HomeMy WebLinkAbout1033-zNO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOL[~, N. Y.
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES that the building located at ..~/.~..~-~.e~:x'~..,,~3zrt'~e. ........................... Street
Map No, XX=C ............... Block No ......3:3~'~ ......... Lot No .....3Q~.....~O.*,Ai;ho].~,..~,.~.o ...................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
..................................... &~3...~....~L~ ......... 196.0... pursuant to which Building Permit No.
dated ............................ ~]~..~,,~,....~..., lg~...., 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 ..........
......... pr.i.v~...c~ne...£~uni&~..d.~ellin§ ......................................................................................
This certificate is issued to .~,.C}.,.I~.'~...~.O~.I~...~I~ ............................. K~WZ~IF ....................................
(owner, lessee or tenant)
of the ~foresaid building.
NOTE: no h~,a.~,tb ~)e~t a-caps, oval ?ecelved on this pe~/~t a~: ye',;.
FOP~M NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS ~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N.° 1033 Z
Dote ............................... A.l~i.].....t3. ..... 19.~0..
Permission is hereby granted to:
A. 6'*'..~,,... ~ome~......~e- .................................. : ......
· . t~.t, ..~!a~ ................ : ..................................
......... .~..~.~.~.....~. ............ . ..................................
to .....B~t t~.. me~e..o~e...ze~:~.y, · ~,~ '],~i~ ............................... : ....................... ...........................
at premises located at~J/J~.....~e~..~.~.~te ........... .: .................... ...... ~ ............................................
....................................................... Sou~h~,~-~'""~;'~'~ ...... i ........... """";": .........................................
pursuant to application doted ................................... '~,.~......~ .......1S60...., and approved by the
13~ilding Inspector
Fee $...10~,00.....~, Cheek
Building Inspector
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
19...~.~.Permit No. ,,,~..!..~...i~...~. .............
Disapproved a/c ...~
.............. .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
............................ ,
iNSTRUCTIONS
o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buiiding
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 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 have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant fo 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 nome, if o corporation)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician~ plumber or.builder.
If app~a/nt is a corporate, signature of duly authorized off, japer.
1. Location of land on which proposed work will be done. Map No: ..~.~....~.. ............................... Lot No:...7..O...'..Zf. ....
2. State existing use and occupancy of premises apd intended use and occupancy of proposed construction:
b. Intended use and occupancy ....................................................................... ~ ................. ..~.] .....................
3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ....................
Repair .................... Removal .................... Demolition .................... ,~)ther Work (Describe) ....................
· -oo --- o
4. Est,mated Cost ....~.. ..................................................... Fee ................ ! ........................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ...........l. ............. Number of dwelling units on each floor ........ ,L.~ ........
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 ......~:7/... .......................
Height ................ ..'mm... ....... Number of Stories
Dimensions of same structure with alterations or additions: Front .............. --'q. ................. Rear ......%7~.. .......................
Depth ............ ~ .............Height ............. 7.:M...: ......... Number of Stories ...~ .....................
/ !
8. Dimensions of entire new construction: Front ..... .~...~.. ............... Rear ...... ~...~.. ............... Depth
!
Height ....... L.~.. ............... Number of Stories .......... ./. ....................
/
9. Size of lot: Front ~OOt' Rear .,/OO ! Depi'h ....~..O....O. ..............
10. Date of Purchase ....,~/~...~'.~..~...O.. .................... Name of Former Owner ...~..O...,~..~../~../~.........~...~.., .,t'~...~'....~....~... ....
1 1. 7one or use district in which premises ore situated ............. ~. ...................................................................................
12. Does proposed construction violate any xoning law, ordinance or regulation? ;.....~....0....~'.. .......................................
k'ome of O'"ner of -remises.~.~'' ..~.0.'3~.~'~ ' Address p on
13. ., ~ ~ .......................................................... ~ ...................... h e NO ........... .~.....~..
