HomeMy WebLinkAbout1063-zF0,EI~ NO. 4
TOWN OF SOUTHOLD
TOWN CLERK'S OFFICE
SOUTHOLD~ 1~. Y.
CERTIF~CAT~ OF OCCUPanCY
THIS CERTIFIES that the building located al Hyat~t ..1~oa~.-Horto~r"Pt,~"~'"-South~f/~t
................... Lot ]No ..............................................
_Map No.//yaitt ......... Block No. **~ ' *** ........
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ..............i4a.y....3 ................... 1~.... pursuant to which Building Permit No...2%..1.063 .......
4areal ............... May-'~ ..................... 19..60, w.as issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is
..................................................................... ..~....~. A.~....0~K. ~A~//~Y..D~L/~ IN~ .................................. .
This certiflcale is issued to ...Herber~..l~]est]~e~e.r..owne~ ..........................................................
(owner, lessee or tenant)
of the afol'esaid building.
FOI~]?I NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS F~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? lO63 Z
Date .............................. ~a~.....~ ............. ~9.6~..
Permission is hereby granted to:
Jo s e ph,.... 3.e~ne .~.....,~..Ck....~e.~.b.e.~',t .. ~.e, ~.~...
......... .~ ~.u.tho~.¢t ...................................................
to .. ~t~t,3,~,.. an.. ac1 flJ, .t,;Lor~..~...~...e.z,~.~!n~...~l~.e..l..~.ittg......~i. .......................................
at premises located at ....~.~,..]:LO~t~..,.~,~.t,O~..~.O,~Z~ .......................................... : ...............
............................................................ ~.a.~..~.~l,....~.,.~., ...........................................
pursuant to application dated .......................... ~&~r .......... 3 ................... 19..~.0.., and approved by the
Building Inspector
Fee $.~..0..0.. .............
I~OP~M NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Approved .................................... , 19....!...Permit No. ~ I O (~ ~
Disapproved a/c ...........(~i.~ Z ... ~.~-~ ..................... J .....
(Building Ins~tor)
AppJication No ..... l...0..~..?. ..............
APPLICATION FOR BUILDING PERMIT
Date .........................
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 an 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.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 nome, Jfa corporation)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
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 No: ...f....~..~: ............ .~..... Lot No:...~...~ ........
Street and Number ...!..~..~....~.., ...... ~.~..M.~.~...../..~..x~......~~ ............ ~..~. .....................
A;'c6nicipality
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ........... :.T4..=. ........................................................
b. Intended use and occupancy ............... ~...~. .............. ~..~. ......................... ~..k ......................... ~ .................................
3. Nature of work (check which applicable): New Building .................... Addition ............... Alteration ....................
Repair ................ =~.Removal .................... Demolition ......... ~,~ ...... Other Work (Describe) ....................
4. EstimatedCost~..~..~.....O....~. .................... .q~g.H:t.'..U.g~'~....~...~...O.:[ ............................................................................
'THbIMT,'tAq]O iDHlaJtHi~ be paid on filing this application)
5. If dwelling, number of dwelling units ........ 3D~i~tW~l'welling units on each floor ..................................
If garage, number of ..... Y .H ,(]JOHTUO~
6. if business cor0mercia[ or mixed occupancy, specify nature and ext~.t.~! ~ac,h type ~f use ............
7. Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth ................................
Height ............................ Number of Star ~ ............... i.i....i .....................
Dimensions of same structure with alterations or additions: Front ..'..'...v...v.'.'.'......'...: ....... Rea~'..'......'.h.J.'..!f.~.¥
Depth ................................ Height ................................ Number of Stories ................................
8. Dimensions of entire new construction: Front ........ ..AJ/i...O. .......... Rear ....... ...'~.....~ .......... Depth .... ~ ..................
Height. ........................... Number of-Stories..- ~
9. Size of lot: Front ............................ Rear ............................ Depth ............................
10. Date of Purchase ......................... ~,r~.~l~lq..[.~H.t(j:lltjSNjjlb~ ~91~!~n$£]~kner ........................................................
1 1. Zone or use district in which premises are situated ...... ~...t .............................................................
12. k~o~s proposed.construction violate a~y~ing law, ordinance or regulation? ........... ~ ...................................
13 Name of Owner of prem sas ~. ~~ Address ............... Phone NO
.... .......................................... .....................
Name
Architect
~,,~ ~ Ham~ 9~[ Cfl~t~9r,~...~,~,z~..~-..r,. ,~.~r~ ,.~..t~, h 'M ....... ,~"~ ........... ~"~" Rh~n~, N~,, ....~,~,~....., ....
