The URL can be used to link to this page

Home My WebLink About788-zTOWN O~ SOUTHOLD SOUTHOLD, ~. Y. CERTIFICATE OF OCCUPANCY No ........ ~..~.~.] .... Date ...................... ff~t~..~t.8 ........... , 19..~.~ THIS CERTIFIES that the building located at 1~.../...~.....~..O.~.~_O.~...~.~..~..o..,.....~....~.~.~.~...~.{~treet Map No .............~t.*.... Block No ....... *.~ .......... Lot No ......~,~ ........................................................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ................. ~tl~t~.~....~. ............ 19..$~ pursuant to which Building Permit No ....... ~...~.i~1~. dated ............... ~11~11~...4~ .............. 19~.9.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is ~ssued is ............................. ...~.....~...~.~.....0...~....~ ~..n. ,~.~.. ~.~...~,;~ .................................................... This certificate is issued to .... _~..~.~..~.....&.....~.~..~.~.~....~..~.~.~..~.~.~.....O...~....~.~. ............................... (owner, lessee or tenant) of the aforesaid building. Building Inspector FOI~M NO. ;~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTiL, FULL COMPLETION OF THE WORK AUTHORIZED) N? 788' z Permission is hereby granted to: l~..a.~ .a...~.~. H..e...Z. en A~arenoR ~or.ton..A~enue ................................................. to ..,bu/ldtng..addltton..on..e~i~giug..o~...f,a~tZ~...Cl:~e~l$~g., ......... k ....................... at premises located a ~..Her. to~enue.,...~tlt~...Hew...~k.; pursuont to opplicction doted ................................. ~..~ ........... 1~.~.., on~d opproved by the BuHdin~ Inspector r, Fee $...~.~..~ '~ ....... ~ .... ~~ Buildin~ InspOctor . ~ FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........... ~...~. ] 9..,,~..7 :. .................. ...:-.-.:.: (Building Inspector) Application No ...................... APPLICATION FOR BUILDING PERMIT Dote ............................. 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 drown on the diagram which is part of this location. c. The work cowered by this opplicatlon 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 alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ......... ~ .-k~,~r~... L,,~...~:z:~~.. ......... (Sig~F~t~,~e:..o~g.~/r?'r ne,me, if a corporation) .......... (Address of oppt~cont) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of ~ ? ~ ~ ~ Y p r e m i se s.... ~..~:...~. ·.... · .~.¢/~,:~... · :~..&~..~~ ........................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work wi be done Mop No: ....... ; ....... .: ? .. Lot No: ..... ~ --~Z // . ~ ,,'~) ~/ Z/-_LZ, /' ~ ~ ' ........... Street andNumbeZ'~',6.~.~...~...Z...~>.~.<...>...~:-..(..~. ~.~~, ...: ...................... // Municipalffy '" State existing use and occupancy of pr. emises and int~ended use and occupancy of proposed construction' a Ex st ng use and occupancy ,('07~'>~]'~/~,-~ ~ ' ......................~~' ~ :"i .......... ~'"" ........ '; .................................................. 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 ............... ../'. .............. Number of dwelling units on each floor ......... ~.. ............... If garage, number of cars ......... ~.....Z ..................................................................... 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 .............. ...... Rea~;'~...~.'.. ..................... Depth ........... .~".~. .......... Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ f..~... ......... Rear ........... .~..'~-~.. .... Depth ....~.-~ ......... Height ............................ Number of Stories .......... ~..'. ............. 9. Size of lot: Front ..... --./..~.,.~....~..... Rear .......... ----'"'"'"~..k~..... Depth ....... ~..~ ...... ! 10. Date of Purchase ........................................................ Name of Former Owne ........................................................ 1 ]. 7one or use district in which premises are situated .................. ]2. Does proposed construction violate any zap)rig law, ordincunce or regulation? .................................................... 13. Name of Owner of premises ..... Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Nome of Contractor .................................................... Address .................... .t.r'. ..................... Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings whether existing or proposed, and indicate all set-bgck dimensions from >roperty lines. Give street and block numbers or description according to deed, and show street ~ames and indicate ~hether..%, interior or corner lot. ,/~,,~6~' ~t STATE OF NEW~ Y~.,R.K/~//~.. S S COUNTY OF~---~/__ _..... ~..~~, ' ....................... ~./":..~.~.,~...~/.~,4¢.~..&~......~.~r........being- ~/~-~ duly sworn, deposes and says that he f, the applicant (Name of individual s~rfing applicatiOn) above named~He is the ~-~...~~ ................................................................. ........................ (Contractor, agent, core)orate 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 ail 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 f,i[ed there,/th. Sworn to be or me this /"'~ / ' "-'~/ /~ day-.of ........... ~.