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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.