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Home My WebLink About271-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the bu,ld,ng located at ..~rntth...D~... N~th ......................... Street Map No ~o~s~..~e~k .......... Block No .............................. , Lot No~j~C)]r.~f ..... ~ho~Ld conforms substantially to the Application for Building Permit heretofore filed in this off,ce dated ....................... ~:~..lO ........ 19. ~., pursuant to which Building Perm,t No ..... ~' 'P.'~i ........... , dated ............ ~J:X~t.~ ]-O ...... 19.~. , was issued, and conforms to all of the requirements of the applicable provisions of the Jaw The occupancy for which this certificate is issued is ............ ........................... ~..~ ~.~.~.'. gWELT~ING ................................................. This certificate is ~ssued to . J~etJ~e~L ;~ec~.~.t,o~.. · (o'~e~') ............................................. (owner, lessee or tenant) of the aforesaid budding Building Inspector N.o 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) 271 Z u[sston is hereby granted to: ~,~:'Z¢ .nev..~vel~.~a ................................................................................................. at premises located ot ........ JJ41~t,]~. ]~:J,~'e---llJO~J~,l~ ..... ~uO~,--9~-,-& ~'~f~L ....................... .............. ! ........................................ ~o s~ i. ~e~c.. ~t.t. es ......................................................... ~ ................................... ~o~]~o]-ds .~[.z. ........................................................ ! pursuont,to apphcat~on dated ........................ ~kJi~.:J~-J.. · ~LJ~ ............19..~'jj., and approved by the Budding ~nspector Fee $...~ Memorandum om · · · BUILDING iNSPECTORS OFFICE TO~iq OF soUTItOLD TOWN [4~LL, BOX 728, SOUT_HOLD, Iq Y. 1197 765-1802 / Memorandum from... BUILDING INSPECTORS OFFICE TOWN OF SOUTttOLD TOWN [u~C, LL, BOX 728, SOUTHOLD, N.Y. 1197 l 765-1802 U~a~h~ alter~on or ad~on to 'h~ su~s a ~o~a~ t~ n ~ ~e~ 7~9 ~ ~e N~Yo~ S~te Education ~w.. ~r~es ~ this su~m~ n~ ~aring the ~and ~u~*~" InkeE ~t ~ em~ss~ sealshall ~ ~ ~i~r~ ~ ~ e ~ G u~m~t ~ ~ t;r~ons in~ hem~ shaft ~n on~ ,' ' . ding InfO,on li~ hereon, and ~ the a~ianees of the ' ' '~n~ng inr~ion Guara~ees ~ cessations are n~' '- Ean~erabla to a~]onal I~bns or ~ue~ ow~m. ' ~r 8~YVtE · ~cAL E DEC. FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19 ........ Permit No ........................ ...................... . :.~?..~......~-~.~.'...~ ............................................... Disapproved .............................. a/c ~.ii.....i ........ ~. ........~-~..,::-:~:~"i.i'i~.~.~:.:,.~,.~.Z~J~/.ii.. (Building Inspector) 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 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 a Building Permit pursuant to the Building Zone Ordinance of the Town of So~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./,~ ~ (Sigffature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome ofownerof premises~......~ .~ .................................................................. If applicant is a corporate, signgture of duly authorized officer. r) 1. Location of t and on w~ _propo, se.d ~wilJ be don e..~ap~N~...j ............ ~.~.~,,.~_~ No: ~...'~:...~.,~..~/ Street and Number ~~.....~.~..'~.~: ............. ~.....~...~. ............ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... L~..~...~ ........................................................................................... b. Intended use and occupancy ......... .~.~ ................................................................................ 3. Nature of work (check which applicable): New Building ....... ~,~...........Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... Estimated Cost......?..~..4...~..~.~ ....'~.. ............................ 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, Jf 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 .....,~.~.. .............. Height ............................ Number of Stories ......... /. ................ 9. Size of lot: Front .......... ~..~.-n. ........ Rear ....... .~..-.l~.. ........... Depth ..../.,.$:.~. ............. 10. Date of Purchase ..,~r+~,......~$.-~. ........................... Name of Former Owner .~o.~'.-.-.4~..r.~.,~.~...~.~.,C..~.,~,~,. 11. Zone or use district in which premises are situated ........ Z"~,~.~.;~.~..~z~'~,.~. ...................