The URL can be used to link to this page

Home My WebLink About632-zFORM NO. 4 'lawn OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, H. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at...~//8....0~k..Ave ......................................... Street Map No.G.~g~.e..~3'..,~O.~ B~ock No ......................... Lot No.]0~..]DR~..~ID3.~:...~,¢)~o~I.~..~1.,~r., ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................ A~.$,~L....~b2..., 19~cj ..... pursuant to which Building P'ermit No, ,,,~,,£~32 dated .............................. ~.t~L....1~ ....... , 19~...., was issued, and conforms to all of the requirements of the applicable provisions of the law, The occupancy for which this certificate is issued is .............. ...... · .~J,v~t~e ..o~e ..£~,Z~...d~e,~.l:~g ................................................................................................... This certfficote is issued to ..... ]~c~:~,;cd**,~d~a,~ ......................... ~o~,~e~ ............................................. (owner, lessee or tenont) of the aforesaid building. FOP. M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BU~LDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 632 Z Date .......................... Ap~"~'~.' ' ' · '~'~ .............. 1~9 ..... Permission is hereby granted to: Riel.feb.. ~,®6~e~ ................................................... ................. Oak..* .Ave ............................................... ............................... .~out, ho;l~] ~....N~,Y,,. .................. to ~t.3.~ ..~n..a~di%iou..on..an .. e~.i~¢~rig. · d~re-~:l. ~g ......................................................................... at premises located at ..... ~O.~O../~'..30~k~..~.~..~.O.~....G~ek.~y ......................................................... ........................................................... ~z~t~o3~.r ...~ ,~. ........................................................................ pursuant to application dated ....... A~.~...3~ ...................................... 19~ .....and approved by the Building Inspector Fee $ -.~o0~ ............... '- Building Inspector J FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL FiFe No ....... ~ ...6. 3..2. ................................................ Date .................................. ~..~.~....2. 3 .......... 19...,,~.~. To ......... Rlch~.~.d...~Le.dd.e.n ............................... .......... 0ak..~v. ez~ue. ........................................ .......... ~o.u~ko. ld ............................................. PLEASE TAKE NOTICE that your application dated ................................. /~,i~7.,....],~.... 19.~.~... for permit to construct ..add~..%io~ ..................... at the premises located at ..N/.S..~ak..A~.e.,., ...... Southotd, N.Y. ...................................................................... Street Map .......~r~ o.~e...Be~y ........... Block ............................................ to~ .0.~.,... ~...0..2..,... 3..0. 3. ............... is ~]~-~:~c~x~xdisapproved on the following groun:ds ~..e.~...f~C1,.:J..~;~.o.T~...~.~.~.e..~....~.Q~.... ............. ~.e.~.to...s.t~.eat~.than..~exis~ting~b~i~ding~.&ine~.~.&e~i~g~`in~f~f~c lent ............. f. mon. t...ya.z~.. ~e]pth. r..A~.tie.te....~.I I.~... ~ o.,.....~0~ ..................................................... /s/ Howard M. Terry Building Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No. ~ ~ ~ .... Disapproved a/c ......... 9">"f? .................. :q .......... '~"~' ....................................... .... p~.,. .......... i~'6¥1~'i'~i~"~l n s p ctor) ................................. APPLICATION FOR BUILDING PERMIT Date ........................... 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 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 issuanc.e 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· .................... (Signature of applicant, or name, if a corporation) (Ad, s~fess of applicant) /- State whethe~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) p No: ..... ../.../...Z~..'. .................... Lot No:~.(.//...~.~.~..~.9~ 1. Location of land on which~J?roposedr~r~/~,/ /g'f'~//~ /~'/~~w°rk will be done. Ma., - '~'~'"'/'"-'/.~ .~.,~ Street and Number Municipality/ / 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: a. Existing use ond occupancy' ...........r.~C:.-~2 _/ ~.~/,,~'~ '~.'."~ ~.. , ...................................................................................... b. Intended use and occupancy ....... f~.///~../.~.,-fPa~.~.~ ......................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition ...~........Alteration .................... Repair .................... Removal .................... Dem~ition .................... Other Work (Describe) .................... 4. Estimated Cost .......... ~...~C....~....~. ................................ 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, spec ify nature and extent of eac/h typO'of use ...... ........................ · 7. Dimensions of existing structures, if any: Front...s~..-~ .................Rear .....~.:~... .............. Depth ..... .~...~... .............. / Height ......~ ................ Number of Stories ........ .~'-4~ ............................................................................. /' Dimensions of same structure with alterations or additions: Front ....... ~..~.. ............. Rear ....~,~ .................... Depth ..... ~...~..../.~...~...../Height ..... ~ ................... Number of Stories ........ / 8. Dimensions of entire new construction: Front ......... ~..~... ............ Rear ...~7..e~....- ............. Depth ......~..~... ............. Height ......... ~... ............. Number of Stories ..... C~T..~ .... 9. Size of lot: Front ........ ~....