HomeMy WebLinkAbout1035-zFORc,M NO. 4
TOWN OF SOUTHOLD
RUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No...Z...70;t ........ Date ............................. ,~ttt~'.... ~ ............ , 19.60'
THIS CERTIFIES that the building located at ....DO~n~ood...-.LeJle ................................. Street
Ma~.l~..O...~..~.....B~....~....~c~k No......~...X.~..X.... Lot No... 8~' &"88 ..........................................................
conforms sabslantially to the Application for Building Permit heretofore filed in this office
dated ................. A.p~l.1.......l.3......, 19.,.~) pursuant to which Building Permit No ....... Z~0.~.~. ....
dated ~ ..................... ~,pl~..~. ........ .1.3, 19._.60 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
............. P~. l~'a.te...o~e .. £ ~£ l[f.· ~l~ettil~lg ...........................................................................................
This certif~cale is issued to ..... Rev,...tla~,i, ta..oeteege..&..k~ife ............. .{.~....~.~.1'.~.). .................
(owner, lessee or tenant)
of the aforesaid building.
Building Inspector
FORM 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? 1035 Z
Date .......................... .~laZ, ~t.]:......]~3 .......... 19..60.
Permission is hereby granted to:
Fred Beoke~......J~/.C ....... ~r.t, in.. 8t~eg~..& .~I~'~ ....
........ {}r eercpo~,¢.c .... ~. y.,. .................................
to ...... B~it~.. ~n...ad~i.ti~>n.. en...an-.exi~tir~.-.d-we~.l.i.n~: ...................................................
ct prem'ises located at '"~ot~#..~'"&-/)8-..-/}aed~n~..Bw~,..~.~a~e~ ..................................
..................................... Do'g~ od'" ~z~e ¥ ....... ~a s t'- -t~laz, i~r~ ~'"" 'N'~ '~ ..........................................
pursuant to application dated ............................. 'A~'~""'~ ............. 19..~, and approved by the
Building Inspector
Fee $"5'~00 ............
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, No Y.
Examined ............ U ..................... '
(Building InslSector)
Application No. / ~ ~'~-~--
APPLICATION FOR BUILDING PEr, MIT
Date .......... .~p..r.$.~..~3. ............................. , 19~ .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 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 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 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 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
BuildLng Zone Ordinance of the. Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Ragu arians for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comp y w th all applicable laws, ordinances and regulations.
(Signature of applicant, or name, if a corporation)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Rev. Martin Th.Steege and Mrs. Lucie Steege
Name of owner of premises .....................................................................................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate, officer)
27~ (~ec.two Gar~iner'~ot ~"o' 87-88
1. Location of land on which proposed work will be done. Map No: ..D~/..E.~6~ ............................................
Street and Number ?..~.~.?..~.~.~'.~.~e.~.~.~.~g.~n..e.~.~s.~.~.~..~..~ ........................................................... Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .~,~I~JI~.~L.0.O..~.~e.-.Q9.g.~?.~...O£.;~.~p~ ...........................................................
b. Intended use and occupancy ...s~,~'lt~..oo~,~a§e-oaattf~.t~r..ef..~.~i.~y: .........................................................
3. Nature of work (check which applicable): New Building .................... Addition ....... ~ .......... Alteration ....................
Repair .................... Removal .................... Demolition.....i .............. Other Work (Describe) ....................
ae yet) (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 1
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................................
7. Dimensions of existing structures, if any: FrA-' 26t
u,.L ............................ Rear ............................ Depth
Height ............. .]:.~! .......... Number of Stories 1
Dimensions of same structure with alterations or additions: Front ..40! ......................... Rear ...2J5.! ........................
Depth ~1~' Height 15' Number of Stories 1
8. Dimensions of entire new construction: Front ..... 2J~t .................. Rear .3J~! ..................... Depth .....2,~...(~ ...............
Height l~ Number of Stones
~ tun,ed Gardiner'~ Ba~ E~tates,W..Marion-re~idential
11. Zone or use district in which premises are ~ ............................... ~ ....................................................
12. Does proposed construction violate any zoning law, ordinance ~o_r reflulation? ...........................
85. 03 Myrtle Ave. .............................
61 Robb%ns D~.
Harold Schalle r
Name of Architect .................................................... *~a .... ~E~Wil~'~tOnyN:'Y'~ ........... Phone
Fred Beaker
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.
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.................................. ~...~.<~ ............... being.duly sworn, deposes and says that he is the applicant
(Name of individual signing ap~ati~ .
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 knowledge and belief;
and that the work will be performed in the manner.]~h~.t~o~the application filed therewith.
Sworn to before me this ~0t~ public,._ ~..S ~te ~°[ New~g~Yar~
................... ........... ......... :..
(S~gnature
1/2 of lot # 87 now under purchase-
to be added to lot # 88 as a unit-
deed being recorded-H.B.Wright,of
Gardiner' s Bay Company,is the lawyer,
72 No. Village Ave.,Rockville Centre,
N.Y.