¢~-~9...~.~.~'¢ ,,~?, 1' .¢,BI(Signature b~p~ican,, ............ ~, ..... ~' ] ¢9' ~ ~.~,/'~.~ . N'otary Public, State of New York Notory Public, ~~~~o. 52.E3'i4963, Suffolk Co,m., FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ..... Disapproved a/c ....~..~ ...~:....%7':~.~:.i~..~. ............................ ::-'-~'2 ......................... ~'~ (Building Inspector) ~(~' Application No .........~'..~.....~'.... ...... APPLICATION FOR BUILDING PERMIT Da,e ............................. 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 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 ti~ 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 alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Address of applicant) State whether applicant is ,owner,,lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................................... ................................................................................................................................. Name of owner of prom ses.....-: ................................. :......':hz ............... ~ ......... ~ ............... z ..................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Locat on of and on which proposed work wiU.-,be done Map No ..~. -¢:~:..~,.. Lot No' ,., /, ' ......................... Street and N u m b e~./~.?:.~:~ ;'./: .~ !:,...(: :/::.:~.~';.~. :~.'~':: :?.., ,.....,,::::~;.?~::..?.~.r...,,.:.., ~.~. ~:: ............................... / Municipality ' State existing use and occupancy of pr.e~jses a~)d intended use and occupancy of proposed construct on ,,/, , ~ ,.;/¢- . a Ex~st~ng use and occupancy ............ ~. ........... :.: : ~.~. ~ ./. ............ '~ d hn Addmon .................... 3. Nature of work (check which applicable): New au' a' g .................... ' ' . ................... Alteration Repair .................. .j?,emoval .................... Demolition ................ ¥~..Other Work (Describe) .................... 4. ~stimatea ~ost ....... :::..~m:....: ............................................. ~ee .......... ~ ............................................................................ (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 ........................... ~.q'~.~ ....................................................................................... 6. If business, commercial or mixed occupancy, specify natuze and extent of each type of use .............................. 7. Dimensions of existing structures, if any: Front .......... ~. ...... Rear .......... ~.~ ...... Depth ....¢~ ............. Height ............................ Number of Stories . ~. ...................................................................................... Dimension~ ~'z°f s~e structure with alterations or additions: Front ............... c~._.~ ......Rea~...~ ...................... Depth . .~x....~:~.~ .......... Height ........................... Number of Stories ................................ 8. Dimensions ~f ~ntire new construction: Front ......... w,. ..... ......... Rear ........... .... Depth ........ Height ........ ~ ................... Number of Stories ...........~. ............. 9. Size of lot: Front ..... ~ ......... Rear ........... Depth ....... /~ ....... 10. Date of Purchase ............................ ~'. ........................ Name of Former Owner .......... v. ............................................ ...... 11 Zone or use d str ct ,n wh,ch prem,ses are s,tuated ................. P P ~,~ ,,' . ....~ .(Z, ~ Z~' ~:.¢/~.Phone NO ..................... 13. Name of Owner of prem,ses~ ~ ............ Addr~ ................. Nome of Architect ........................................................ Address ............................................ Phone NO ..................... Nome of Controctor .................................................... Address ..................... q~. .................... Phone MO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings whether existing or proposed, and indicate all set-yack dimensions from property lines. Give street and block numbers or description according to deed, and show street~names and indicote ,hether, interior or corner lot. S TA'I'EOFNEW. Y~~Z SS COUNTY OF .~7~...?.:....~,~z,''',.1., ' ~ ~. ~_~....be ng du y sworn, deposes ,nd s~ys that he is t~e ~pplicont ................ .... ~bove nomed~He is the .................... '. .............................................................................................................................. (Contractor. ~gent. corporate officer, etc.) of said owner or owners. ~nd is duly outhori~ed to perform or h~ve performed the s~id work ond to m~ke ~nd file this ~pplic~tion that ~11 statements contained in ~his ~pplic~tion ~re true to t~e best of hi, knowledge ond belief; ~nd that the work will be performed in the m~nner set forth in t~e ~pplic~tion ~iled therewit~ - [~ .......... ~,..,,,; ..... y aT ~ ................................................. ,, ~ ~ -Ii-//~1~ ~ . ................ ;C~ No 5t'.;;,!9~3 SuffOlk Count)l/