HomeMy WebLinkAbout1582-z~gOEM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's O~ice
Southold, N. Y.
Certificate Of Occupancy
No..M?0.~O ..... Date ............ t~a~f~ ....~.~. ...., 19..~6
THIS CERTIFIES that the building located at . .S/~. ~L~etor~ .Dr&ye'. ...... Street
Map No.. X~ ....... Block No... X,~ ..... Lot No, . .XXX .... ~ot~%hold...~.~, .......
. conforms substantially to the Application for Building Permit heretofore filed in this office
dated ............. ~;...].3, 19.. 6.~ pursuant to which Building Permit No..] .~2 .~
dated ............. ~;...].3., 19. (~., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is .. ~X~.¥.~..~.e... 9.1x~ ..~. {i.m.5.'~:~r. fl:g.~..~.]~.~g. .....................................
The certificate is issued to . gambol.. 2gark~.3, ..... 1>.3~.**..,:. ...........................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval .. ~ay... l.h:.. ] 97Jfi .. l>g .tt,..V.:l&J,a ....
UNDERWRITERS CERTIFICATE No..p.o.ll.~t.'J:gg ........... . ...................
HOUSE NUMBER ... 8~5 ....... Street ..... I~ee.ton. I)x:~vo .......................
Building Inspector
FOR~I[ NO. 2
TOWN OE $OUTHOLD
~UILDIHG DEPARTMENT
TOWN CLERK'S OFFIC£
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FuLL
COMPLETION OF THE WORK AUTHORIZED)
No. 1582 Z
Dote ...................
Permission is hereby granted to:
~,m~t~&.....~'4a.~k~l ..............................................
.................... ~ ea.. C l.~£..... ~..t ~ ........................
to ...Er.e at.. a.. neY...one,. £smil¥,, rl~,~ llit~g ...............................................................................
at premises located c,t ....~/~.,...~eC>o~...~iV¢ ...............................................................................
.................................................. ~o,uI;h~3A ..........................................................................................
pursuant to application doted ...................... 0DJ~O,~P.,...~:~ ................ 19,,~b., and approved by the
Duilding Inspector
Fee $.1.0..~0 ...........
Building Inspector
S-9
SCHD
SDFFOLK CODNTY DEPARTMENT OF HEALTH
TO
at
WHOM IT MAY CONCERN:
The sewage disposal facilities for a structure located
(Give deed location)
have been inspected by this department and found to be satisfactory.
~f~eT of General Engineering Services
~[CT ON 7~ O~c TH~ NEW YO~i~X STATE
BuILrDINt BLEIPAIKTMINT f I -
TOWN CLERK'S OFFICE
Examined....~...!....~.. ......... , 19...~.~.C.. -/J~/,9-'9,~/;' "~Ap~o.:.~.~....~.~..~:..~
Approved ............................. ~. .......... , , 9.....:!.Permit No. ,...~'....../.....-~.....~'.. i...,)-,.'~......~//~/f~' ~1~ ~'1 - /(~'~l~'~'~j~ ~"~
DisapprovecJ a/c ..................... ~ ......
................ ....................................... "
APPLICATION FOR BUILDING PERMIT
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 ~treets or ..
areas, and giving a detailed description of layout of property muSt be drawn on the diagram which is part of this aPPl~cation,~-
c. The walk Covered by this application may not be cam menced before issuance of Building Permit; ~
d. Upon approval of this application, the Building Inspector will issue o Building Permit to the applicant. Such~
permit shall be kept on the premises available for inspection throughout the progress of the wo~'k.
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, O.~ir~ances 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, ordinance~s and regulations. 'i
(Signature of applicant, or name, if a corporation)
S19 Littleworth La ,Sea Cliff ,
(Address of applicant)
State whether applicant is owner~ lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.~/j
Name of owner of premises ...~LLe. l.....a/'-~e. ............................... ~ ......... : .................................................................
If applicant is a corporate, signature of duly authorized officer. L,
(Name and title of corporate officer)
1. 'l-°~otion of land on which proposed work will be done. Map No: ..~ ............... :.4 ...... 2~ lot No:I~X.X ..............
Street and Number ~/.~,..~.fL$'QI0,.'~)~'~..V.¢~ ..,,....~.9,~]~Old ..................
/~ I ._,~C:~_~ Municipality.
2.State existing use and occupancy, of premises and .i nteqded use and occupancy of proposed construction:
a. ~isting use and occupancy ..j......l~'a.aa.B.'l;...l~l:tct.~. .................................. i: ....................... ~; .................................
b. Intended use and occupancy ....... 0::e../~.nm1Z,~...~w,q.;lln& .................................................
10.
11.
12.
13.
Nature of work (check which applicable): NewrBuilding ....~7~-~ ...... Addition .................. Alteration ........... ..'~...
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....... : ................
E~timated Cost ...... .~.~..O..Q.O...~/.~ ............................... Fee .~...~,.0. ................................................... .J ............................
~to be paid on filing this application)
If dwellin~g, number of dwelling units ...q~. ...................... Number of dwelling units on each floor ............................
If garage, number of cars .............................................................................................................................................
If business, commercial or mixed occupancy, specify natureond extent of each type of use ................................
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 ........................................
Dimensions of entire new construction: Front ...... ~,~ ................... Rear ...... 2.~ ................. DePth .....,~Q .................
Height ............................ Number of Stories~.....~.~ .......................
