HomeMy WebLinkAbout987-zNO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLEI1K'S OFFICE
SOUTHOLD, N. Y.
CERTIFICA'I~E OF' OCCUPANCY
No .......... ~...?.74. Date .............................. 0'~y' ~* ........... ' 19'~0'
THIS CERTIFIES that the building located al .t~/'a../~Ia~Ox~...D~£v~,.~....Cu~¢~o~ Street
.Map No..~.~ .............. Block No .......,.*..~ ...... Lot ~No...~,~ ......................................................................
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ............. ~Ch...2 .............. , 1960... pursuant to which Building Permit No ....... g...9~'~ .....
4ated .............. ~'~1-..~ ................. 19.6.0.., 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
~RIVAT~ Olx~ PA~4~L¥ DW~LL~N6~
This certificate is issued to ............. ~...~,?..~.~,...&..,,~.~:..~L..~..°..~.~-~.,,...~~r~. ..............................
(owner, lessee or tenant)
of the aforesaid building.
FOEi~I NO. 2
TOWN OF SOUTHOLD
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? 987 Z
Date .................... ~I~....~. .................. 19~,0...
Permission is hereby granted to:
F~'d..*~o~n ...............................................
......... ~,~son..dr.i~v~ ............................................
................... ~ttteh'Ogue.~......~.~ ¥ ~ .......................
t o ....B~li t~** ~n.. *a d~ l.tfon., on.. *a~.. c~ tln~., d~et tin~ .....................................................
ot premises located at ....~/~.....~.~ofl..~f~e ........ *~ .............. : ...........................................................
........................................................ ~u.t, ehog.ue.~ - - ·.. ~.:.~., ..................................................................
pu'~suani'to application dated ....................... }~tqlh"'"~. ...................... 19/~O.., and approved by the
Building Inspector
FOF,~ NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Exomined .........
Approved " 19..,~/..,.PermJt ~o .................................
Disapproved a/ c ...........
(Buildin~ Inspector)
Application No ..........?..., ,~, ....-(. ...........
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
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 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 o Building Permit to the applicant. Such
permit shall be kept on the premises ava,ilable 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 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 ~corporation)
........ ......
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises.......~....mc~-...~...~q'...~-.~..<...'~..::..~...'~....~.~..~...'<~...-~./....~...~.4¢~....,c~...~.~..~ ...................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Lot No: ....................
1. Location of land on which proposed work will be done. Mop 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 ............. ./../. ............. ~.......(... ............. ~i[ ....... ~..~....~...?...~. ~..~...:: .................
3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ....................
Repair .................... Rer~oval .................... Demolition ........... .~. ....... Ot~her Work (Describe) ....................
4. Estimated Cost .............. ..~'.~..~.?.......-;' ........................... Fee ....... ...k~....~ .....................................................................
(to be paid on filing this application)
5. tf 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 ........c~.....~.././..~.<
Height ............................ Number of Stories .............../.. ........................................................................................... /
Dimensions of same structure with alterations or additions: Front ............. ..~....O.. ........... Rear /o
Depth .............. ./....~.~... ......... Height ................................ Number of Stories .........../.. ...................
8. Dimensions of entire new construction: Front .......... ..~.....'..~.~Rear ........... ..~'........~....... Depth ...¢~...~/~.',~'. ......
Height ............................ Number of Stories ........... ./.. .................
9. Size of lot: Front ........,/~..~.) ......... Rear ............. .r~.~..~...... Depth ......... ..r~....~.~....~.C~.. .....
10. Date of Purchase ...... ~¢.~.~....../.....~'...~.......z~... .......... Name of Former Owner ....... ~....~..~..~ .............
1 1. Zone or use d,stnct ,n wh,ch premises are s,tuated ............. ~....x~.r--~..~..~.-~,'~c.......~.'.r...~.~.· ..............................
12. Does proposed construction violate any zoniqg law, ordinance or regulation? ......... ~ .....................................
13. Name of Owner of premises~(~..e~..~...~..~.'./.~m'c~r~ss~' ---- '~' ~"~-~'/"~ -' '~'~"~.'~ ................................ Phone NO .....................
Name of Architect ................~ ...... v"'"* ................... Address .......................... (~ ............ Phone NO .....................
Name of Contractor..../.~....~<~-.~..~-~-.f.f~...~7~...Address .. g~~~...~-z'q:~one 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 NE,W~'~O~.I~ ~::~). S S
COUNTY ' '
.......................... ~...~.~..~ .............. being dumy s~om, deposes and soys that he is the applicant
(Name of individual signing~pH~
(~/
above named.~He is the .................... ~z~.~x.~ ...................................................................................................................
(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 this JUDITH T. BOK£N
~.....z~ Not~rv Pu:,l:c, State of New York
..................... day of ..... .Z'..//.~ ....... 19 ...... ..'tbmm~ssioj~ ~.x~res Ra~h 30, ]~
(Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ........... : ~:.t. ~.:'.i ~.....~'~. ~..., 19.~..°...
Approved ........................ ~.: .......... , 19..:.~...Permit ~o .................................
Disapproved a/c ............................ ~ ......... ~ ........... ~ ............................
'--:?,,
......... ......................
(Building Inspector)
Application No .......... ~(....~.i...~. ...........
APPLICATION FOR BUILDING PERMIT
Date ....... ........... ...~./~..J.~.~...~ ........, 19..~..~.
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 prope'rty 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 avo.ilable for inSperCtion 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 issuance of a Building Permit pursqant 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.
....... ..< ............
(Signature of applicant, or name, if~' corporation)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde.r.
............................................................... .............................................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate, officer)
............................................ Lot No .....................
1. Location of land on which proposed work will be done. Map No: ' '
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
b. Intended use and occupancy .......................................................................................................................
/'/ Alt t
3. Nature of work (check which applicable): New Buildin~ .................... Addition .................... era on ....................
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, specify nature and extent of each type of use ............ _.;~_.7; .................
. . .
7. D~mens~ons of ex~stmg structures, f 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 tot: Front. ........ /~. ........ Rear ............. ~'T~... Depth ......... ~ .....
Date of Purchase ~-- / ~ ~ Name,.of ~ormer Owner ~/~ ~ .
,0 .......... ............................ ....
1 1. Zone or use district in which premises are situatea ............. ~.¢ ...... ~¢¢~.~;f.'; ................... ~.%~.~;.~ ...........................
12. Does proposed construction violate any zoning law, ordinance or regulation? ......... ~ .....................................
13. Name of Owner of premises..~.~..~..7..~/.~df~.~~~.:.....~]. Phone~7~- --~ NO .....................
Nome of Architect .................................................... Address ........................... t,~ .......... Phone NO .....................
Name of Contractor ..... ~.~z4~Address .. ,~::: P~one NO .................. :..
P.LOT DIAGRAM
Locate clearly and distinctly ali 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~/ ~/) S S
(Name of individual signing applica,on)
above named.~e is the ....................~r~ ................................................................................................................
' (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 Jn the application filed therewith.
........... ~.~. day of .......
Notary P~bli¢, ~,..., ... ~t~v (~i~t~r~