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HomeMy WebLinkAbout657-zFO~ NO. 4 TOWN OF SOUTHOILD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z 60.3. Date June 7 19 '60 THIS CERTIFIES that the building located at _S,h.~4L~.~.~.z:~..Z~,tl.~.~...[']ft~.tL.Z~,~L.. Street Map No. ........................ *** Block No ......................... *** Lot No ................................................................... *** conforms substantially to the Application for Building Permit heretofore filed in this office dated AprJ,1 30 19~.?...., pursuant to which Building Permit No. Z 65'? dated ........................ ..~p..z:~,.-'k...$.Q .......... 19...~.~.., was issued, and conforms to ell of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ................ ...................................................... ~ ~.:~ .. o~s.. ~,~ ~....~,~,~z.~ ........................................... This certificate is issued to ......~..e..~...~..J...?...?,.,o.~..~.~..~!,...,o,~,.,~,,e,,~ ........................................................... (owne,r, lessee or tenant) of the aforesaid building. Building Inspector FO~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Iq. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 657 z Date ................................ Permission is hereby granted to: e ss.t~ .~.ot~n~k~ ............................................... .......... ..s.~!~.~r~..~.~.~ ........................................... ...................... l~a~..~ri~n,....~ ....................... to .... ~v.e.a..d~ell lng..~o.. ~hi s.. loca.~J.~ ...................................................................................... at premises located at .E/.~....Sh:tp~tard..T~a ....................................................................................... ................................................... ~ z.¢.. ~;Lo~z,.... ~ J .......................................................................... pursuant to application dated ......................... A~:~J,]....30 ..................... 19~9...., and approved by the Building Inspector Fee $10.,00 .............. FOI~M NO. ~ TOWN 0[: SOUTHOLD BUILDING DEPART/vlENT TOWN CLERK'S OFFICE SOLITHOLD, N. Y. NOTICE OF DISAPPROVAL PLEASE TAKE NOTICE that your application dated ............... ~..c~...~.. 19...,~...'~..~ for permit to construct ....~ ........... at the premises located at .~..~ Map ........................................ Block ....... ~ .................. ~~Z..T~-~ ............ ~ ................... is .~ ~ . ~ . · .............,~ -- -~~;~~...~~.~~ ......................... ~. ...... .z ..................... Building Inspector ~_/ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×ammed ............. ~! .......................... 19 ........ Approved ........................................ 9...'~.~.Perm t No ............................... Disapproved a/c ................................... ~..' ........................................................ ......... ~"~'~- .~?:~.~.~ 'A ~'~ ' ~. ~:.~Y ....... ~..'..~ ............................. Application No ..... ~?...~.~. / ............. APPLICATION FOR BUILDING PERMIT Date,~ F ,~, ,~.L.., ~., .~. .............................. '. 19~...,(1 .... 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 constroction 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 o corporation) ~' ~/ "(Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 't~Z..~. ' ~.' ..... . ......................... Name of owner of prem scs ....... If applicant is a corporat.e, signature of duly authorized officer. · " iName and title of corporate officer) 1. Location of [and on which proposed work will be done. Mo~ No: ............................................ Lot No: .................... Street and Number ~ -.~' ' 'q~'~"~' "~'~ '~'"~?'("['": .................................................. .... '""" .............. '""'"' ' '"Municipality ' 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... .~.,, .~.., .C~:..~v.O]~.......~. ~.. ~..~.. ....................................................................... ', ............... b. Intended use and occupancy......~..~..~ ........... J'~ ......, ' '~ .... ~: ....... '~'"¢'""~' ............ 3. Nature of work (check which applicable}: New Budding .................... Addition .................... Alteration .................... Repair .................... Removal ..................... Demolition .................... Other Work (Describe) 4. Estimated ............... ....................... Fee ~....~'..~. ................................................... (to be paid on filing this applica~i~i ................. 5. If dwelling, number of dwelling units....~..¢~....~...~. ~. ........ Number of dwelling units on each f oar ..~..~,dd ~- If garage number of cars .4(¢.'~--' ...... ~]~ ....... 6. if business, commercial or mixed occupancy, specify nature and extent of each type of use......~..f~.4...~.. .............. 7. Dimensions of existing structures, if any: Front......~..~. ...............Rear .~ ......... Depth Height .......~ ................. Number of ....................................................................... .¢. ............... 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 ............................ use dstrct n whch premses are stuated ~ I1. Zone or . .~ ........................................................................ 12. Does proposed construction violate any zon ng aw ord nonce or regu at on> Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor .................................................... Address ............................................ 