The URL can be used to link to this page

Home My WebLink About1275-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at '~'/="M~t.~I,~"~=e~'"BC~tI~I: ..... Street Map No.,~ ........... :.... Block No....~ ............ Lot No ................... j~/j ........................................... conforms substantially to the Application for Building Permit heretofore filed in this office doted .............. l~.~e~'...~ ............................. 19..~.0. pursuant to which Building Permit No. dated ...~,~..~, ......................... , 19....~0 was issued, and conforms to a~[ of the requirements of the applicable provisions of the law. The occupancy for which this certificate Is issued is .......... .............. I~R~/&~...01~, · ~1~1~.. t:~l:~:/~:~ ................................................................................. This certificate is issued to .......... ~,~,~I~O~'.t~...&..~.~I,~.~..O,~-,.~'~X~,,~ .............. (owner, 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 PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1275' Z Date ........................ D..~.e. _e.~?_z'.... ~ .......... 19...B...0.. Permission is hereby granted to: .....'~a~n.. RC~.d ....................................................... .... .................................. to ...... ~cemo.~.e.. ~o~l~..&..e~,Lc~.e ..~...~.J~aclo~ ~....~a~.~.~.~... :~.~.~... ]~. ~'.~..h..L~ .................. .... ~aild ne~. ~ar~h a~ exi~tiug .aue f~mil~..dw,~ll.ln~ ........................... at premises located at ....e../~..~.~..~..~....~..o.,.~..~..~...~..o.~.~..O.~...~.~....l~.e...~.....~..Q~ ....................................... pursuant to application dated ................................ .D..e..,~..~.~.e.,.~....,~. ........ 19....6..0.., and approved by the J~uilding inspector Fee $....5...0g...~l:le.~; p~£d Building Inspector FOR~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ..... .~...~..,~'~...~.... ....... Disapproved a/c ..................... ~ ........ (Building Inspector) ~:~ APPLICATION FOR BUILDING PERMIT December 1 60 Date ........................................................ , 19 ........ INSTRUCTIONS a. This application must be comple¥61y filled in by typewriteF 6r ih 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 app!ication, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises ava.liable 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 o 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 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. (Signature of applicant, or name, if a corporation) Main Street, Southold, New York (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner Name of owner of premises~?'l'~;~s`.'~..~.~r.~'~..~'~.&.~W~.'.~.~..r.~.~..G.~a.~.~.~..w..~..~..~ ........................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and tide of corporate officer) 1. Location of land on which proposed work will be done. Mop No: ............... *..*...*. ...................... Lot' No: ........... .*..*...*.- Street and Number e/s Main Street, $outhold Muqicipality . 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Private one family dwelling - " " " w/ addition b. Intended use and occupancy ................................................................................................................................. 3. Nature of work (check which applicable): New Building .................... Addition......~.. ............ Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... $2,000. appx. r $5.00 4. Estimated Cost ............................................................ tee ' (to be paid on filing this application) 5. Jf 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 ...... .2..:~ .................. ,~ :~:~ 18 54 Kear ............................ Depth ................................ Height ............................ Number of Stories 2 Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth ................................ Height ..................... Z~ .....Number of Stories .]..~ .......................... ~.~ 8. Dimens OhS of ent 'e new construct on: Front ...... .~.~..~..8, .......... Rear .......... ,+..~. ............. Depth ........ ~5 ............ Height ............................ Number of Stories ........ ~ ...................... 9, Size of lot: Front ........ .~.Q ............... Rear ....... ~..0 ................. Depth ...,,4.,0.0. ................. 10. Date of Purchase ...... ..~..a.~....1...9..6...0. .............................. Name of Former Owner ~.a...~..~..e...~...~'.~.a..,~..c...e..s. ....................... .... "A" Residential & Agricultural ' ] J. Zone or use district in which premises are slruarea ..................................................................................................... TtO 12. Does proposed construction violate any zoning law, ordinance or regulation? ........................................................ 13. Name of Owner of premisesE.'l'l~wpr~'~..&..Hin;Lf~J~'eJ~ss ~i.i~ Rd. · S°uth°l~hone NO. Grathwohl Name of Architect .................................................... Address .......................................... Phone NO ..................... Name of Contractor Ells~orth & ~TJ.~.t~recl Address~ain Rd. ~ Boutholcl, m,~_~ NO. ...................... G~f~%~/O~l' ....................................................... ~ .................... PLOT DIAGRAM Locate clearly and distinctly alt 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 ca ne,r lot. STATE-' OF NEW YORK ) S.S. COUNTY OF ...S...q~_~.o...~..~. ....... ) Ellsworth Grathwohl ................................................................................................. being d~u/y sworn, deposes and says that he is the applicant (Name of individual signing application) O~ner-Contractor 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 forth in the application filed therewith. Sworn to before me th s ,'~,,,,,,~ p, . - ~N Notary ................... Public,~.k,,.~..~~.*~'~day of ............ ~.e..s:.~..~..,e,.z'...,....:"~J'9~L~L..~u.q~s~v;:'r':~,n~';i '~;:"J~, (Signature of applicant)