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Home My WebLink About641-z~O~NL ~0. 4 TOWN O1=. SOUTHOLD BUILDING D~--PARTMENT TOWN CL'ERK'S OFFICE SOUTHOLD. N. CERTIFICATE OF OCCUPANCY TH~S CERTIFIES that the building located at s/~..~ew..~uf.~ol~..A.v.e...& ........ Street Map No. *~'* **~ e/s D~ Hole D~ve, Ma~ti~ck ....................... Block No .................. Lot No . 7. conforms substantially to the Application for Building Permit heretofore filed in this office dated .................~.p..~...i..~....~l~. ............ 19.~..?.... pursuant to which Building Permit No ....... dated .................. .~.j~..~..i..~...~..~ ........... 19....~...9, was issned, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is ssued is ................................... ............................................... This certificate is issued to ..(J.,...J~.,...l'l~,8~.ll.~....O.~q~. ......................................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector / FO~ NO. ~ 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.° 641, Z Date ................... A~'~,~,....~ .................... 19.~.~... Permission is hereby granted to: ...c.......~,::~....~.z.~ ........................................... ....... ~,~..~....~.~.d.~..~ ....................................... ........... .B~g~,d....~.,. ~: ................................... to ~l. ld..n~..cne..g~$~y..~,.~j.j j ~ ................................................................................................ at premises located at .~i~'..$~l.~.g~.~.~.~L.~..~.~p..)~..~..~.., ............................................................. pursuant to application dated ......................... .~,P.~.~.~.....~ .................... 19~.?....., and approved by the Building Inspector Fee $...~g..~[~.. ............. Building InspectorJ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examinea ........ .v..?~ .~...-- .................... ~ ........ Approved .................... :?. ................. 19 ........ Permit No ............................... (BuiJding Inspector) Application No. /~ H ] APPLICATION FOR BUILDING PERMIT ate ................ti°-",,.... ...................................... 1 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 adioining 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 Southotd, 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 hereir~ described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applidant, or name, if a corporation) ,,'? (A~dress of app, licant,) State whether applicant is owner, lessee, agent, architect, engineer/'general contractor, electrician, plumber or builder. (;. c'. ......... ........ 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: ............................................Lot No: .................... Street and Number .:.~.....~. .............. '~:....'/. ................. ~.....~ ......... .4~...~z.....i~..~..~. ....... ' ........... J....~.J......~.'..e.<. I ~'/r Municipality 2. State existing use and occupancy of pr. emises and intended use and occupancy of proposed construction: a. Existing use and occupanc ............................ .c?.,~.;-; ................ ~.~. ....................................................................... b. Intended use and occupancy .................... .~..J....z~..¥~..(.~..~b:..~;:'...~t ............................................................................ J t 3. Nature of work (check which applicable): New Building .................... Addi ion .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...........~ ......... 4. Estimated Cost.../..~.~ ............................................ Fee ....R..:..,.~ ........................................................................... (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 .............. ~..,,~...:.....~,..~:....-~,...c..~.~...~). ..................................................................... 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 ....J.....Z'~... ................ Depth ..,~....°...~..~..'?,~,..17... of Purchase ...~ ....... ./.'...~...?....2. ................ Name of Former Owner ~'~"~"~ 10. Date 11. Zone or use district in which premises are situated ............... ~.'.'. ........................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ....... ~ ..................................... ]3. Nome of Owner of premises...:; .......... ; ....................... Add ss ............................................ Phone NO.'. ................... Name of Arch~tect..~.' .......... ~ ..................................... Address ~ ................................. Phone NO ..................... Name of Contractor .......... ~...,~..x.- ................................ Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-bock 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~R~ ~ff) S S . ~....~..~ duly deposes and that he is the applicant being above na~m~e ~J ti;;i.~.i.?.~.~;.