HomeMy WebLinkAbout710-zTOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S aFl:lICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No ...... ~687 ......... Date .................................... ~'~:me""'~" 19'60'
THIS CERTIFIES that the buJJdJng located at ...... ~."l'~,"~'~)~'"~.'~/~i ............................ Street
Map No. "l~rB'i'Ha~ld"' Block No .......... ~ .......... Lot No.:z:X ............ a~t:~thog~¥'""if~'Y'~ ......... ~..
conforms substantially to the Application for Building Permit heretofore filed in this office dated
........................ ~VZrt~g'""8 ............... , 19..~r¢)., pursuant to which Building Permit No ...... ~'"~'"10 .........
dated ........................ ~rte.....8 ............. 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 ................
............... l~v//~'~"~"'r~l~'I~'"dw~l'II~/g ..................................................................................
This certificate is issued to ...... G'~'L'~ .... PC~l~J~t'lO ............................................................. ~ G~{~b~r, lessee or tenant)
of the aforesaid building.
FORM NO. 2
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS P~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N.o 710~ Z
Date ................. ,1'tm ~ 8 ......19.~.?...
Permission is hereby granted to:
.~.~.o..¢. ~ ...........
· .~e ~..~e~..~ ~k .........................................
to b~ld a new one-fa~ly dwell~g
at premises located at Stillwater Avenue, Map ~0, 1280
Outohoguo~ N~w Y~rk
~'t~ 8 ...................... ¢....., end ~pproved by the
Building Inspector
Fee
............... :':.'.':':7: ...............................
Building Insl~ctor
FORM NO.!
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
Examined ....... ~v,~, ? 19 :~ ?
-, . ,...,..=
Approved ........................................ 1c) ........ Permit No ..............
Application No.
APPLICATION FOR BUILDING PEP, MIT
Date ~4:~ 19 ~c.~..
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 ~vork.
e. No building shall be occupied or used in whble or in p art for any purpose whatever until a Certificai~e 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)
.......
(Address of applicant) ~
State whether applicant is owner, lessee; agent, architect, engineer, general contractor, electrician, plumber or builder.
.................... ........
Name of owner of ~, .............................. .j .....................................................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Nome and title of corporate officer)
Location of land on which proposed work will be done. Map No: ............................................ Lot No~:~.. ......
Street and Number ......... ,5..l..L.~.:Jr:...~...c:~.J...~.~ .......... A..u...~.~..~c,:.~.k,.:?'.,:..~, .... ~.,¢.~..~ .,.x..,xt.' .~..{..c~..< ........................
Municipality
State existing use and occupancy o~ premises and intended use and occupancy of proposed construction:
a. Ex'st'rig use a P Y .............. 2:'"I ...... :~"' ',~.L'., .........................................................................................
b. Intended use and occupancy........~.....~.h.6..!..d.~..h.(../.~.)~: ...................................................................................
3. Nature of work (check which applicable): New Building ...... ~......Addition .................... Alteration ....................
~ Repair ........... .~..F..Removol .................... Demolition .................... Other Work (Describe) ....................
4. Estimated Cost...~../;~.D.¢..6 .......................................... Fee ..........................................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling u~g~its .......... ./. .................... Number of dwelling units on each floor .......... ,/.. ..............
If garage, number of car~ .'~/.~..~ ...................................................................................................................
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 ............................
Helght ............................ 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 Stor'es .................
9. Size of lot' Front ........ /.,~.~ ........... Rear /r~.d) ........... Depth ..~r~,)¥'~. ............ ~
10. Date of Pu'rchase ...... ,.~. ~..l~Z...;~,'..7,../...~.~ .~..?.....Name of Former Owner ..~k:.~...z...J.~...f.~.~x.~.(. .................
11. Zone or use district in which premises are
12. Does proposed construction violate any zoning law, ordinance or regulation? ...... j~.~). ........................ : ...........
................ )a.....%~....~ ........ Phone NO .....................
13. Name of Owner of premises...~'..~=.O.~.~.~ ...... ~.~.~..~.i~,ddress C c~"~ o
Name of Architect......~]O..~mtZ~i ...... ~f~...~..(:¢-.~cT.. .......... Address ...(~.~.~..'~,.~....~.~f.~4 ......... Phone NOf~..?.'~.~.~./
"e o ~-', ~' ..r~.~.~.m~).Address,- ....~.. '.., .....................
Name of Contractor ...... ~.. ........... ~ ....... '.~.c~.c.McJ...~...~.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 corner lot.
STATE OF NEW Y~RK,~//~/~,) S S
c o,
, '~.~/...~.~./~(.~..~ ................... being duly sworn, deposes and says that he is the applicant
(Name of individC~l signing application)
above named. He is the ................ ~~.....~..~?.~..'~..~ .............................................................................
(Contractor, agent, corl~orate officer, etc.)
of so d owner or owners, and is duly authorized to perform or have performed the said work and to make and file
this app cot on; that all statements contained in this application o~e true to the best of his knowledge and belief;
and that the work will be performed in the manner set forth in the opplic~ion filed therewith.
Sworn to b¢.for~ me this ~ .~,~ 1, ~?~'~, /
........................ ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ........... ;, ................... ~/...... 19 ........
Approved ........... .~ ............... '.; ........... 19....;...Permit No ...............................
~ (Building Inspector) j
Application No ..... ..~...../....~.. ..........
APPLICATION FOR BUILDING PERMIT
IN$~'RUCTIONS
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. 'l'he work coYered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Build~ng Inspector will issue a Building Permit to the applicant. Such
permit shall be kept on the premises available for inspection throughout the progress o~f 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 Buffdi~g Permit pursuant to the
Building Zone Ordinance of the Town of So~thold, Suffolk County, New York, and other applicable Lows, Ordinances or
Regulations, for the construction of buildings, additions or alteratlons, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances and regulations.
ca orporotion)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
............. ............. ......... ...................................................................................................
· ~_ c~ c~ ~ C~ ~
Name of owner of premises ........... -,.~ .f ................~.~....~. ..........................................................................................
If applJcadt 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. MaD No: ...,(..~.~..~.~..Q ...................... Lot No: .~...~..~../. .....
Street and Number ...... '.~.. ~.~...~...~..¢.k].~:.~'. ....... ~.~./a.?~.~*~,2.. .f./..~.. ....................................
Municipality ' /
2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....... ~'~..J (~-.J)..l..,crk. ............................................................................................
b. Intended use and occupancy ......... ?..z.~./...~/..~:k~ .!..c.~./~ ....................................................................................
3. Nature of work (check which applicable): New Building....'i~...... ...... Addition .................... Alteration ....................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....................
Estimated Cost.....,.i,~..~.f¢ ............................................. Fee ..........................................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units....../.: ...................... Number of dwelling units on each floor ............... ./ ...........
If garage, hum f ca ..........................................................................................................................................
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 ................................
10. Date of Purchase .... k'.~.L..../..~,./_~ ~ ........... Name of Former Owner ..~
12. Does proposed construction violate any zoning law, ordinance or regulation? ..~..~.. ..........................................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil 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.
JO0
I
STATE OF NEW~'COI~K~ z~/) SS
............................ ............. being duly sworn, deposes 6nd says that he is the applicant
(Name of individual~igning application)
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 a I 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 appli&~tio~¢iled therewith.
Sworn to b~ me this /'
.......................