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Home My WebLink About571-zFO~R~ ~0. 4 TOWN OF SOUTHOLD EUILDING DEPARTMENT TOWN CLEEK'S OFFICE SOD'THOLD, N. Y. CEHTIF~CATE OF OCCUPANCY THIS CERTIFIES that the building located at .../~l.d ..,]'ll~e..~/~ffl~ ................................... Street -Map No ...... ~X ........... Block No....XX ........... Lot ~o .... ~ .......... ~4~.~i.~lQ~.~......~.,.~ ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ .~./~Z'L...~.~. .................... 19...~. pursuant to which Building Permit No. g...~.~. .......... -lated ................... ,~/~.....2~.. .......... , 19.~9.., was issued, and conforms to all of the requirements of the applicable provisions of the law. The ocm~pancy for which this certificate is issued is ......... .Pit. i~a .t.e...OZla.. i~. ~mi !.y... dI4e.], Z izlg. .............................................................................................. This certificale is issued to .....~.~.1~...~..~.~7.0.~;~'./l~...~ll4a~.dfi ........... 01/i~,~.~ ............................... (owner, lessee or tenant) of the aforesaid building. Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS P~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N,o 571 Z Permission is hereby granted to: ...~k¢.~.t.e.~...O~.l~;.:.,:~i...~/..~. ............................ Paul &¢Arol~n Edwards PeqUash Aven~e ....... C~tt~h~'gu~ ~'"" ~{~w" ~o~k ....................... :' to ... 3utl~.. ne~..d~e ~t:g ............................................................................................................. at premises located at D. leJ~t].ft &~o.e~ ~.~I~,it,~.~k.~ ~e'~. Yo~k ........................... pursuant to application dated JO/~%%a1~' 19 19 ~9, and approved by the Building Inspector Fee $..]r..O. ?...0..0.. .......... Building Inspectc~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. Examined ......... 9....~..~ Approved...~-4~... ............... ~..~ ............ 19...~...Permit No.....~.....~..~.~./. ............ Application No.......~...~..~.. ............. (Building Inspector)[ APPLICATION FOR BUILDING PERMIT l~nt~ - ' ' 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, relotlonship to odioining premises or public streets or areas, and giving o detailed description of layout of property must be drawn on the diagram which is part of this location. c. The work cov, ered by t'his 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 I~ept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in port 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 issuance of a Building Permit pursuant to the Buitding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, 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 applioable laws, ordinances and regulations. ............ ................................. (Signature 6f'opplicont, 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 premises ........................... 4 ......................................................................................................................... If applicant 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. Map No: ............................................ Lot No: .................... Street and Number ¥.=~,f~ff~.?~..~Z....~-.~..,/.'./..~ ............ ....... :..:.'..'.'..:: ................................................... Municipality 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................................................................................... b. Intended use and occupancy ........ .d~./.~ .............................................................................................................. r, ~ A ~t~o .................... Alteration 3. Nature of work (check which applicable): New building .................... dd' ' n .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost..z..;z...../.....~'.4...'.7....~..~q .............................. Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelhng umts ................................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 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 .....'.Tz..../.....~.: ............. Height ...~ .............. Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ ..-~...~.. ............ Rear ......... ...~....~'..~ ......... Depth Height /(:~, t Number of Stm-ies 9. Size of lot: Front ,~'z,~ I Rear / 00 ~ Depth ~./.,k? '..~. 10. Date of Purchase .../.~..~..~..'~..~..<.~.. ........ ..~.,..../.~....v[..~/..Name of Former Owner ..~¢~:.~.~.~..~.~.: ......... 11. Zone or use district in which premises are situated ................................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ........ ~ ................................... 13. iName or Dwner or premises ........................................ ~aaress ............................................ rnone ~Nu ..................... Name of Arch tect ........................................................ Address .....~..' ................................... rnone NO ..................... Name of Contractor..~7~;~....~.~:~.Address---- ~- C'~c-~o¢¢~ /CZ' ............................................ mane ........................ 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 YQ.R~,, , ) COUNTY OF ..~.~.~...t:..%~...~. ....... ) SS. ............... ../...'~...~....~..~......~...~S,.~...,;~...~.?....z~..~.~'. ..................... being duly sworn, deposes .and says that he is the applicant (Name of individual signing 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 all statements contained in this application are true to the best of his knowledge and belief; and that the work will ~performed in the manner set forth in the application filed therewith. Sworn t~ before me this ~ X RAYMOND A~?OU~ SKI Nm .......... k..fi......~day) of .~:~.....~.~ .................. ~u~.(~.~otK COUNZY (Signature of applicant) Nota~ PubJic~L.~..~.~.~.~ ......... County TOWN OF $OL~TI-IOLD BUILDING DEPAP~TMENT TOWN CLERK'S OFFICE SOUTHOLD, hi. Y. Disapproved a/c ................. :~ .............. · ............................................................ Application No......~...~..~.. ............... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be campier, ely 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 cov, ered 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of al~plicant, 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 premises ...................... / .............................................................................................................................. If applicant 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. Mai) No: ............................................ Lot No: .................... Street and Number ....................................................................................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................................................................................... b. Intended use and occupancy ........ ..~.~;~'./...~. .................. : ...................................................................................... / 3. Nature of work (check which applica'ble): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ...... ~..../..~..7....~...~. .................................... Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling umts ................................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................ 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 ................................ 8. Dimensions of entire new construction: Front.......-~..?..~ ............... Rear _4~yz ' ............................ Depth ............................ Height /¢¢ ~ Number of Stories 9. Size of lot: Front ........ .'.7. g....'. .......... Rear ....... ........ Depth...................;Z/Z .... .......................... ./.?..c-.r: .................. 10. Date of Purchase ...~...%~..¢.'./.~...~..¢,...~........~'~,. ...... Name of Former Owner /~'¢"~';~'~'< 1 1. Zone or use district in which premises are situated ................................................................................................ 12. Does proposed construction violcte any zoning law, ordinance or regulation? .................................................... 13. Name of Owner of premises ........................................ Address ....¢./.,¢..~.:f:~.:~?.. ................ Phone NO./..?.'~.:..'.7. T.?...°..d.:~¢ ~'--'- ~ ~- ~/~?$,~ ~ Phr~n~ . ................... Name of Architect ........................................................ Address ................................................... NO. ............................................ Phone NO Name of ContractorC/"~-~" .................................................... cJ/<zo~.~./ Address ~'r~/°~'~z= ..................... PLOT DIAGRAM Locate clearly and distinctly all buildfngs, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, whether interior or corner lot. and show street names and indicate STATF OF NEW ,YOR,K~ ,-- ) S S. COUNTY OF .... . .'-)..~..fT..F.. ?...~...~....) ................................................................................................. being duly sworn, deposes .and says that he is the applicant (Name of individual signing application) above named. He is the C"-~ (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 th s app cation; that al statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the m.on,n, er set forth in the application filed therewith. Sworn t~ before me thJs~'"x( ,¥,',"~,o~'D A.~I/~70,J! SKI No. ~ ~ ~ ...... ~OI~RY 'ur~f~.:, T t; STATE OF N[~V YOI~K ,. , ..................... ~ d~ of ,~.T.Z.~ .................. r.~?.sd~otK,counT~ (Signature of app,,canb Notary Public~...~- :..~.~ .......... County