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Home My WebLink About589-zFORM TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ~ 291 ~-. May 13 ~o59 ........................ uQTe ..........................................................~ .......... THIS CERTIFIES that the building located at..//i'/.~....~A~rA.~e ...................................... Stree~t Map No.G.:.~...~.t,.~3~.I..Z.... Block No...~ ................ Lot No. ~.~ ........ ~ef~.~,...~..*..~..~ ................................ conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................. J~rs3~...],c)....~ 19.5.9..., pursuant to which Building Permit No ..... ~...5.8.1~..~..~.~..~.., dated ................................... ~z,,e~,,,.l~t, 19.~[9..,, 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 .............. ......................... .~..r..t.v..a.~ .e., .9,.~ .e., .~.a..a..t..z.~...~,w.,e. Z. Z..t.~. ~ ................................................................................ This certificate is issued to ,...~..Mg~BI~.~.'~ ........................................................................................ (owner, lessee or tenant) of the aforesaid building. Building Inspector FORM NO. 2 TOWN OF $0UTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT N? (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 589' Z ~o,'e .................. ~.*.~ ......... ./....~ .............. ~ ~.~.~.... Permission is hereby granted to: ~gette }~or%o~.....~.~..0..... ~D.e. ~.. ~.e....~..o...¢.~.. ................................... .... ~.e:,t..~.~.~-.~......~. ,.¥. ~ ........................................ at premises located at ...~..~....~,~.],....~.~:.~.¢.~.~...~J~jl.~.e....~/..$.....~.~....~.y.~ ........................................... ........................................... 1L~ .~M,t,~ ~ ....~,,~., ..................................................................................... pursuant to application dated ....................... ..[~..~.~.....~ ......................... 1~......, and approved by the Building Inspector ]/C~ ~' ~ '~ ~ ~ ~' ~ ...... Y...':i.!Z.r..:.Z...t::......Cff.'.....L,:'f:::t::t'.'~. .................. Building Inspector / FOI~i~ NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL uilding Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ................ ./:~ ........... ./..5....19.~..Permit No. ~ ~'~- ~ Disapproved a/c ....~.....~.~....~ ....... (..~...~.. .~....~....?...~4~-~*... .................. .......................... (Building Inspector) Application No. ~'°~" f ° APPLICATION FOR BUILDING PERMIT 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 diogFam whlch 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 c 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 issuanoe of o 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 oil applicable laws, ordinances and regulations. .~ , ................ ;~'~.~-.x~:. .............................................. (Signg~re of applicant, or name, if a corporation) ~ State wheth,er applicap, t is owner, lessee,"a~ent~,architect, engineer, general contractor, electrician, plumber or builder. ............................. . . . .. . . , . . . . , ........................................................ Name of owner of premiSes....~ .~](~..~~~f~...Z~:~ ~~ ................................................ '. ........ If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) 1. Location of land on wh ch proposed woE~ willie d~% ~9~ Ng: .................... > ....................... Lot No: ~ ........... ......... ........... ................................................... /-- "' Municipality / 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: Existing use and occupancy ....... ~(~~~ ......... , ................ ~ .......................................................... / 3. Nature of work (check which applicable): New Building ......... . ..~.......Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ................ ..4~..~;~ ........................... 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 ................. ¥~.~ ..................................................................................................... 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 ..............................,~P I',Jgmber of Stories ............... 8. Dimensions of entire new construction' Front =.~.'~ ~Rear Depth Height ............ ./..~. ....... Number of Stories ...... ~.....;.... 9. Size of lot: Front ...............'~...~.. ....... Rea~ ............................ Depth ......... ..'~..'-~...i~. ........... 10. Date of Purchase ....... ;..~.~~...'.C~..-.~.. .......... Name of Former Owner ,-:~~__~,,,,, ..... 