HomeMy WebLinkAbout979-zTOWN OF SOUTHOLD
BUILDING DEPAI~TMENT
TOWN CLEI~K'S OFFXCE
SOUTHOLD, N. Y.
CERTIFY[CATE OF OCC~3PAHC¥
No .......... .~,.,7,.~,9,_ Date .............................. .0:~,Y.., ~.0 ............ 19.~.0. ·
THIS CERTIFIES that the building located al lqain R~to ~ R~e 25~ Sou93aold Street
.~. - *** ..................
_Map No. ......................... *e* Block No .....................Lot No.
conforms substantially to the Application'for Building Permit herotofore filed in this office
dated F'ebr~ta~!,* 25 1960 pursuant to which Building Permit No. 7~ 979
4ated Feb~c~ary. 25 19.~.0 , was issued, and conforms to all of the requirements
of the appiicable provisions of the law. The occupancy for ~vhich this certificate is issued is
................................................................. P'R~VATI~' "0~" FA~'~/Y "DWE~I~ .......................................
This certificate is issued to ....... ~.~.~.~.~.. J~. ?.er~Y.~.....°-..~.-.-e-r-, ...........
(owner, lessee or tenant)
of the aforesaid building.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. ¥.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 979' Z
Date ..................... ~.e~.:~'~. · .... 2~ ............ 19.60...
Permission is hereby granted to:
.. ~'7..Q..~ ,...~e~t~h~..~pk ...............................
....... ~t~f,~g~,....l~ .~ ~ .......................................
to ~e. ke ~.t~.~t,l~, ~n ~ ~..t,~.~g ¢J~.~bIJ.~ ............................................
at premises located at S/~ ~ ~uc~ ~/,8. ~.~ Sf~.ee~ ~,~t,~..~,~., .........................
pursuant to application dated ......................... ~i'.~.'l~¢4~'~....~¢~, ................ I9..(~.1~..., and opproved by the
Building Inspector
Building Inspector
TOWN OF $O~THOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD', N. Y.
........ ...................... ........
~pproved ........................................ 19 ........ Permit No ...............................
Disapproved o/c
(Building Inspector)
Application No ..... .~...7....c~. ............
APPLICATION FOR BUILDING PERMIT
Date ..~..~' /~ ~2~.~.. 19Y~
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 punic 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 qsi~d ip 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 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, ord~es and regu,~s.
~ / (Signature of applicant, or name, if a corporation)
(Address of a~licant)
State wheth.er applicant is owner, lessee, agent, architect, engineer, general contra~;tor, electrician, plumber or builder.
.................. ..A. ...................................................................................................
Name of owner of p ...............................................................................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate off ceo
1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: ....................
Street and Number t~ T ~ :.2.~ i~ff ~9. a~ ~;.~[d~.~.6 ~Z
Municipality
2. State existing use and occupancy of pPemises and intended use and occupancy of proposed construction:
b. intended use and occupancy ............... ~.~ ...... Z.~.~.X.~..~. ...............................................................
3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ........ ~ .....
Repair .............. ~.Removal .................... Demolition ................ ....~ther Work (Describe)
4. Esbmated Cost .......//.....9~..~,~ ....................................... Fee ............... ~ ..........................................................................
(to be paid on filing this application)
5, If dwelling, number of dwelling units....,~...~..~..../~.../...~..~......Number of dwelling units on each floor...:.../.fcF~,,,~,~,./~.,,/
If garage, number of cars .............................................................................................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each.type of use ............... 3' .............
7. Dimensions of existing structures, if any: Front ...... ..~...?'.. ....... ] ...... Rear ....... ?,...~.., ............ Depth ,,,..',~....~. ................
Height ......-~....~. ................ Number o{ Stories ........................................................................................................
Dimensions of same structure with alterations or additions: Front ~ ~ ' Rear
Depth .......... ...'~'......~....~...~... Height '.~'...~..'.... ,~....'~. ........ Number of Stories ........ ./..'.~.. .................
8. Dimensions of entire new construction: Front ........ 4 .................. Rear ........ ~...~...: ......... Depth ......././.. .................
Height ........ 2..i...~...~.~. ....... Number of Stories ....... /. ...................
~ ~ ~.~, 0 '
9. Size of lot: Front .......... /...O...0.....~. ..... Rear ........ ,¢'.. ................. Depth ............................
10. Date of Purchase ........................................................ 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? ..... .~..o.. .........................................
13. Name of Owner of premises..~.....L..~..J..~.,/~/:.[.~...,R../~.'~...AddressRr~z;"~'/"~//¥/~ n/~ Phone NO,S~t?.:.~]:~.I..9..~.
