HomeMy WebLinkAbout319-zFOR!Yf 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 W~'~.....'~rLj[~'~.. ~,,~rt$ ............. Street
Map No ~T,...0$.t~l~.t~l~ .......... Block No ............................, Lot Nop.2t ..... ~t~.'l~j .....
conforms substant,ally to the Apphcation for Building Perm,t heretofore filed ,n th,s office dated
............................. ~t~...P.~ .......... 19 .~., pursuant to which Building Perm,t No ..... Z...~I.~ ........... ,
dated .................... l/~,~..~.]. .......... 19..~'~:S.., was issued, and conforms to all of the requirements
of the applicable prowsions of the law The occupancy for which this certificate ,s issued is ...........
Th,s cert,flcate ,s ,$sued to ~a... ~(e~..~t. ....... (~..O~r~e~.) .......................................................
(owner, lessee or tenant)
of the aforesa,d bu,ld~ng
FOP~ ~0. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS F~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 319' Z
Permission is hereby 9ranted to:
Harold Kevlar- &..~ens.- &/C- d~ma-~ernel, ........
............. 2 er'l dml ........................................
to ..... Ih~3.~l.. Ile,,~. d,~e~[l .~ ~g ................................................................................................
et premises located at ...... ~t'~ .-.~OWl~"~'~']~Ol'*'~t~tll~ .......................................................
............. ~- ............. Lot. ~..2~t....l~o~ln~ers"{~s~a~es'"llt 8~k* .....................................................
.................................................. ~mthot~l ¥ ..... N;Y~ .................. '~ ..............................................
pursuant'to applicatmn dated ............................... l/~..~ ................ 19.g~.., and approved by the
Budding Inspector
Fee $'~'0
Building Inspector
/~-~ ~ ~b--?-/ TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET VILLAGE DISTRICT SUB. LOT/~/~//~
~ ~ ..... ~PEOF BUILDING /
LAND
SEAS. ¢ VL.
I M P. TOTAL
Tillable 1
Tillable 2
Tillable 3
Woodland
Swampland
Brushland
Total
~f.D~G CO
FARM
DATE
COMM. J~ND. JCB. J M~SC.
Est. Mkt. Value
REMARKS 4: ~ ,-- t
,
NEW NORMAL BELOW ABOVE FRONTAGE ON WATER
Farm Acre Value Per Acre Value FRONTAGE ON ROAD
BULKHEAD
DOCK
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ..................... 19 ........
............. ;i ......................
Application No .............................
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ipk 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 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 applicant, or name, if a corporation)
De-
(Address of applicant)
State whett~er applicant is owner, lessee, agent, architect, engineer, general contrRctor, electrician, plumber or builder.
................................................................. .............. .................................................
Name of owner of premises ....... .V....~....~....~... ....... ~ ............... ~ .......................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
1. Location of land on which proposed work will be done. Map No: ?.~.~...~......o?...~.. ...... Lot No: ~...~
Street and Numb ....... ~ .............................. ...i .................. ; .......... :. ......... ..; .........................................................
Municipolity
2. Stote existing use and occupancy of premises and intended Use and occupancy of proposed construction:
o. Existing use and occupancy ............. .~......~..:L.~.:~.'C.~ ......................................................... : ..........................
b. Intended use and occupancy ....................... ~ ....................................................................
property lines. Give street and block numbers or description according to dee
whether interior or corner lot.
3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ....................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....................
4. Estimated Cost..~.~..~....~....~...~.*. ......................... Fee ....~..g...~. .........................................................................
(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 ............ ~....Y~.. ..... Depth .... ~....Y'.. ...............
Height ............................ Number of Stories ...~ ..........
9. Size of lot: Front ...... ,~.~ ........ x:: .~,Rear ......... :~;...?.. ........... Depth ..~../...'~/...~..'/...!..~' -._._..~. -~
10. Date of Purchase ............./ ~'.......~. ................................ "~ Name,;L. ~), ~ . ~'~'~t'°f Former Owner /~.."7'~ /~- ,," 'k_~-,~-~--,, ...............................................
11. Zone or use district in which premises are situated ....... Z..~......?.~.'..~'~'''
12. Does proposed construction violate any zoning law, ordinance or regulation? ...................................... ~~ .~,;..
Name of Owner of premises.~..~....'..~...~...~Z~..Address .~..~...~....~...~-'~~;~'O
3
Name
of
Architect'""~'~/"~""~/,I J 1~'_ II,J). ~] ~ ....................... Address .............. O i~P,i ............................. Phone NO .....................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from
and show street names and indicate
STATE OF ND~ Y,g~l(,/, ) S S
COUNTY OF .~....~T.....~) '
(Name of J~dividual siej~ing application)
above named. He ~s 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,t_his application are true to the best of his knowledge and belief;
and that the work will be performed in the%~..,~.j~, et.~h in the applicatiol3 fi/? therJiwi~h./
Sworn to before me this ~i~ ~,
................ o, ....... ..........
~ ~ .. ~ ~ ~ ~. I '~ ~e~h ~, ,