11. Zone or use district in which premises are situated ................... ..,... ...... ~..........2 ...: ................................. 12. Does proposed construction vi~ate qny zgning law,,,ordinonce or regulation? .................................................... 13. Name of Owner of premise~~ess ............ .m~.~..~..Fhone NO ........ :.ZZ..T;.: .... Name of Architect .......... ..~...~.,~..:.....Address ~.. ............ ,....,~......, ........... ~..Phon~ Ng,. /~,,1 ................ Name of Contractor.~.~...~ ...... Address ~~~......~~~....~...~..Z/~ 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//¥O~K~. ,, ,/ ) S S COUNTY OF ~,.,) ' ,}fqame of individual sign?.n..n..n..n..n.n~ appI~c_ation) ' above no;ed. He is the .........~~ ........................................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform, o~ haye perfo?med the said work and to make and file this application; that all statements contained Jnthis application are true to the best of his knowledge and belief; and that the work'will be performed in the ~nn~e~ f~zth in the application filed ther~ith.~ Sworn to before me-th~s . ' , ~.~"~,e, st~ o?~ ~' -- ~ 4au of ~-~ ~r .... ?~ ~'~,,,~,, t~ ~(Signature of apphcant) .. .' ntv ~ ~, FOI~IV~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. · / YI&-, ,-.- ,'~ 9 Examined ........................ .%......~ ...... 1 .,,. ..... 1' / L:, ') / Approved ..................~. ..................... 19 ........ Permit No. ~ ~'~ ~ Application No. ~' ~';~ ~ ......... APPLICATION FOR BUILDING PERMIT 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 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 issuanoe of a Building Permit pursuant to the Building Zone Ordinance of the Town of Sou'thold, 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. ),/ , ' (Signa ~J~.~.~of applicant, or name, if a corporation)//t ................................ ...... .......... ............. rAddrgFJ " pplicant) ...... State wheth,er applicant is owner, lessee, ag~nt,,architect, engineer, general contractor, electrician, plumber or builder. , Name of owner of pr m ses ............ ............................................................ f appl cant s a corporaSe, s~gnature of dv~- 'uly author zed officer. (Name and title of corporate officer) 1. Location of land on which proposed wo~ will,be done~_~g.R N.p: ................... ~ ....................... Lot No: ..~.-~L'.. ........... Street and Number ....... .~."~:.~.~..~.:.(..~..~.'.~...~~..> .......... ~..~:./....: .................................................... / Municipality 2. State existing use and occupancy of premises an,d, intended use and occupancy of proposed construction: o. hxisting use ana occupancy ....... ~.~.~.&..~::~k..~......f3 .............................................................................. , ..................... b. Intended use and occupancy....,,..:~cm'~.~,:.~......z.~.~.~.....:': ............... ."'~'.'¢'~::':',, e. ......................... 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 ................. ~ ..................................................................................................... 6. If business, commercial or mixed occupancy, spec/fy 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 .......... ...... Depth ~..~..... Height ............ ./..~.. ....... Number of Stories ...... .~..?.~ .... 9. Size of lot: Front ............~..d~.. ....... Rear, .......... ..~..i~..) .......... Depth ......... 10. Date of Purchase ........ ...'~.,~'~..~..~.....~....7... ......... Name of Former Owner.~~~ .... 12. Does proposed construction,,-/ ~.~L~Z.z.~v'L~late /=ny ~oning law ordinance or regulation? .................................................... 13. Name of Owner of premise,~~..~'.~/"t~..Address .......... .~...~.~~..,~hone NO ................ Name of Architect ~'~' ~:-~- ~,'~-~ ~'~'~',,-~xP . Address ¢= .~~/' -.,~ , ,, Phone~NQ, /~. .~, _ ..... r~ame aT ~on,racror...~.......'m~..z.../.~.~ ................... ~aaress ............... ,..,~,~.:.: ........... ,~ ...... ~'none~u ..................... 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 ¢ ) S S · · OF · ' ................ ~ ......... ~...'.' ................................................... being duly sworn, deposes and says that he ~s the applicant ~ame of individua~si~a~cation) 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 be performed in the manner set f~_in the app~ation filed ther~ith. Sworn to b~fore me this ,,, , ~t~t?'s~.Z~,~,~z~,~ .~ '~' dav of ~t,k ~.,.,., ,.,,~ ~9,?~'r~'c ,, ~,.ro,~ c0~ t~ ~(S gnature of app cant) '~ , ~ . , ~Z' ..................................... -~ ',~,~'~ ,. ' -;/,,.0