILDING PERMIT
................................
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and suSmitted 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 wilJ 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 p art for any pubpose 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.
.(Si.c'(natui'e of applicant, or name, if a corporation)
(Address of op,plicant)
State whether ~ap.~lzicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ........ (., ..........................................................................................................................................
If applicant is a corporate, signatur~e of dj~ly authorized officer.
(Name and title o;[~'cor~ord~e-ott~Cer}
1.
Location of land on which proposed work will be done. Map No: .....~/...i.~....~......~...... ~..'~..'..~.-] ..... Lot No: 4 ...................
Street and Number ~,.,~Lt~q~J£¢'7~
Municipality
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 ......... /. .....................................................................................................................
3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ....................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....................
4. Estimated Cost ....... : ...................................................... t-ee ..........................................................................................
(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 ........ ~ ................... Rear ..J.~. ...................... Depth '~'
Height ../...~. ..................... Number of Stories .../. ........................
9. Size of lot: Front ...~...~...?..~. ............. Rear ........ /....~..(.:J .......... Depth ....../...~....6~.. ...........
~ of Former ~ ~.' ,~~
10. Date of Purchase .?i!.'.~...../.~.~..-.?. ......................... Name Owner w..:...; ..................
11. Zone or use district in which premises are sltuated...~['~ ...............................................................
12. Does proposed construction violate any zoning law, ordinance or regulation? .'.?...-?. ...................... .~ ..................
13. Name of Owner of premise~"a, rr~ ...M~..?..~~ddress~. I17 1/1~..¢~...~.~ ......... 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 YORK, ) S S.
COUNTY OF ............................ )
.. /~~//'f,,~,;,~z,,~ ./rY(~ //?~/'/-~/~ '/') be du s rn e ose an sth th s
...... ~ ........ ~....~:~..~...~: ........................... 'ng y wa , d p s. d say a e' the applicant
(Name of indiv~f~6in~application)
above named He is the ':~f~x~. ~?' 24m , ...... ............................................. .....................
' //~(G~htractor, 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 appUcation; 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.(iled therewith.
Sworn to before me this
.-~ f~ day of ..~
...................... . .
Not~ Public, ~..~ .................