~. ............. Rear .....~..~ ................ Depth .....~..:...~.. ............ 10. Date of Pun::hase .... ~. ~...--..:,~.~.~..~.~t~e of Former O~ner . .. ! ]. Zone or use district in which premiss are situated ........................................................................................... 12. Do~s prOl:~d construction ¥~olqte or,t_ zo~i~ law, .ordinance or r~ulgtion? ............. ..~....0. ................................. ]3. Name of Owner of Name of Architect ............... .~ .................................... ;.Add,ss .......................................... Phone NO Name of Contrm:tor......~..~...~.~.~.~.....^~dr--s .~.~.~ .~.'../~.t...~ ~iO. ~.~...T..~'...~.~...~. PLOT DIAGF~M Locate clearly and distinctly all buildi~s, w~r ex~-orp~, ~.i~ica~ll~t~ck dlmenei~s f~ property lines. Give street and block numbe~ or d~rlption acco~i~ to deed and ~ street ~s a~ indicate W~ther interior or co~ mr lot. Pfc STATE OF NEW,~YC~Ki/,, ) S S COUNTY OF ...~ ...... ) ' beln duty sworn, deposes and says that he is'the applicant (Name of individua signing application)- · above named. He is the .................................. ~ ............................................................................................... (Contractor, agent, corporate office~; of said owner or owners, and is duly authorized to perform or have performed the said w0.d¢ and to ~ and file this aPPlication; t~at all statements contained in thil~gl~llcatlort.am ¢me-.t~.the best of~f~':~~nd.~belief; and that the work will be performed in the mar~ll~l~Ld~Jl~the application filed therewith. Sworn to before me this '~l~lt~.~~.~-/~ . ~ . ~. 41otory Public, ~..~~,..~:.......'Z~unty ' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined rT , ~ ~ 19 ~, Approved ........................................ 19 ...... Permit No. ~...~...~.,b.~. ....... Application No ........~...~.....~.~i ......... APPLICATION FOR BUILDING PERMIT Date ~.~.~/~ 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 odioining 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 Certificat~e of Occuponcy 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 appHcaNe laws, ordinances and regulations. (Signature of applicant, or name, if o corporation) (~s of applicant) State whet~r applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......... ................................................................................................................................................................ Name of owner of premises ........... ........... r ................................ If applicant is a corporafe, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ......~..~.......7....~.. .................... Lot Street and Number ...~, ..~/~.......k~..~./,~.~../.......~../~.'~,~.,..~.~~..../....~.r-~ ..~ ....~..~.~¢.~.... Municil~'f~l'ty 2.State existing use and occupancy of pr,~mises and intended use and accupancy of proposed constructian: a. Ex,sling use and occupancy .......... ~, ~ ..~.-~. 4~....m~.. ......................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition .....~Iteration .................... Repair ........ : ........... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Eost ...........~....7..~.....~. .................................. 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 ........... ~.,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 ...... .¥~.-r~r..../. ......... Depth ....... .~'.ac~......./. ........ Height ..... .~... ................. Number of Stories ........................................................................................ , , ...... ............ Dimensions of some structure with o~ter.etJons or additions: Front ...... .-~...'.,~.. ................. Rear I t , j Depth . .~.C~....-..~....,~...J.. ...... Height ........ .~..'. ................ Number of Stories ..... .c~.. ,~ .~.~.. ...... 8. Dimensions of entire new construction: Front ....... .~..~.~.. ............. Rear ......~.. .................... Depth .....'.~....~....~ ........... Height ........ ~ .............Number of Stories ..,~'~k ,~.d. ...... 9. Size of lot: Front ............................ Rear ....... ~..~.. .............. Depth ......~.....~..¢~'.i ........... 10. Date of Purchase ...-- '-" .~¢~.~/'.~/,~....~...~..~....~..~..~Name of Former Owner / 11. Zone or use district in which premises are situated ..................... iL~ ........................................................................ 12. Does proposed construction violate any Toeing law, ordinance or regulation? ................. ..j~....O. ............................ 13. Name of Owner of premises/,~ .,~r..~/~.ff. ddress ..... Phone NO...O'.....'Z...~...O..~. Name of Architect .................................................... :..Address ............................................ ,,~ ~,L/ __ Phone NO ..................... Name of Contractor....~..; ./~....~Z?,/~.~-~/,~¥.....Address ..(~K~.~-~.~/F~..../'~.~.f~...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 cor mr lot. C" & A v o' STATE OF NEW~YO.R,K~//_~ ) S S COUNTY OF ...~-~5..'~.~..'.~Zf ........ ) ' ~ c~,~ ~ r~ ~ ~ ben duly sworn, deposes and says that he is the applicant (Name of individual signing application) ~bove n~med. He is the ............................. ~ ............................................................................................................................. (Contractor, q~ent, co~porate officer, etc.) o~ s~id owner or owners, ~nd is duly authorized to perform or h~w performed tho s~id work ~nd to m~ke ~nd file this ap)lication; that aJJ statements contained in this a~pJication are true to the best of his knowledge and belief; and that the work will be performed Jn the mann~ ~. the application filed therewith. Sworn to before me th~s , ~1~ ~ et~te of ,,