Size qf lot: Front ...],.Q.g...: ................ ~. Rear ........... ~LO.O .......... Depth ....... ~.C)ID. ......................... '
Date of Purchase ................. ,],c]~.(~ ............................. Name of Former Owner ..... ~...~....~.~,~ ...............................
7one or use district in which premises are situated.....!!A.?...]~J.,S.~, .................................................................. .' ......
Does proposed construction violate any zoning law, ordinance or regulation? ........ .~..0. ........................................
Name of Owner of prem,ses ............... Address ....... ~e~.c'l ::i.~'f' ................. Phone No .................. .?~
f "
Name o Architect ............................. ~. ...................... Address ............................................ Phone No ..............
Nome of Co[~tractor ............... ~o....~..~ce.]L ............... Address .................................. . ......... Phone No ..... . .............. .'
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck dimensions fram
property lines. Give street and block numbers or description according to deed, and show street names and indicate
whether interior'6r comer lot.
t 00'
STATE OF NEW YORK.
COUNTY OF ...... ~.l~.oJ-~ ..... S.S.
................... : ........... .~...a...~...~.?..1........~..a..?..i~.e...1. ............................... Jbeing duly sworn, deposes ond~says that he is the applicant
(Nome of individual signing application)
, above named. He is the .............. O::~ZtP_~. ...............................................................................................................................
(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 O?~lp.ne7 ~.ql~E;~orth in the appli,qation filed there~vi,t,h
Swam to before me th~s
Notary Public, StIte of New Yor //
1'~ 'O f ^ ~- ~ No. 52-0344963, Suffolk.County ~
.................... ,4.. aay..o ................ UC~.~..l~i~m...j,x, pi~ Jl~_ j~. 1.9i' ~
~'~/ ~* / ~-"-,~d_ J. ,,~-,~E~ ............ ~.~..: .....................................................................
.. Notary Public, .../%~-,C~..,,~...<.~...L/~Coun-Ty (- (Signature of applicant)
TOWN OF $OUTHOLD
TOWN C,E.K's OmCE
SOUT.O D, N. v.
(Buffdin~ Insp~tor)
APPLICATION FOP. BUILDING PERMIT
Ootober 13 61
Date ........................................................ , 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 Ioco¢ion of lot and of buildings on premise~, 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 be(ore 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 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, if a corporation)
319 Littleworth La ,Sea Cliff
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
........................................... 0.~Jke;R. ................................................................................. ~.: ........................................................
Name of owner of premises .J~.~.-.~ .J~.~.~.~ ............................................................
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: XXX]J~ Lot No: ~
Street and Number ~.~8 Leeton Drive ~ 8outhold
Municipality
2. State existing use and occupancy of premises and intended use and occupancy oF proposed construction:
a. Existing ~se and occupancy ..V.$.¢.f~.t..1..a..~..d.
b. Intended use and occupancy . 0.~ family...d..w..e, llin~
3. Nature of work (check which applicable): New Building ..~ ...... Addition .................. Alteration ..................
Repair ....................Removal .................... Demolition .................... Other Work (Describe) ... ....................
4. Estimated Cost ...... ~..t.,0..,0..0..,.l~.?...~. ................................ Fee .....1'..,0. .................................................................................
(to be paid on filing this application)
. nit. one ., -
5. If dwelling, number of dwellin9 .................................. i,~umoer of dwellin9 units on each floor ............................
If garage, number of cars .............................................................................................................................................
6. If business, commercial or mixed occupancy, specify notureand extent of each type of uise ................................
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 ..... 3,0, ..................
Height ............................Number of Stories.....~.~'. ........................
9. Size of lot: Front 100 Rear 100 Depth ~.0.~,
10. Date of Purchase ................. .]:?..~...0. .............................. Name of Former Owner .....~..:.....~.~.~....1~... ................................
Il. Zone or use district in which premises are situated....!!~!!....]}..t-..~.~, ..........................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation? lt'o
13. Name of Owner of premises ...~.*.....~...~.?..k..~.l]r. ............... Address ....... ~..~..8,..O...~..i.~,~. .................. Phone No .....................
Name of Architect ...................................................... Address ............................................ Phone No .....................
Name of Contractor .............. ..~.,~....,l~,..Jt..k...~..].. ................ 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 indicote
whether interior or corner lot.
L E~--I 0 /v
t00'
STATE OF NEW Y,,QRI~. ,, )
COUNTY OF ..... ?...~..l. 7.l;.O...~..~.......) S.S.
................................................................................................. being duly sworn, deposes and says that he is the applicant
(No'me of individual signing application)
above named. He is the ............. O.~.~..~.~ ................................................................................................................................
(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 oppJiFation filed the~wiih.
Sworn to before me this I~ JUDIT~I T, BOK£N // ,.~ ~/' ~ /~ ~
.~.. ~ ote~ Public, State of Ne,~-r,- ~ // ~ ~.. F/~ ~
......... ~.~.. day of ............... ~.~.'9.~3..~,a~.~ ~ ~ ~-~< ~ ~ ~--
,, // ~ ~' ~,m%ss,e, ~p,r~S~r? ~, 1~.~......;~3 .......... ;;... ............... ; ........ ;; ...... ~. .............................
Notary PuD,ic, .,C~.,~.~...~....~:~; ......... ~}!~ty ~ L~lgnature aT applicant)