.... '$~; ~' 7;J-)'~ '~:'~"';9 Y: ........
/1. --___ .- . .-- -- IJ . .__1
j Name of Architect,.k,].~...l~,[,i..l-,.,I..~....~.....#l...O...'~l.....E. ........ Address ~.~.m.'..~¢,..~..~.~J..g. kt.~....~'...~./K..~Phone NO .....................
Name of Contractor ...... /~...../~......~4....../.../~..,.~,. ................. Address ..~...o/..~..~/..O4.~4~../~..../~.'.~....Phone
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 YORK, )
COUNTY OF ............................
SS.
k
............. ,"~.~.~.,~..~ ..................................................................... beiDD du¥ sworn, ~eDos~s ~D~ SO~S ~HD~ He ~5 ~He ~DDHCODt
(Name of individual signing application)
above named. He is the .........~.~..~.~..~.~.~ ........ ~..~.~.~..~.~.~..~.Z ..........................................................................
(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 or,rue to the bes~f his knowledge and belief;
and that the work will be performed in the manner set ~orth ~n the~p~licat~on fil~with.
Sworn~o b~fore me this ~ / / k'~ ~~
............ ~..... ~ay of ,...~~. - "--'~-~1'C~ .... ~~tu re ~f~)~
FORM NO* 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUT~IOLD, N. Y.
Examined
Approved ..................... ~..k ................ 19...L...Permit No. ~Z...~...-.~..~. ............
Disapproved a/c ..............................
(Building Inspector)
Application No ..... .(~...~L ~I ............
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 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 fo~ 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 demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordizr~es and reg~t,~,ns.
................ ...............................
/ /(Signature of applicant, or nome, if a corporation)
(~aaress or a~icanT)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
................. 0 ............................................................
Name of owner of premises ~ .~....~....J...~....~.~/..~....~..~.(.~.~'. ..........................................................................................
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 .~,~: ............................................ t-o~ t'~o ....................
Street and Number ...... ~..~,...~.....?.,....~.,...~...~.....~../..~'.,..~.).¢~.~,.~.~.....~..~...(4..~.~.~).L.~....~,.~, .....................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy..../.~.~...~..~...~....~/..~.'i/¢-,4~6.~..~...~.'.(/J~Z;~.~..../)...~4..X~./--..~'.(.(~.~·
y
b. Intended use and occupancy ............ ~:~zl./.~,~ ....... /.. A.?.J./F./../, ...................................................................
3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ........ ~ .....
Repair .................... Removal .................... Dern01'ition ................ .../Other Work (Describe) ....................
4. Estimated ~
Cost ....... ./,Z.. ~..rd~. ~ ...................................... Fee ............ . .-~. t. .........................................................................
(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 ~.,~.'i...~.'.~. ........ Number of Stories ........ ~..~.. .................
8. Dimensions of entire new construction: Front ......... T'..~ ............. Rear ........ ,.~..~....: ........ Depth ......././. .................
Height ........ 1.....~. .......... Number of Stories ....... 1 ...................
9. Size of lot: Front .......... ,~/.~.~....'. ..... Rear ........ ,Z~...~....~. ....... Depth .....~..~...,~. ...............
10. Date of Purchase ........................................................ Name of Former Owner ........................................................
1 1. Zone or use district in which premises are situated ................................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation? ..... t~,~. .................................. '. ......
13. Name of Owner of premises.~...~..l.r.L,~.~.,.~.~..~./].'~....Address I~/'[~$/xd,,~/,V' .~.~ ~ Phone NO.~..9.*...~.:
(Name of Architect..~l.~.~.~...I..F.../.~..~l....~...o...~...~ ....... Address ~.~....l~..:.~.~..~,!.C~.fLo...~...P..4f.~'Phone NO .....................
)Name of Contractor ....... L..~/J....~..:....L.~.....~. ................. Address ...~....o:..~Y.../..E~.~.Z~.,~....~:../:....Phone NO,
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 YORK, ) S S.
COUNTY OF ............................
9-5
·
....... ,,~.4/.,0.e..~....(,,~.~/~z,a.~[.[~,~. ...................................... being duly sworn, deposes and says that he is the applicant
(Name of individual signing application)
above named. He is the .......... ~.~.~.~.~..~.e.(~,......~.fl..~..~,.~.&~..CR..~.z ..........................................................................
(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 ~lication fil~¢H~with.
Swom..~tobefore methis ~ / ...................... r ....... . k / ~ ~ . ~/x~ .
...................... ~gy aT ............ .~,,~-,. ~u~. ~.~ ...... ~
H
Notary Publi~~2~;~.~ty
!
!