Name of Architect ...~..~.,.~,.~...~..~':.......~.......~.~..~...~.~....Address ..*~'~-~.Z...~'.~..~...~.~...~".'~t~hone NO.~...~'..~...~...~.~?-'
Name of Contractor ....~..~.: .~.'.....~.~...~...~...~.. ............ Address ...... ~....~........~...~...'~...~...~...~ Phone NO..,~..~...~.7../.~..~
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 er corner lot.
STATE OF NEW
~OUNT¥ OF .......................... )
................................................................................................. being duly sworn, deposes and says that he is the applicant
(Nome of individual signing application)
above named. He is the .........................................................................................................................................................
(Contractor, agent, corporate, officer, etc.)
of said owner or owners, and is duly authorized to perform or have performe,~?the said work and to make end file
this applicot on; that a I statements contained in this application ore true ,tc~,the best of his knowledge and belief;
and that the work will be performed in t~h~lz{r~r~l~r~i~ii~th in the appli~ti~n filed lher~ewitb. , ~l
~O~ ~tate 0~ ~e~ . ~,~. -
~om to aerate me mis a,s,,'~ ~,~s ~. '~,~ ~ ~ / ~ ' // //
................... 7 .......... _ .
N eta ry pu b~ C,/~ C~Z~....~ Co u n t y ~ flSignatu r~of opphcan,)
FOI~M NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined .......... /t. .............. ....... , 19 . ..
,7..::....vermit No .................................
Approved .................................... ,
Disapproved a/c ....
................................ ~...~... ............... z ........................................... ':.:. ...............
................./Cx,,,~"~I/: '~- '~-~ ........ .....:...:.....: .......................................... '
(Building In~(~ector)
Application No...~..~....~.".&'.4 ..............
APPLICATION FOR BUILDING PERMIT
Dote ................ ~./:.:. ............................. , ~9..~.0
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 o 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 ma,/ 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 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, ~* a corporador~~
............ ......................
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
If appl~ant is a corporate, signature qf duly authorized officer.~
.... .......
' ~ome ond title of corporate officer) ' ~}, ~+~ '/~ ~ ~
1. Location of land whmh roposed work w II be done. Ma No ........... ~...~ ............. Lot No on p p ..............................
Street and ~umber ................ ~ ......
2. State existing use and occupancy of p~mises and intended use and occupancy o~ proposed construction:
a.. 'o d ............. .................................
b. Intended use and occupancy ......... Z~~~..~ .........
3. Nature of work (check which applicable): New Building ........ ~.. Addition ....................Alteration ....................
Repair .................... Rem~)val ....~ ............ 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 ..................................
6. If gl~[~gn~'ssn, Ucmobmee2fr ~lf, c IrSor ................................................................................................................ m,xed oc~ s"'-'per'nd 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 ........ ~'/'"'~"~'"~ ..... ..~Rear ......... /...~...~ ........ Depth ...... ,~.....~...~ ....... ~ _ ,,__,¢~Z/~-~ --
10. Date of Purchase ..... .,~../..4:~¢q~. ........ ./.~..~....¢. ............... Name of Former Owner ~...~...~.....~ff...(.../.~.... .......
1 ]. 7one ar use district in which premises ore situated ................... ..~....~.....: .....................................................................
12. Does proposed construction violate any zoning low, ordinance or regulation? ......... ~..._~. ...................................
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.
I¢~,, ,,
STATE OF NEW
COUNTY OF .......................... )
................................................................................................. being duly sworn, deposes and says that he is the applicant
(Name of individual signing application)
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 kng,wledge apd belief;
al2d that the work will be performed in the manner set forth in ~'be application fj4,ed therewith. /J/q /-
'~ c e~%~ / / I ~ ~ /~ %
. 0~~ '~ste~t~ ~ t/
Sw~, to before me th,s . ~.~,,~,~_ .,~,~o~%~¢~ . (/ . Jrl'
'~ ~ ~ ~t~b,]~,~s?'~,~'~%~ ~G~ ~ / /I //
..... ~...~ ........... ~ of ..~ ............... ~¢~%,,,o¢ ,~ b~ J~ ~ ~.~.~.,
Notary Publ~~.~~ ...... ~nty /(SignatUre of applf~ant)
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec-
tor with the following; for new buildings or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual
natural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or
topographic features.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use
3. Copy of certificate of occupancy $1.00
$5.00
Date ... Sept,...2~2.,..lgS& ........
