HomeMy WebLinkAbout537-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUFANCY
No....~..~.?.~ ........... Date ....................... .AUi~tZ~,....8 ................. 1959 ....
THIS CERTIFIES that the building located at~J/.~....~.ipe~..}~JeOk..~gft~, ............................ Stree~t
Map No....~ ............... Black No...~....~.. ................ Lot No..~X ..........G~:ee~tgQ~.~,....J~.,:[.~ ..................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.......................... .~.P..~.........~. ............... , 19..~..8...., pursuant to which Building Permit No ....... &..~.~ ...........
doted De~etlber ~ ~8 ~
...................................................... , 19 ........ , was 'ssued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is ..............
Priw. te one family d~zetling
This certificate is issued to ..[~XO,..~.~B~.8.-.~. ........ (....~...~..~..~.). ..................................................................
(owner, lessee or tenant)
of the aforesaid building.
Building Inspector /'
FOI~M NO. ~
TOWN OF SOUTHOLD
BUILDING DEPA~,TMENT
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? 537 Z
December 3 19..~.
Date
Permission is hereby granted to:
John ~u~.~.....&/.C.....P~ul....Eckar.d t. .....................
............. fi Z'.%e. ?.~.o..~.t..~......~f..: .~ ... .............................
to ........ B~A~:l..ne~..d~e~].lng .........................................................................................................
at premises located at /~ ~ ~p,,~. ~e~ ~O~d .....................
...}~'? .... ~.. ,~.~.. ¢~ ... · ................................
pursuant to application dated ........................ .De.¢~:¢her.....~ ........... 19..~.~., and approved by the
Building Inspector
Fee $.~0,.QO. ..........
Building Inspector (,3
TOWN OF SOUTHOLD
BUILD~NG DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined .............. ~ .~....~z~......~..~..... 19....~..' .~
Approved ........................................ 19 ........ Permit No. ~ ~' :~ 7
Application No ..... ~...~....7.. ..........
Disapproved a/c ..............................................................................................
................ .........................
" ~Building Insp~ector) [
APPLICATION FOR BUILDING PERMIT
Date....... z~.~.: .......... ~ ........................... 19.?.~.......
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 coyered 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 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 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. ·
. ..~.~, .... . .... ; ................. : ...........
~llcant, or na~e, If a.corporatlon)
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)
,,,Location of land on whicb_groposed work will be do~e. Map No: ...~............~'~'~.~'~i .................... ~.. Lot No: ......~. .............
1.
Street and Number .... ~i~'i "'"~¢':~ ..................
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
........... ..... ........ ........ ./ ........ .................................................... : .....
b.,, Intended use and occupancy..~....~...~.~ ........................................................
/
3. Nature of work (check which applicable): New Building ...... ~(_.........Addition .................... Alteration ....................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....................
4. Estimated ~ost .......... '.~..v~ ....................................................................................................................................
(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.....J~.~.~..~.~ .......... Rear .~ ~ r~., ~ K~ ~
............................ Depth ............................
Height .....~.~ ................. Number of Stories ....Z~. .............. --
]]. Zono or uso district in which premisos ore sffuoted .................................................................................................
]2. Does proposed construction/~ ~~ ~ ~ ~~~_.._.~..~~lote ony xonia~ law, ordinonc~or re~ul~tion¢ ................ ~ .............................
13 ~(~ Name of Owner of premise~<~X~~Addross~.~~~N~.~:~
Name of Architect ........................................................ Address ............................................ Phone NO .....................
Name of Controctor..~....~:~Tk~. ........... Address 4~.c~ ............. ~hone 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"~~ YORK, ,, ) S S
COUNTY OFrJ'"~F?)&.~'.Z~r~x" ' "-2.
.
(Name of~in~idual signing applicatJo~
above named. He is the ......................................... ~~.~..Z~ .........................................................................
(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 in this application are true to the best of his knowledge and belief;
and that the work will be performed in the manner, set f~ in the applicat]o~ file~ therewith. //
Notary PuN,c, ..~--..~~ .......
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined' ............. 't~.' ..q~...-~.... 19. ~..~.
Approved ........................................ t9 ........ Permit No.
Disapproved ale ..............................................................................................
....................... .........................
Application No....?....~...~. ...........
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 Jot 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 k, ept 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 a Iterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances and regulations.
(Signature of a#p'licant, or nome, if a corporation)
(Address of applicant) "'
State whether 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)
Location of land on which propose~ work will be done. Map No:/ ....... ~.M..T.' .................... ,( ....... Lot No: .........~'~. ..........
Street and Numbe .~.-..~..~.(~...~~....~~.~'/'/~'~ ' ~ ~ ~ ' "'~ ......................
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
o. ........... ....................__"""1'"" ........_'""/' ......... ..................................................
3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ....................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....................
t f o
4. Estimated Cos ............................................................. ~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 .............................................................................................................................................
~5. If business, commercial or mixed occupancy, specify nature and extant 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...;/.~.~'..i.'. ............. Rear .,~.~.....~.. ................ Depth
Height ...... /.~. ................. Number of Stories ..... .¢...~-.... ..............
9.Size of Iot:/'Front ....~'..~,..~...N'...,~/, 7~-' Rear ....~..&..~..,~...'... Depth ../.....~.....'~'...'.~:~'T~.
I0. Date of Purchase ....~r-~-...~ ................................... Name of Former Owner ..................
11. Zone or use district in which premises are situated ............................................................................................ : ....
12. Does proposed construction v,i~,late any zonlna law, ordinonc~ or rffgulatioQ? ............. /...~ ................ ~ ...............
13. Name of Owner of premise~,,~mc......-~,,....~.~~Addres~,~.~-~ ............... ~-~.',~.....P~one NO,'~CT.(...-,c.., .....
Name of Architect ........................................................ Address ............................................ Phone NO .....................
Name of Contractor...?.~l~ ........... ~,~..fZ.~..~:.. ......... Address .~-v~-~ .~.... .............. Phone NO.~..TT...~.~.~....
PLOT DIAGRAM
Locate clearly and distinctly oil 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~IYORK~, ,, ) S S
COUNW
.............................. ,~.~: ..................................... .r; ........ being duly sworn, deposes .and says that he is the applicant
(Name ' ~dividual signing application)
(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 t~,_ap~k~ation are true to the best of his knowledge and belief;
and that the work will be performed n the manner'~'~f~L'ia~o~bp application~ filed,~therewith.
Notaq
Public,
/