HomeMy WebLinkAbout1563-zTOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No ........... ~'":.1.'~46'" Date .................................... ~alt~"5'"'"' 19""~2
THIS CERTIFIES that the building located ot~/~..~..V.~..~G.~.~...~~. Street
~p~ ....................... ~i~k ~o. ,..~.~ ............ ~ ~o ......... .~ ........................ ? ...........................
conforms substantially to the Application for Building Permit heretofore filed in ~his office dated
............................... ~e~...2~ ...... 19~... pursuant to which Building Permit No. ~...~G~..
dated .................... ~~...25..., 19..~., was issued, and conforms to 6ll of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is .issued is ..........
This certificate is issued to ........ .~.~J~.~,/~.~f~.*~.O.:~. ~l.~t,~,....~s~..~ ...................... : ...........................
(owner, lessee or tenant)
of the aforesaid building.
Building Inspector
FOI~[ 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.° 1563 Z
Date .............. Se ]~t, ellll)~... ·..2.~ ............ 19.(~%..
Permission is hereby granted to:
.Chr. i~t ~he~..... He~ ......................................
.......... ~ay...Y.i~w.. Av~ ........................................
........... G~. ~eapo~.t~ ...............................................
to ........ ~_ild...an.. a~dit ion..on., s_n.. exiating.. ~el ]~Dg .................................................
at premises located at ...LO.t,..~. ............ ~,~._~...~If~.h~.T.~.l~l .......................................................................
.................................. ~/.S......~a~...l~.te.~..~e ............................. (~r...~n~.~.~.~ ...................................
pursuant to application dated ................................ ~e~tem~e~.....~,.~.19~..., and approved by the
Building Inspector
.Z~..~j............., ~] Building Inspector
FOP~M NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLER~('S Oi:~:[C~;
SOUTHOLD, N. Y.
E× om,ned .......
Approved ........................................ , 19..~.L...Permit No. ~7/,~' ~ 3
.......... ....................................................
~ (Builc~'~ng Inspector)
Application No. / ~'~ 3
APPLICATION FOR BUILDING PERMIT
............ ........... .........
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 on the diagram which is part of this application.
c. The work covered by this application may not be commenced before issuance of Building Parfait.
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 g~anted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to the
Building Zone Ordiaance 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.
....... ~....h...~.:. ~.. :.o... ~ .b...e.~/.c ...... ...~......~:.. T~ ...............
(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.
r f rem ses .~...~:.L:..x~% ' ")'~0.~
Name of owne o p ,..: ...... ~ .................. ~ ...............................................................................
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: ............................................ eNo: ....................
Street and Number ..... ..~.../..~...........~....c'.:..~........~...~....C~ ........... ~~ .............................
Municipality
2. State existing use and occupancy of premises and intended use and occupdncy of proposed construction:
a. Existing use and occupancy .........................................................................................................
b. Intended use and occupancy .................. ~.5. ............... .C....~...~...~....~....?.-;~: ....................
3. Nmure of work (check which applicable): New Building .................. Addition ....)~..~.... Alteration ..................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................
4. Estimated Cost ..... h ,~....0...,0.....~-,,. ................................... 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, commercial or mixed occupancy, specify nature and extent of each type of use ................................
7. Dimensions of existing structures, if any: Front........ ~.~ ........ Rear........ l~. ~ ...................................... 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 ....... 'L....'~.. ................ Rear ...... /...~ ...........Depth ....~..~ .........
Height ............................ Number of Stories ........ ~ .........
9. Size of lot: Front ..... J.....0~... .................. Rear ......... ./......6~.. .......... Depth ........................................
10. Date of Purchase ........................................................ Name of Form~r Owper ........................................................
11. Zone or use district in which premises are situated ........ ~'~ ......... ~.: .........................................................
12. Does proposed construction v~l~e an~ z,oning/41a,,~_, ordinance or regulation? ......... ~ ...................................
13. Name of Owner of premises ..,,,,~-¢,,em....~..~'0.'.-::.~,..:..~..i~Address(~:~/~'-'~',~///"/"~ ............................................ Phone No .....................
Nome of Architect .................. "~l~"~"'~"-~'~-'"~ ........ t: ..................... Address ............................................ Phone No .....................
Nome of Contractor ...~1~/.~...,. .................. Address ............................................ Phone 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 or corner lot.
STATE OF
COUNTY OF S.S.
being duly sworn, deposes and says that he is the applicant
(Name of signing
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 thdt the work will be performed in the mann~l~f~tT.fci~tl~Nin the application filed therewith.
Sworn to before me this ~ ,~0t~lry Public, Sta~ of New York ~ ~
.............. ~.. day g~......~..~M~gp~t~ar~3o, ~. /'1%y ,, ~ 7~///~ ' ~/~ ~
.............. ...................
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Approved ...................... !.: ............... , 19.!/.....Permit No. ~Z/5' & ,~
Disapproved a/c ....... ,'/'~,.,,,,~"~.~,.,,,,',~J'~j ...................................................................
......... ............................................
-- (Buil~?~g InspeCtOr) ....
Application No. } ~,~"6 --~
APPLICATION FOR BUILDING PERMIT
Date Ik 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 adjoining premises or public streets or
areas, and giving a detailed description of layout of property must be drawn on the diagram which is port of this application.
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 pa rt for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Deportment 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, 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 .. ~.,. ~,~.~.~,~,~.......~[~.A.. ..............................................................................
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: ..... ~:..~'~..~,...!.~.~.6,-:~.'v.'bot No: ....................
Street and Number .......... , ................. :'"7' .........
Municipality
2. State existing use and occupancy of premises and intended use ~nd occupancy of proposed construction:
~. Ex~stfn~ use end occupcncy ...... ;: ...... . ............. ~ ................................................................................................
b. Intended use and occupancy ........................................ /... .............. ,.~.:......- ........................................................
3. Nature of work (check which applicable): New Building .................. Addition ......~.,...~...... Alteration ..................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................
/5oo 5' .
Estimated Cost ............................................................ Fee ..........................................................................................
~[ (to be pa~d on filing this application)
5. I If~welling, number of dwelling units ........ ~.....Number of dwelling units on each floor ............................
~lf garage, number of cars
6. ~lf business, commercial or mixed occupancy, specify nature andL 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 '~,-~ 2----
Height ............................ Number of Stories ........ ...C;~....~.~ .........
9. Size of lot: Front ..... L...0~.. .................. Rear ! /f'O Depth
10. Date of Purchase ........................................................ Name of Form~r Owner ........................................................ '~A '~ I'q.~
11. Zone or use d~stnct in whmh premises are situated ......... ?.7~ ......... ~ ....................................................................
,2. Does proposed construction-~'~i}~'"t~" ' '~*~/~'?'~Addressv~n-y~z°~ni'ng/'?w~ ordinance or regulation? ......... Ph° e N°~"d'"'~'""'" ......................
13. Name of Owner of premises ..................................................................
Name of Architect .............................. '..' ..................... Address ............................................ Phone No .....................
Name of Contractor .... ~...' ................... Address ............................................ Phone 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 or corner lot.
.................. ~~.....~'.....,~TY....~:.~..~.. ........... being duly sworn, deposes and soys that he is the applicant
(Name or inaiviauo~ signing appdcationkJ '
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 a.pplication; that all statements contained in thi~_.,oDpl~:~on are true to the best of his knowledge and belief;
and that the work will be performed in the manne~¥s(~[[~'~application filed therewith.
Sworn to before me this ~ot~r~ ru, ,
........ - . ?. ,
.......