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Home My WebLink About852-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT T01NN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY Z 531 June 7 19oG No. ........................ Date ............................................ THIS CERTIFIES that the building locoted at .Z�t�,yee..Waic,ey&..Z�ane,...dJr.leIIt,,...DT'�treet +� Z, ♦wr en� D The Map� . ........................ �6�k No. ........................ Lot No. .................................................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...............Septena�r 19 �9 Z 852 . ................................ 19........, pursuant to which Building Permit No. ...,...................... dated ..............S�j�tP�.WJz�k...J..:t........... 19.3y..,was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificote is issued is ................ PRIV,':TF. ONE FAMILY D�VELLSNG .................................................................................................................................................................. This certificate is issued t�o�(xl Potter OwneY .................r......................................................................................... (owner, lessee or tenant) of the aforesaid building. �� • l. ...................:............................................................. Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTNOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N�+ grJ�i Z Date ......................Sept�ber....,�t)......... 19c�.... Permission is hereby granted to: �'elt:;r t7h1„Inc....p�C....RoY��..�".4C1.9.i'.............. �. ...........SYPba<'..�a....Lr.i,r....................................... ................................................................................ toSuilA new dwel?-�?Y........................................................................................... ..... . . . .. . ........................... ................................................................................ ................................................................................ at premises located at�t..�..��`....OX'.�,bXt�..bJ...�hs..SAit....................................................................... ...............................................Os.i.fx.t,,....�i.��......................................................................................... ................................................................................................................................................................. pursuant to application dated .........................;�.��se1y�y�.....js�............1�......, ond opproved by the Building Inspector .ao �ia oa.ot Fee ................. . .....��.�,.:.�..�...- ..... Building Inspector � �''%vr✓ /' J ss u �s� , FORM NO. 1 1 f t.r.lJ� -�'�� ' � TOWN AF SOUTHOLD / `� � L `� c�.� �3 BUILDING DEPARTMENT T01NN 6LERK'S OFFICE SOUTHOLD, N. Y. Examined......... . .. . . .�j.19�� Application No. ....(��.�.�........... Approved...... .. .. . . . . . .��1`.19..S�ermit No. ..��.Q..y`..n�. Disapproved a/c ..................... _..:.:,:..::...�..... ................... . . ................ �Y �—.. ..,..... --- ........................................................................................................................ ��.��.�.,. .�'�..,...�..�� (Building lnspector) APPLICATION FOR BllILDING PERMiT Date............e3"::',d.`.:........� / � . .....................19.....�..... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building I nspector. b. Plot plan Showing location of Iot 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 issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, fyew Yorl<, 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 Inws, ordinances and regulations. �� , t y�, �J 1 ..�../.`....,�'�i4�,�1 V �l.✓'� � `�.�._ ,�'/ ............ .............`............................................ '" (Signature of applicant, or name, if p corporotion) ' �s0.y� 4 ...�.� ..........�..�..................................................... (Address of applicant) State whether opplicant is owner, lessee, agent, architect, engineer, general contr4ctor, electrician, plumber or builder. ............................................................�.�?,.'.:�'.::.`.�..�ti"............................................,...................................................... Nameof owner of premises....�t5.V:.c�.l.................�.:�4��:�.................................................................................... / If applicant is a corporate, signature of duly authorized officer. ................................................................................................ (Name and Yitle of corporate officer) �� 1. Location of lond on which proposed work will be done. Mop No: .�r�.Cl�'aG��JC....�i�.�..:?.�� Lot No: ...li,l.......... Street and Number ...f.... .f.7.d:?.�.�.........i/�(G'J.1.�G:t"..5.........�v�7l.4!.�....................................................................... Municipality 2. State existing use and occuponcy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy....�.CY)..c:.!„�,.11.u.�v................................................................................................... b. Intended use and occupancy...................�........................................................................................................ 3. Nature of Work (check which applicable): New Building......Y..........Addition ....................Alteration .................... Repair .Removcal ....................Demolition....................Other Work (Describe) ,.,,.,.,,,,.......,. .......... ..... /� O 00 • O t)...........................Fee ...�.. .�.G.?................................................................... 4. Estimated Cost........... ....................... ld.e (to be paid on filing this application) 5. If dwelling, number of dwelling units.....qN.�,-..............Number af dwelling units on each floor......U. ..N....�'�,........ Ifgarage, number of cars......f.�,./1/..E.......................... ................................................................................................ 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 qltercations or additions: Front ................................ Rear ................................ Depth .............................. Height ..............................Number of Stories .............,.................. > u , i .i 8. Dimensions of entire new construction: Front.....t3...r.?...:'.Q:...... Rear ...i,3�.�..:'.A.y....., Depth ....�.�..."�?.......... Height ..../..�.�.:'.°.o•........ Number of Stories ..C�/.V..�................ 9. Size of lot: Front ..J..�?.U.�t�C..'.'..... Rear ..I.A.�?..�.-5?.'.�...... depth ...I..v7�.J.:�:. V.�� 10. Dote of Purchase ........................................................Name of Formner Owner ...................................1•::•:lF'........... 11- Zone or use district in which premises are situated.....................!`�.:....�.................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ...NR.......................................... 13. Name ot Owner of premises,�o.�!,c?�.....1'�0.��?..Address ............................................Phone N0. .................... Name of Architect...�.�A,/il.......dl,3G.