New Building ............. Old or Pre-existing Building .... X. ...... Vacant Land .............
Location of Property .(~0.5. Leeten. Dr. ive .................................. Southo{d ........
House No. Street Ham/et
Owner or Owners of Property .. B.ar~qr.~l .Mi~5~;~r ...........................................
County Tax Map No. 1000 Section ...~c~ .......... Block ....... ~ ....... Lot.. ~. ............
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No ..... - ...... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted$...1,00 .................. /~. /~ ' ~)~
Construction on above described building an plicable codes and regulations, t0 ~. ~,1. ~ I~J
Applicant...//./~'.. ~.././/,~. / ........................... ' .~. _~. [~ .~ -~'
* J~H~q J. IV~INZ~L, ESQ.
Rev 10 1078 Premises known as P nd 71 on a c " of
· - - ' ~'~l~s 6q,65,70/~nd i ertain map entitled, Mal~
West Southold-on-Sol~d, Plots 1-~3q", Town of Southold, Suffolk County', New
YOrk, owned by Lidico Corp., made July 1950 by William L miller.
John J. Murine1 ~
RLvb~ne*d, ~ew ~'ox~k 11901
At the t~e ~h~e
Re~,Oez~. o£ 0eoupano~'~Z~29
L®®ton D~fve,~BoUthold,
when
~nd '~ept./e'B~stem to'D~elI[n~s.
to ~egulate the;¥eiI:
=,T~i.- Ce~tifioa~e ii.legal fo~ a One'-Fa~Xl2 D~elling.
It _appeaPo ~e WeI1 - Septi'. SFstem wan pPioP totho H%altli;
Deponent me~Alationo, Therefore, no app~oval was'z~q~iPo~.
Yours t~ul2,
,GeOZ*l~e .H. jFlehe~ ,
Senior, Bldg. inspee~O~
TOWN OF $OUTHOLD
OWNER
FORMER OWNER
PROPERTY
STREET
VILLAGE
RECORD CARD /~- ~-
j DISTJ SUB. LOT
SEAS'~6 i
LAND
RES.
IMP.
S
DATE
TOTAL
W TYPE OF BUILDIN .,. ,.
COMM. CB. MISC. Mkt. Value
J REMARKSi'/I~/';~, /V..C.
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre
Tillable
Tillable 2
:Tillable 3
i Woodland
! Swampland FRONTAGE ON WATER
FRONTAGE ON ROAD
i Brushland
L
Value Per Value
Acre
J House Plot
J Total
DEPTH
BULKHEAD
16 0
TOWN OF
$OUTHOLD PROPERTY RECORD CARD
OWNER
- /
FORMER OWNER
STREET
VILLAGE
W
DISTRICT SUB.
ACREAGE
T'~'PE OF BUILDING
LOT
RES.
LAND
SEAS ~" I VL.
FARM
IMP. TOTAL DATE
COMM.
REMARKS
~ I t MISC.
.lIND' CB.
Farm Acre Value Per
Tillable 1
Tillable 2
Tillable 3
Woodland
Swampland
Brushland
House Plot
Total j
TION
ABOVE
Value
M. Bldg. )'~m-~/~ £,50 [ ,.~O Foundation
ExtensionJ~ ~J Ba~nt
.......~,~,Extensi°n'~.~ f ~ ~ FirePlace ~o~ He~ ~_ ~ ,
:~ . . . ~ / ~ Porch R~ms 1st Flor
Breezewo ratio ~-~/~ R~ms 2nd Flor
Garage ! Driveway
i ,
o.B.