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 shaw slreet names and indicate whether interior or corner lot. STATE OF NE~f_f¥~( ) S S, COUNTY OF .....~'~..........~' ~Z.*: .......... ) ,Tem;J,e Vol.:L~ak:t ................................................................................................. being duly sworn, deposes and'says thaf'~he is the applicant (Name of individual signing application) ts . above name~ .............. ~ ................................ (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 best of his knowledge and belief; and that the Work will be performed in the manner set forth in the applicqtlon filed therewith. Sworn tobefore me this cORNELIA C KEOGH 30¢ r'u uc, stae u% ff ......... ~ ......... qy //.....~ ....... ~,l~......a,. 29;~ ~19 ............ ~~%~~--~'~q'¢]~qua,fied t,, s~,,~'¢~ ~ (Signature of applicant) , , FORM NO. 1 TOWN OF $0UI'HOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. xammea ............ ~ ......................... .7 ....... Disdpproved d/c .............................................................................................. ') *'""*'-- -----..--....,..,...-*u-r-- (Building .............. I nspector~' ......................... '"*"*'" 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 ~ocation of lot and of buildings on premises~ relationship to adjoining premises or public streets or areas, and giving o detailed description of layout of property must be drawn on the diagram which is port 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 o 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 whale 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 Deportment for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buiIdings, additions or a~terotions, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable lows, ordinances and regulations. ...... ........... ................... ~/(Signature of applicant, or name, if a corporation) ~' ~ (Address or appdcant) State whether applicant is owner, [essee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......... ........................................ Nome of owner of premises......--;..~.-~.~.-/.,~ ...... ~..~.."~..J.. '~'~'~"/' ..................................................................................... If applicant is a corporate, signature of duty authorized officer. .... ('Name and title of corporate ~f:f'iceri 1. Location of land on which proposed work wi[[ be done. Map No: ............................................ Lot No: .................... ' ~ ' ~ ' Street and Number :~.~.. ! .~. ~ ,,..~.~ .f:~. ~...,~..~z.,,~ ............. ' Mun~'~'~'~"~'c pa ty ............................................................... 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: a. Existing use and occupancy......~.~'~,~'~''''~5~''~ .......................................................................................... b. Intended use and occupancy..[~L~.~Z'~,...~..~..~.~../.~(.~...~./~.~..l~ZC'~ ..................................... 3. Nature of work (check which applicable): New Building .................... Addition .................... AIteratlon .................... · Repair .................... Removal .................... Demolition .................... OtherWodc (Describe) ~].&.~/j£~.~/?~,,/ok:~c~r/ 4, EstiMated Cost~.~...~T~.0.,.~.0. ......................................... Fee ....~..Z.rJ,:..~. ..................................................................... (to be paid on filing this application) If garage, number of cars ...... ~.A~ ........................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. J.~,0.~J.~. ................. 7. Dimensions of existing structures, if any: Front ....... ,o~...~...! .......... Rear ..... ~,..~.....! ........... Depth ....,/~..! ................ Height ..... .................. Numbe Stor es .......... /. ............ 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 ...... ~..CL.~ ........Rear ...... ~..~....~ ...... Depth .....]"~'~'".~1~- ...... 10. Date of Purchase ?...~.¢~¢.~/~.X....~.?../..~.o .~.... Name of Former Owner ..~.b,~. ~ 11. Zone or use district in which premises are situoted.~.~/~.!,¢.Ij..L.T...(.J./~ ............................................................... 12, Does proposed construction violate any zoning law, ordinance ar regulation? .... ~..~;~ 13. Name of Owner of premises..~'.~'.5.~.~/,~.....].f¢..L..~./~.~l....Address ~.~fi.'~.....~f(I/~.,/..~,/L]. ......... Phone NO. Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor .................................................... Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oll 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 ~Q,I~J¢, ) COUNTY OF :.S...U..~..?..0...~..~.. ......... ) S S. .......................... : ............... .J..te.~,t,l~....V.o.'l J,~skJ. ................. being duly sworn, deposes and says that~he is the applicant (Name of individual signing application) above nomed~ k~,,~dd~,,,..,.~ho,.;:J-,~,...J:i~...OY/~.e,~. ................................................................................................................ (Contractor, agent, corlborate officer, etc.) of said owner or owners, and is duly aathorized to perform or have performed the said work and to make and file this application; that oil 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. Sworn to before me this CORNELIA C. KEOGH JOth NX3~,,~p~iBL,C, St*re of New York .......................... , ...... :: ','L 'i:: ,.:..' ' , ............ . app~cant)