~~ ................................................................................................................. (Controctor, oOont, corporate officer, etc.) of said owner or owners, ~nd is dul~ outhorized to perform or h,ye performed the s~id work ond to make and th~s oppl~cot~on; thor oll stotements contained in this opp~ic~tion ~ro truo to the best of h~s knowledge ~nd belief; ond thor the work will be performed in the monner set forth in the opplicotion fllod therewlth. Sworn to befo~ me th~s ~ - ~,~ey ~]z~ ~ ~---- .......... ~.~ ......... u y ...............~ ........ ~ ~,..~ .... ~ m~r~ /z~;~ ~ ,, ~ ~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ...................... ' .................. 19 ........ Permit No ............................... 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 lo'arian 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 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, Ord.inances 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. (Signature of applicant, or name, if a corporation) (Address. of applicant) State whether applicant is owner, lessee, agent, architect, engineer,~ner ntrac[or, e]ectricld lumber or builder. ....................................... .~ ~ >z~.7.¢.v:~ X~:. ................................................................................................................................ Name of owner of premmes ...... ~w..,..~ ....... ~..~.~.....~.~ ...................................................................................... 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. ~ap~N% ............................................ Lot No: .................... Street and Number ..'..,.;.....:.....:...7.....'..~.¥..:...~ ................... · .................. 7:..,:,e...:. ............................................................. Municipality 2. State existing use and occupancy of pr. emises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..............,t...¢..~'.~m':.~'.'~;v.r~ ......... ~ ..................................................................................... b. Intended use and occupancy .................... :~ ~'"l ............................................................................ 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 ......d~r..~..--,~rt~.~ .......... 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 existin; 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 ................................ ~/ ~t ~ ~/ ~/~ ~ 8. Dimensions of entire ~ew construction: Front ............................Rear ............................ Depth Height ............................ Number of Stories ............................ 9. Size of lot: Front ........:......' ............. Xear ............................ uepth ............................ ~ ~ ]0. Dote of Purchase ....~...~ .......................................... Nome o~ ~,)~,mer uwner ................... '....: ................................ ]]. Zone or use district in which premises ~re situated ................................................................................................ ]2. Does proposed construction violate any zoning l~w, ordinance or regulation? .................................................... ~. ~, ,,~' '.~ ....... ]3. Name of Owner of premises ........................................ Address ............................................ Phone NO ..................... , ~- t2-,..~ .... .~:L.~.t...'7.t.:..F'.t .................. pko,~ NO ..................... N~me of Arch tecf ........................................................ Address N~, o~ Co~t~tor....~:fi.'...~.:..:}.:~ ...................... Aae~,~ ............................................ ~o,~ NO ..................... PLOT DIAGRAM Locate cle(:rly 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, (:nd show street names and indicate whether interior or corner lot. i ,? /,/'~t: 11/ STA'TE OF NEW~DP,,~ ,~/ ) SS COUNTY OF ................. .~..~.~~ ...................... be ng du-~ sworn, deposes and says that he s the applicant (Name of individual~.~ion) 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 app Jcation; that al 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 filed therewith. n to befo me this ...... ZZ . of .................. .... . ~.~ ...................... ...... JOB D,^w,.¥w~'-.~ SAMUEL pAUL, ARC T c.~c~o .,~ THE DATE 89-51, 164t~ LEET JAMAICA 3, NEW yORK P. IGhlT ~ EL E: V,L\, t0/'4 I I I EL~ ,/ATt Ot,~ SAMU, E[ PAUL, ARC-HITECT 89-$1 164th ST.REET J~MAICA 3, NEW YORIC THE SAMUEL PAUL, A~C sTovER ,o,,o.~,~~.,=~. 89-51 164th STREET JAMAICA ~, NEW YORK .................. 4" I ~ ~./~-4 ~- -~ ~ ..... ~ ~--4 h~ ~ ~~ ~, i '- I- ~ . ..., ,... , , + '--.' .'.. ,.. ,,,.~ j, ,,.~,....' ~__ ,,. t INSTEAD OF WOOD D H {{ 43 FIXED Jj ~z~ " X" '~ ~a~2 " x4~5>~' J ............... J 1~ ~ ~'~:x ~:m" ~o~,sJ ~ --r-------- CHEc.E~,.,,, -.....UEL PAUL, ARCHITECT THEWESTOVER l .:,'.;;',,,,, ,,,,,, JOe NO. 5Zlq ~'FE F:L.I, I~ ~ 2LO'' zto>~-p 5~' NT. : SAMUEL PAUL,' 'ARCHITECT THE WESTOVER _ ~-- A-SPH4LT r~ L:r=V&T, OA ,IFpLL,ow DIMENS bN$-DO NOT SCA[~E DRA~ING~. I; '1