�Y.............Address ..............................,.............Phone NO. .....,.............. Name of Contractor...�W.1/C�!......U!7.�...... .�.eV.�•Address ...�S�t.Q.S!s/./........,.N�.,..Phone NO. WI.+':a.:o,�$"� PLOT DlAGRAM Loccate clearly and distinctly all buildings, whether existing or proposed, and indieate all set-bacic dimensions trom pro�erty lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. / �.5^ � 'ycs'' � 3� ° `/ 8'' v � v l / � � a ' / � � � v � / � o v � � Gaie. r � � _u____. _._..__ ____-------��S_ STATE OF NEW O K, � � S S. COUNTY OF .. .. . ... .. ) ....... ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,�i;`,C„P'1-c>`;�:.,�t�e;Cl�...............being duly sworn, deposes and says thqt he is the applicant (Name of individu4l signing application) above named. He is the...............................................��,.�........'..�.... .. .. .��:c . ` ` �'— '' . . . ....:........................................... (Con acttf or, ag nt, 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 tl��i��pTli�DKEN filed therewith. $WOI'Yl t0 60f01'B I'Y10 th15 Motary Punl:c, St�Co o( New �� , No, 52�byq49G3, Suffot�y • �pty.�r Of a �ICOnY� ...... ...........�.f da�, o�f �../............ .... ............... 19.....J.... &vnmissmn L�cPiras MarsH� 14�/e PP Notary Public,G��/!.c�N�C...c...t��....-�oant�+ �/j✓j °"iJ."u'"' ° . W..e�.Q� 1 FORM NO. 1 TOWN AF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined.......�s��X.l�lll...�,�19.5.,(.. Application No. ......�/.4..�`.vZ�.. Approved........�f%��G��?��• �9..�ermit No. ..�d:�.7a�.......... Disapproveda/c .................... ...... ........................ ...........................1.,� .............��r�.�.,,, ./.�/..,�?�....� (Building Inspector) APPLICATION FOR BUILDING PEItMIT Date............��.�.'.�........J.j�.............19.�./..... INSTRUCTIONS a. This opplication must be completely filled in by typewriter or in ink and submitted in duplicote to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or oreas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this locotion. 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 applicont. 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 hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuanoe 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, odditions or a Iterations, or for removal or demolition, as herein described. The opplicant agrees to comply with all applicable laws, ordinances and regulations. f,✓�� (c rz U F/ L �' r� c._ ..............................................................................................:.. (Signature of applicant, or name, if a corporation) ' ' S�.O S S �"(� L. /. .............. ............... .... .................................................... (Address of applicanU State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electricion, plumber or builder. �� .................................................................................................................................................................................................. Name of owner of premises.........��j}.:.:`�....��............................................................................................ V • � If applicant is a corporate, signature of duly authorized officer. ................................................................................................ (Name and title of corporate officer) l. Locatian of land on which proposed work will be done. Map No: .�'.':::�!....�.�..j...�:.`.`.--.. Lot No: 1..��...�......... Streetand Number .....��.....�i.4��....�..................�.�....��..................................................... Municipality 2. State existing use and occupancy of pnemises and intended use and occupancy of proposed construction: a. Existing use and occupancy........................ ............................................................................................................ b. Intended use and occupancy...........�:�.:�........................................................................................ 3. Nature of worl< (checic which applicable): New Building......�...Addition ....................Alteration .................... Repair .............. .....Removal ...........,..,.....Demolition........,...........Other Worl< (Describe) ................,... rt9 � 4. Esfimated Cost...��..,j.Q�:.... .................................Fee ..�.v.................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units........C.'."�l...........Number of dwelling units on each floor............................ Ifgarage, number of cars..................�'..`.'..�........................................................................................................... 6. If business, commerciol or mixed occupancy, spec ify nature and extent of each type of use.............................. 7. Dimensions of existing structures, if ony: 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..........:5�.'.�...... Rear .........��....�.�.�...... Depth ...�'7..z..�............... Height ........�`.5..�.......... Number of Stories ....a�".`..�......... 9. Size of lot: Front ........<..':?:`.'.......... Rear ......:...�.�....... Depth ....�..�.:.g.�-..�...�.. 10. Dote of Purchase . .... .. ......Name of Former Owner G" """a """`"'" '""" �"� ........................................ . . ........................................................ 11. Zone or use district in which premises are situated..........`�.. �"� ................................................................................ 12. Does proposed construction vionlate any zoning law, ordinance or regulation? ..../.VU........................................ 13. Name of Owner of premises....K. .t�:-�.!{....��.........Address ............................................Phone NO. .................... }��i Name of Architect...�^..-.....(J4,dT!��✓..............Address ............................................Phone NO. .................... Name of Contractor..�P'�.�^r 1��..9.`-::�r..........Address ..��'�"":....•••••• •••••••••••Phone NO. ............ .................... PLOT DIAGRAM Locate clecrly and distinctly oll buildings, whether existing or proposed, and indicote all set-badc dimensions trom property lines. Give street and blocl< numbers or description according to deed, and show street names and indicate whether interior or corner lot. � --- 2-4 4 �- y�� g I � � � STA'TE OF NEW O , L > S S. COUNTY OF .. . .. . ....... . . ) .... . . s,.f�,,.(,��—�n ��;?��..........being duly sworn, deposes and says that he is the applicant ................................... . ......................... (Name of individual signing application) ��_— above named. He is the.................. . .. �`tp� . . .....................c�•••••••'••:,..... .........................................................,............................... (Contract , agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform r 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 application filed therewith. Sworn to before me this �uniYti P. noK�rvf / y Notary Pu'�,I��c, State nf Dlew Yark ................(..dc.. day Of ................ .�,�.....'`�.... ��I..."'.�.1...... Na. 52C�:{d4963, Sulfolk( �u re of applicant) /�, ��'� �ommission E.xpues Ma�ch _�(�/ Notary Public, ��r��R%scnt-•,..-lw.�,,h'`��??�2�.C-oart#Y �a-A--c��-- b � W -c��