HomeMy WebLinkAbout1158-z'/'OWN OF SOUTHOLD
BUILDING DEPARTMENT
~;OWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
TH]IS CERTIFIES that the building located
V. I/, K/14~Up Pal:m,
Map No ..... .*..?.~ ............ Block No ..........~..~ ........ Lot No ........*** ......................................................
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ................. ~[tl].~..~.0. ............... 19.....~.0pursuant to which Building Permit No..~....]....~...5.~
dated ............... ~:L.9~...~..~.....1. .............. 19..6-.0..., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is ........................... Eg ~[%~&%"E...Ok~'E... F~%'~I ~Y.. J~.~,I,Y~ ~ .......................................................
This certificate is issued to .... ~;l,£~r~...th~.~.l~.~,....~.~.e..~- ............................................
(owner, lessee or tenant)
of the aforesaid building.
FOR,~I NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS P'ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 1158, Z
Dote ............................ ~llg.~/l~.t,. ·...~. ........ ]9..60
Permission is hereby granted to:
~,t~ o }tee~re..4..p..o.n.L..~..O....~L.Z;~e~...~e~:Lb.~eh .....
.............. },[a~ ~;:Lt',,~k.r .....~, :~.. ...........................
to..~.u..t...z.~...~...~..t.~L.o.~....o.~...~,~...e.~..t..~..C..~c...~.e.~.;L~r~ ..................................... ' ..................
at premises located at]~..t,...e...~..O.~.~.~.....~/~.......~.O~Zt~..~/'.e ............................................................
.................................................. · ~t;.t~uek~.....N.,.~,, .........................................................................
pursuant to application dated ................................... ~T.I~[],.~......~O. ......... 19.~0.., and approved by the
Building Inspector
Fee $ ~.. ~..0..0........e..~. ~.~,}C
FOR~ NOol
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ........ ~ ...... ~..k ............ 19 ........
Approved ........................... ....... Ig... ...Permit
Disapproved a/c .................... ~
Application No. f I ~'~
APPLICATION FOR BUILDING PERMIT
July 30
Date ............................ 19.6-0..
1N'STRUCTIONS
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 [~roperty 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 p art for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Deportment 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, additions or a Iterations, or for removal or de?olition, as herein described.
The applicant agrees to comply with oil applicable laws, ordinanc.es /g,~d regulations.
/(Signoture~'f applicant, o¥ ~on~e, if,c~orporot on)
...... ;; .......... ". ......
(Address of applicant)
State wheth.er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
General Contractor
remises Milliam Unkelbach .
Nome of owner of p .............................................................................................................. ."r ...................................
if applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
1.
Acreage
Location of land on which proposed work will be done. Map No: .~,.~,.i~,.J,.~..k~..R..~.~..z~.. ............. Lot No: ....................
Street and Number ....[.r..i.~.e....z?.$~...o.~....~..~.. ..........................................................................................................
Municipality
State existing use and occupancy of pr, emises and intended use and occupancy of proposed construction:
o. Existing use and occupancy ...... .~..e..~..~.~..etg...~.~...8-!-... ........................................................................................................
b. Intended use and occuponcy...!~.?..~.~..~..e~....~.~...~:.. .......................................................................................................
\
/
3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ....................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....................
4. Estimated Cos~.....~.,...0¢~....: ............................................ Fee ...... ~.5.....0..0. ..........................................................................
(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...~.8.%. .................Rear ....~..8..~..'r ................ Depth ..... ~]..-.. ..............
Height ...;~).~..-. ................. Number of Stories ....]:.~. ....................................................................................................
Dimensions of same structure with alterations or additions: Front ..... ~..-.t ................. Rear ..2..8..~..-. .......................
Depth .....~- ..................... Height ....'~..~..-. ................... Number of Stories ...... ~ .....................
8. Dimensions of entire new construction: Front.....~.$.!.-..8!! ...........Rear ..~.8..~..-..8..". .............. Depth ...~.0..!~..0.. ..............
Height ...,~5..~ ................... Number of Stories ....... .]-. ...................
9. Size of lot: Front ....~.0.(~..-. .............. Rear ....... ~..0..~..-. ............. Depth ............................
10. Date of Purchase ..... '19~ ........................................... 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. Name of Owner of premises...~fl:~ttl~],~k¢~k ............ Address ....8.O.g~cl,.,&l~.fl,. .................... Phone NO. tf~.,.9.-..8.~.??...
Name' of Architect ................... 01¢rt~z' ........................... Address ............................................ Phone NO .....................
Name of Contractor~[az~o'lcl,..~...Ree.~'e..&..Sm~,8. ......Address ~10..~,.,..~,~.'~.~.]¢ ...... Phone NO..}~...,~..-..8..2...8~...
PLOT DIAGRAM
Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate oil set-bock 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/~'OR~ ~ ) S S
COUNTY..,~./ ~- ~2 ~. ~,~../0~' i~~')' ~ ' ~'
....... ,,Z~.,~~;....,,~.,~ .............. being du,y sworn, deposes and says that he is the applicant
(Nome of individual signing apM~cotion)
above named. He is the .............. ~x'.~.,~..ff~.~&.~ ............................................................ : ........................................
~ (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 fife
th s applicat on; 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 s~t4~de ~e application filed ther~th.~
Sworn to b¢ore me this .... ~,/q ~?~ K'/, ~,~
/ ~ ~.. ~ ~-~.x--~ -' 19~ ~oo,,~"~'--~ ~ig~a~ure ot appl~ant)
.......................... ~ 5Z ......... 2~-'YZ ....... V~ ........ ~ ......... ~ ~ , -