PLOT D AGRAM
property nas G ye street ap~ bloc¢ numbers or~ d~cript on accor~ ng to deed agd show stqe~t name~ and lad cate
(Im~.~ilqc h)
STATE OF NE~ ~O~KO ~ ) S S
~...~z~ ~,~.~being duly sworn deposes and say~ ~ th~ggpplicant
"'.'"' '.' '.'.'.'.' '.' 'u 'L' ' '.','.'.'.' ' ' ','. ..... ',' '.' '.'.','.'."[ ',""...','.".u ' '; · , ................. )
above named. He ........ ~s th~ ........................' . ............... ~~ ......................................................................
of said owner or owners and is duly authorized to perform or hove performed the said work and to make and file
and that the work will be performed in the manner set forth in the application filed therewith.
Sworn to be ore me t ...... ~ ~
da of ...L.Z.~ 19 ~]ssl0, ~ i~0s ~c~ ..
................. y ........................ ........ ,
Notory ........ County ~Jturf ~f'~pplicant)
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Approved .................................... , 19 ........ Permit No .................................
Application No ....../..0.f~..~? ..............
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. -I'his 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 opp!icotion, the Building Inspector will issue o 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
Building Zone Ordinance of the. Town of Southold, Suffolk County, New York, and other applicable Lows, 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 a corporation)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
........................................ ~...~,::~ .~ ." :..--.~..--'" ........ ~ ................................................................................................
Name of owner of premises...../.~.~.?.~..~.):~r.~;:..~.......~.~..4, r~~'~ ~ ~-- .................................. ~ .......................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
wh c roposed war w II b done. ap o ....................................... Lot : ....................
Street and Number ......... ~. ................................ :~ .....................................................................................................
Municipality
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..... ~...~.~k ........ c~..~ ....... \ .....................................................
b. Intended use and occupancy ............. I..~. ............... !..., ......................... .~..1 ................ ~...~.....~.~.~..~. ~. ...................
3. Nature of work (check which applicable): New Building ...........
Repair .................... Removal .................... Demolit on ..........
5. If dwelling, number of dwelling units .......
If garage, number of cars ..............................
6. if business, cor0mercial or .mixed occu
7. Dimensions of existing structures, if an:
Height ............................ Number of
Dimensions of same structure with al'
Depth ................................Height
8. Dimensions of entire new constru(
~.',,.....Alteration ....................
Work (Describe) ....................
JtP be paid on filing this application)
units on each floor ..................................
pec[fy nature and extent of ¢jach type of use .......................
, Rear ............................ Depth ................................
, ...... ~.1 h~,~,'~
or additions: Front ...'.....' ............ '.....'....... Rea¢
Number of Stories ................................
Front .......... .~'..I..o ......... Rear ......... .~.~/...E) ......... Depth ...... ~
Height ............................ fi, Star es ¢~ ....
9. Size of lot: Rear ............................Depth ............................
10. Date of Purchase ........................ y[.t¢i;l~q..D, f4.t¢idi.u~lN~e e.~¢~j~r~q~[j/~t~er ........................................................
] 1. Zone or use district in which premises are situated ..................................................................................................... ~
']2. vBofs p[opo~ed construction violate a~y,~ing law, ordinance or regulation? ..... ........ ~.~ ..................................
13. Name of Owner of premises....~.:.~J~&~ ...... Address .......................................... Phone NO .....................
Name of Arch ct ...... ~..~ .......... ~ ......... :,...~.:.¢ ....... AS~ s .......................................... Phone NO .....................
,..,N,,,am, ¢.f C*,t~a:~,or..,..,~,¢,,7,,,~,¢¢*,*~,~'f.~..,,....,.,.,hw~r,,, ,.,..~¥,,h~..,,h,h,k.,,...,,.,.,...,.,..,,...,R**n¢:ND,,, ........ ~., ...........
PLOT D AGRAM ¢
property lines. Give street ep¢ b. lock numbers or d¢~cription according to deed ood show street nemeE end iodicete
whether ~nterior o~"¢6¢~e. VqbW'"~ h~ ,~,.~..~ ~v¢t,,~,,,~,~,,.,~,,~ ,/!.,~ 'd"''"'~'"'.q,,~'."h /.,..~,',.'~ ~.,.~¢ .,,~ '
STATE OF NE~YQBK~ ¢. ) 'c ~.
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file
thEs f ~p(icfti¢~;.. tbo.t all statemeQts coQtq ned .in.. this .flpp l ic~tio~ .are..t.~ue.. to..t~er~bffsf)-ef IbJs~ bu~w e~e~-~nd ~,belief;.~
and that the work will be performed in the manner set forth in the application filed th~ '