The URL can be used to link to this page

Home My WebLink About1567-z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERKS OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. . .Z..1390.......... Date ........................... .J41-3r.. ..3........ .. 1962... THIS CERTIFIES that the building located at .................... Street R..P9�iB�J.PPZ?ck No. . . . ....... Lot No. .}�,Q�'.......{;� 4S� c�$ @ Vis. ............ conforms substantially to ,the Application for Building Permit heretofore filed in this office-dated ..........................................,��arf;..... j....., 19 ,x... pursuant to which Building Permit No. 7- dated .............................:e@rt.....2 ,.., 19� ..., 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 .......... ze••.ami-1 €uell—in ................................................................................ This certificate is issued to ...Th®Ma5 D,3 13•eJSGn...............f}tomer............................................... (owner, lessee or tenant) of the .aforesaid building.,' Building'lnspector 10 ,t I 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) NQ15567 Z Date ..................September....26........ 19.01,.. Permission is hereby granted to: Riverhead••ConstruetlonXo. A/C•.......Thomas Danielsen ........Riverhead................................................... ................................................................................. to .bAld..naw..one..fam1l.y..dwelling...................................................................................... ................................................................................ ................................................................................ at premises located at .....jpt..#405.....fi@sselm-pOH.nt...p"pertles........................................ ................................................Haywater...Road.y.....Cutehogue.................................................... ................................................................................................................................................................. pursuant to application dated ....................................sept........26......19.Ej1 , and approved by the Building Inspector Fee $...10.00........ Building Inspector , FORM NO. z . . ' TOWN OF SOUTHOLD BUILDING DEPARTMENT ' TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exonninad -- _u, l9../ Application No. .. .7—.—. ' Approved -------..�.'----., l9—.L.Perno|t No. Disapproved o/c --- ' ' -'~ ------------..~..--.^��°~..-------------------. . . .----...---.~� .........—. . — . � y ' <Bui|ding inspector) ` ' | ` / APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o This application must be completely n//uo in by typewriter or in mu and submitted in duplicate no the Building ' b. Plot,plan showing location of lot and of buildings on premises, relationship to adjoining premis�s-or pubiic streets or areas, and giving a detailed description of layout of property must be drawn on the diagram whi�'h is pa�,�of this application. c. The work covered by this application may not be commenced before issuance of Building Per��it.' d. Upon approval of this application, the Building Inspector will issue a Building Perrhit to ike cipplicant. Such permit shall be kept on the premises available for inspection throughout the progress of th, work. e. No building shall be occupied or used in whole or in part for any purpose whatever untii/19 Certific"ate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Buil rmit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other a 'plic�ble 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. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, elec.,t ician, plump' \er or builder. Name ofowner ofpremises. �f�}�� J��3��/ \ � ' —'' '' -------------------'�'.------^---�r---� If applicant iso corporate, signature ofduly authorized officer. .---.—.-----~......^--.--.......—.------- (Name and title of corporate officer) l. Location of land on which _a~~~U ^ ~�^^~ . �� ` Street and Number 2 State existing use and occupqncy of premises and intended use and occupancy of 0 posed construction: / o. Existing use and occupancy —�/aa&��f,..Jand---..-------______..� /..�,_________. ^ .. ` b. Intended use and occupancy .......one'.f lmi..1y...dwe ............................ ,/_,,'.�_ ....................... � .. 3. Nature of work (check which applicable): New Building ......?��.... Addition .................. Alteration .................. Repair .................... Removal .................... Demolition.................... Other Work (Describe)• ........................ 4. Estimated Cost 000.. Fee .......................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...one...................Number of dwelling units on each floor ............................ Ifgarage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify natureand extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front............:............. Rear .......................... Depth .............................. Height ............................ Number of Stories ..................:.......................................................................................... Dimensions of some structure with alterations or additions Front ................................ Rear,................................. Depth Height ................................Number of Stories ........................................ 8. Dimensions of entire,new construction: Front.............36............... Rear .....36.................. Depth .....22.................. Height ............................ Number of Stories.....0110.................... '.. 9. Size of lot: Front ......103................... Rear 91,'.5...... Depth .........2..9.5/3Q 10. Date of Purchase ........................................................Name of,Former Owner ........:.............................................. 11. Zone or use district in which premises are situated......etpsa Cilu iI 12. Does proposed construction violate any zoning law, ordinance or regulation? ........:....... ................................. 13. Name of Owner of premises p; ........Address ....................................... ... Phone No. Name of Architect ......................................................Address ............................................ Phone No. .................... Name of Contractor ;�11? "'flt ..vp ��'iX+Stl�l................................................Phone No. . . .................... PLOT DIAGRAM -Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all setback 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. 75 STATE OF NEW YORK, ) S S COUNTY OF RU-01k.7 .. __a) �.. C:: ' ........being duly sworn, deposes and says that he is the applicant 3ST...fr4X1 ..�rKividual .. ............ ..................... (Name of in _signing application) above named. He is the Cf.FYI:L'raiator...................... . (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 set forth in the application filed therewith. Sworn to before me this JUDITH T. BOKEN Notary Public, State of New York �0 52.-^344963, Suff I Co °' .................26.. day of ............... .,=,� 4`{� c � .... 9!...............................Notary Public, �, .. /-. ,: ° rrt� (Signature of applicant)