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Home My WebLink About1068-zP,O~'[ NIO. 4 ?OWN OF SOUTHOLD BUILDING D?-PARTM~NT 'I'OWN CL~-RK'S OFFICE SOUTHOLD, N. Y, CERTIFICATE OF OCCUPANCY No. ,. Z...ll2.B ...... Date ........ Selatealab$r...,% ......... : .............. 19.,.61 Mat~i~uck THIS CERTIFIES that the building located at L...&..L...~;;hQ,~:~.i ..L~'~m .L.~. ,.., ...... Street Map No ...... ~?.~ ........... Block No ....... .9~'.~ .......... Lot No ......... ~.?.~ ..................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............... ~'...~. ...................... 19..6..Q.. pursuant to which Building Permit No ........ dated . Ma~ 5 19..?.?..., was issued, and conforms to all of the require- merits of lhe applicable provisions of the law. The occupancy for which this certificate is BUS IN~$~ ~UILDt~G ~ssued is This certificate is issued to ..... M.,~._..A...*....~-,ls2{~i(,,....qv~.e...<. ....................................................... (owner, lessee or tenant) of the aforesaid building. FORUM NO. 2 TOWN OF SOU, THOLD BUILDING DEPARTMENT TOWN CLERK'S.OFFICE SOUT~HOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 1068 Z Permission is hereby granted to: .... ,, H, R, Ree~.e..&.,aons.....A/C.....M ..~¢.1~.e~. ............ j ...... ........ li~t~t~.....l~ I,, ....... ::: ........ to .Bu~bl~t.. ~r~..a~cl ~.~c~on.. ~t ..sn .. e~.i.s t.l. ng ...Bu~i.n~ s:s..bu~.~d ~g. .................................. at premises locatedat ...]~/~......L~..~,~R-~ .............................................................................. ................................................. ~.~i.tuck ~.....N~ ~[. ......................................................................... pursuant to application dated ................................ ~a~7. ...... ~ ............... ]9~0..., and opproved by the Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD~, N. Y. APPLICATION FOR BUILDING PERMIT Date ....... "~"'~'"~7 ........... ~ ............. 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 <]dioining premises or public streets or areas, and giving a detailed description of layout of property must be drown on the diagram which is part of this location. c. The work covered by this applicatior] may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Builaing I~spector ~ill issue o Building Permit to the applicant. Such permit shall be kept on the premises ovailoble for inspection throu~h6ut'tFie progress of the work, e. No building shall be occupied or used in whole or in part for any pukpose whotgver 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 a Iterations, or for removol or demolition, es herein described, The applicant agrees to comply with all opplicoble laws, ordinances and regulations. ..................... State wheth.er applicant is ow,her, lessee, a, gent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises...,~...~.~. *~../.~...~.:: ........................................................................................... 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: ............................................Lot No: ....... ~ ............ Street o,d Number ..... ;, ......... .............. Municipahty 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. E×is.ng use and occupancy ......... ................................................................................ b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition ............. Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ....................... ~.~4.~., ...................... 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, co,'nmercial or mixed occupancy, specify nature and extent of each type of 7. Dimensions of existing structures, If any: Front ........ ..~'~...~....,c..... Rear ....... ~;~..<; .......Depth ........ ~j~Lr~'...~.~r... Height ......./..., .~..,:. ........ Number of Stories ............. ~.. .......................................................................................... --~. Dimensions of same structure with alterations or additions: Front ........... ~--~... .......... Rear ........ ,,,~.~? ............... Depth .............. ~,~'~..~. Height .......... '~"7'":' ....... Nur~ber of Stories .............. ...,~... ............ B. [Dimensions of entire new construction: Front ......... .,~..~...(A? ...... R~r,~..~..~.~.~. ..... Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situoted.......~. ....... 12. Does proposed construction violate any. zon!ng law, ordinance or regula,tion? ......... .~..~..~.. ................................. 13. N~me~f~wner~fprem~s~s~~..~.~f/~.~Address.../'~.~/~./~..~.~.~.~.'~..`.P/~neN~~/~,~,//-~ ..................... Nome of Architect ............ ,......¢,,~.../~..~.~..~..~.. .............. Address .....%:~...~....~-Z.~.~..4.~...~..~....Phone NO ..................... Name of Contractor....~..'.~.~.~.~.~./~......~..