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ..... ~.,~ ........................................ 13. Name of Owner of premises.,~l/~../~,~.f~.~ ......... Address ............................................ Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor. F,~/-.~'./,~.~.~.~....~...~.~....Address ...,~.~.~,.-r.~.~/,~ ........... Phor~ NO. ~,.~.L-.°...~.~..~.~ 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. ~,,~ ~ 70' ' .................. ,.....~~.....~;1:~ ......... being duly sworn, deposes end says that he is the applicant (Name of individual signing application) above named. He ~s the ............................................ ~..... ....... z. ..................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform Car have performed the said work and to make and file this application; that all statements contained in thi~p~tion are true to the ~st of his knowl~ge and beJief; and that the work will be performed in the ~nner se~n ~e application filed therewith.,-~ ./ - / FO~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. App oved ........................................ 19 ........ Pe mt No .................... Disapproved a/c .......... ~.~.. ::: ............................. · ............................................ ......... ....... .......... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. 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 drown 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 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with afl applicable laws, ordinances and regulations../,, (Sig~l~ture of applicant, or name, if a corporation) (Address of a~')' .............................. 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, signgture of duly authorized officer. · '"'"' '(Name dnd tJtl~f corporate officer) 1. Location of land on wh~ propo, sed ,~k will b~ done. Map N .~..~...~..~...~......~...~...~....~'....~....'~...~....?~..?Lot No: Street and Number~~-4~t~.....~ ........ !..~..-~.~ ............. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use end 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......?r../..~...~....mg....]]. ............................ 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 .......'~.....*~.. .............. Height ............................ Number of Stories ......... /. ................ 9. Size of lot: Front ..........~..~..~.. ....... Rear ....... ~....,~.. ........... Depth ....../~.~-.P. ............. 10. Date of Purchase ..~.,~,~,.....4(~..~?~. ........................... Name of Former Owner ...~..:...~'..~../R'..~....~..~..~..¥..P......'~...~¢I...c.. 11. Zone or use district in which premises are situated ......... ./~..~-R(~.~...x-~...~.~.?..~..: .................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ..... ..~....o. ........................................ 13. Name of Owner of premises..~..~...../~..~.~.~.~..~..~.~ ......... Address .....'J ...................................... Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor.~.,~.:--~'~'~.~ZA...~......~...~..~...~/.~.....Address ....~...c~...'~..'~..~'-'~.~..~:....~.. ........... Phone NO. ~T..s.Q..].~..~.'~ 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. ~," / t STATE OF NEW/,YORK,_ .: ) 5 5 --: ~-~/01]~4 J) ~' I'~, .... j~ o f~ I~ COUN~ O ~~.~ ' (Name of individual signing ~l~cation~. 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 all statements contained in this application are true to the ~st of his knowledge and belief; and that the work will be performed in the ~nner sera--he application ~gd therewith.¢ ..,; /' Sworn tobefore methis ~i~o~ ~ ~ ~- -- '~ /'1~ ~ ........................ o, .......... ........................ ........... Nota~ Public, ..~...~~....X~...~nty 4~axh Po -'~ ~ /~./ /~-~- ~-z-/~ TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DISTRICT SUB. LOT Lo~, ,J. O~-o~__r~__~.o~-~ _ _ ~ --~- FO~ER OWNER ~,~-~.~ N E ACR ~' , ~Y~(Z( ~ ~S W ~PE OF BUILDING RES. LAND SEAS. IMP. AGE NEW Farm Tillable 1 Tillable 2 Tillable 3 Woadland VL. TOTAL DATE REMARKS BUILDING CONDITION NORMAL Acre BELOW Value Per Acre Swampland Brushland House Plot Tota I ABOVE Value 'FRONTAGE ON WATER FRONTAGE ON ROAD BULKHEAD DOCK M. Bldg. Extension Extension Extenslon Breezeway Garage O.B. Foundation ~ ~, Bath / Basement /~'o ~ z. Floors 0 ~/k" · Ext. Walls Interior Finish Fire Place Patio .... ~ _ Heat Porch Roof Type Porch ! Rooms ]st Floor Rooms 2nd Floor I Dormer ~ _0__. Driveway