~.......Address /~'¢~L~.-~..~.../~l~'hone 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 ar corner lot. l I N STATE OF NEW YORK, ) S S. COUNTY OF ............................ ) ~....~..~..'.~..~...../._~..~C~,:'~_..~,~.~.--:.....~....¢/~... .......................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ................................................. ~.~9,..~.~.~.~ ~.~.Z..~... ................................................................ (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 per, formed in the manner set forth_ !n the applicgtion filed therewith. ~ ,,~ Sworn toe,ore me this ~ 'v~r~Z "c,~' ~t Iv~/ ~"( / ' -- ~ / ~ ~/'~"'~ ~' ' ~ / 't~''' ;,~//;,~,-~Z.~'er_.5¢ ~l- ...... f~.....~..J~..-T..., day of; .......... ~,,~,,,c~ ................ 19.~/a.~..~(;-.:?~i.;]o~ol,~.. (Signature of applicant) ........................... ~,~ . r. z~,¢' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined Approved ........................................ 19 ........ Permit No ............................... Application No...../...~....~......~... ...... Disapproved a/c .~... ~ (Building InspectOr) APPLICATION FOR BUILDING PERMIT Date ........ /~.~ ............. ~ ............. 19.,,.~..~ 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 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 puFpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuanoe 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 a corporation) ...................... (Address of'applicant) 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 wo.rk will be done. Map No: ........................................... [:ot No: ....... ~ ............ ...cf.. Lo. Street and Number .... ,~..~....'r..<~.~-T......, .... ~..~..~..C~. .... ~...m... ,~'~.~.,'~.' ............. ~ Municipality ~ 2. State existing use and occupancy of pr,emises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... ~..~..~:..-r.:.'..~.......-:~.,.~...,~..,.~... ................................................................................ b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition ...... ...1~..._ ...... Alteration .................... Repair .................... Removal .................... Demolition .................... Othe r~Wg. rJ~ (Desc rlbe) .................... 4. Estimated Cost ........................ ~--,~...~...~..f:.....'~... .............. Fee ................ ~"""~,,,~,' .Z ................................................................ (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. Dimensions of ~xisting structures, if any: Front ............ '-'lZ......~'~....."..... Rear ........ ,~.....~i~. ........... Depth ......... .~....t~1~......'~... ; Height L.~.... Number of Stories ............................................... .................................................. ............... Dimensions of same structure with alterations or additions: ran ........... ..!...~... .......... Rear ................................ Depth ............... ~....~...... Height ........... ..~...7.,. ........ ~ber of S~s_~, .............................. 8. Dimensions of entire new construction; Front .......... ..~,, .~,,...~,, ..... R~,,.-~.,,'~,,,~,~,_ .... Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ........................................................ Name. z~of For~r Owner ......................................................... 1_1. Zone or use district in w~hich premises are situated,.........'~e..'t?.... ...... 4,~.~..-~...~'...,~.....~....~...'~..~ ................................ 12. Does proposed construction' violate,4,,~ 7-,~any~ ~on~ng law, ordinance,,,~ ,~---- ~',2 _~,,°r regular, ion? ..........." ~'"~ ......................................... ' 13. Name of Owner of premls~s...~..~.~...~..t...~.l..~...~..~..i. Address../..~:.~../.~c....~2,,~'~One NO Name of Architect ......... ,.,~..~,,~?'~,.~....~....~..*. .......... ,~ ...... Address ...~.~._..~,.~'..~'~.~Phone NO .............. Cant ractor.~~.~....~....~... ~....~.../~....... Add ress Name of N~..L'".~.....~ 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. ~.. ~' V'~" ~'~,~"" sTAT[! OF NEW YORK, ) S S. COUNTY OF ............................ ) ~..!.~...~....~.%~...~..~.~.~.~,.~...(.?.~.~.......~.....~... ............ , .............. being duly sworn, deposes and says that he is the appl,cant (N~me of individual signing applicatldn)~ ~ ~ ~ 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 oil statements contained in this application are true to the best of his knowledge and belief; and that the work wil be performed n the manner set forth i~ tNe app~c~ion filed there~th. Sworn to before me this ~. ~u~'"~;,~? ~? ~/z. _. ,t,/ /~-~" ~ t ,,:,,~:,~,~ ~ ~ ....... ~. .............. day ofz~, ....... .~,~,,~ .................. ]9,~,~?._, sur~o[~ ~,~ (S~gnature of appl~ant) Nota~ Public, .....~:i.f..~f.~".../Z~.Z,...~.~:~,~Z:~......Coun~