HomeMy WebLinkAbout1587-zFOR~ NO. 4
TOWN OF SOUTHOI-D
BUILDING DEPARTMENT
TOWN CLERK'S OFF~CE
SOUTHOL~, H. Y.
CERYIFICATe OF OCCUPANCY
No...ZZ..3.~.~ ............. Date ........................ '~prit'""~3 .......... ' ~96~"'
THIS CERTIFIES that the building located atW./~...N.,...(h!tk~oo~..~rJ.,V,e, ................... Street
~L~al~rel Park
p ,'~o ....................... Block No ....................... Lot No. "2~'"&"a9 ....... E~et' ...........................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
................................ 0e~obe.~....~, ........ 196~:.. pursuant to which Building Permit No. ,~1.~.~....
dated .................................. 0~:~:"-'1'6""', 196:~"', 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 ..........
.............. P~i~at~ .. ~ne ..£.a~'~ l~'"d~e.~ila~ .................................................................................
This certificate is issued to ....])~..~T~O~i~p[t..ltl~l[d~ I1 ............ '0~'~ ................. .":'"~ ................
~olwner, lessee or tenant)
of the aforesaid building.
~.D. approval ap~. aO 1962 by R. Villa
.......................... .....................
FOI~I NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS DERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 1587, Z
Date ................... 0e. to.be~......16 ............. 19.6~..
Permission is hereby granted to:
.......... }~ jJ,~'.e r~ e ~,~d ~... Z,...Z ....................................
to ..... ~i~,d...n~e~;...one../:ami ,'q,¥.. d.~xe.1 l£ng. ................................................................................
at premises located at ..... t~f;,e, ~-L) ~ [?-.~...,.[-S~.~.t"%"~'~e~ ..........................................................
................................................... ¥~/g.....~('-~...Oa!~d...c]~?~:ve ...........................................................
pursuant to applicatian dated ........................... O~'bO~O~.....~ ...........19_63.. and approved by the
Buitding Inspector
Fee $, 3,0.o.Of~.....'. ....
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, Iq. Y.
Exam,ned ...........
Approved .............................. I.., ........ , 9...:....Perm t No......~...../....~...~)../. .......
Disapproved a/c ..................
......................... ........ ...; ......................
(Building InspectOr)
APPLICATION FOR BUILDING PERMIT
Application No..../...~.~4/ .............
INSTRUCTIONS ;~ .
a. This appli,cation must be completely filled in by typewriter or in ink and submitted (n'~d~plicate to the Building
Inspector.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining prem ,ses or public streets or
areas, and g v ng a detailed description of layout of property must bedrawn on thediogram wh ch'~.s p\art of th s application.
c. The work covered by this application may not be commenced before .ssuonce of Bu~k%ngI Peri, it.
d. Upon approval of this application, the Building Inspecfror will issue a Building Per~it to ~th~, 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 unt a Certi~fico~ of Occupancy
shall have been granted by the Bulld~ng Inspector. /
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Per,it pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other a~pli¢~able L(~dws/Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or ¢lbmoht(~on, ds hereto described.
The applicant agrees to comoly with all applicable laws, ordinances and regulations. / ~ ~
(Sign,ature of applicant, or,r~gme, Jr a corporation)
(Address ~f .bpplicont)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, ~l~ctricia0, plumbeF,~ ,or builder.
.................................. ~. o~t~ac¢.or .......................................................................................... ~r .............. 'v ............ ? ............
Name of owner of premises ..................................... D~.J. oseph-....We~.de~man. / 7
If applicant is a corporate, signature of duly authorized officer. "
1. Location of land on which proposed work will be done. Map No.[a~l~.f~..P~ltk .................... Lot N0! 2~..&.-2.9 ....
Street and ~ / '
'Munic~pahty ~ ./' '
2. State existing use and occupancy of premises and intended use and occupancy o? proposed construction:
a. Existing use and occupancy .....V~:b..l~tq~. ............................................... fi ......................................... . ..........
b. Intended use and occupancy ..O~f~...~ai/li y....~l~.e2~l, il~g ........................ x ........... : ............................................
3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ..................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................
4. Estimated Cost ..... ~'f{)(~)-~/l~ ................................ Fee.loi. O0 ...............................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling unffs ...... ~l~ ................. Number of dwelling units on each floor ............................
tf garage, number of cars .............................................................................................................................................
6. If business, commercial or mixed occupancy, specify nature.and extent of each type df use ................................
7. Dimensions of existing structures, if any: Front .................... ~ ...... Rear ...... ~; .................. ~Depth
Height ............................ Number of Stories ................................................. ; ...........................................................
Dimensions of same structure with alterations or additions: Front ............... ................': ~ear ................................
Depth ............................ Height ................................ Number of Stories ...................... '~ .................
8. Dimensions of entire new construction: Front ....... 6 ...................... Rear
Height
Number
of
9. Size of [at: Front '"'I~0 ..................... Rear ........ Ia0 ............ . Depth ....... IiO"P/I~I
10. Date of Purchase ................... 1961' ........................... Name of Former Owner ........................................................
11. Zone or use district in which premises are situated""ti'~'tt ...................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation?
13. Name of Owner of premises "'~";'"~.~'ll~"l~litl ........ Address ............................................ Phone No .....................
Name of Architect ...................................................... Address .......................................... '.. PhOne No .....................
PLOT DIAGRAM .,
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all §et-back dimensions from
property lines. Give street and block numbers or description according to deed, and show Street n~cmes and indicate
whether interior or corner lot.
STATE OF NEW YORK, ) S.S.
COUNTY OF 'S'ii~fi~t.~ .......... ) .,
........................................................................................... being duly sworn, deposes and says that he is the applicant
(Name o~d~signing application) ,.
above named. He is the ......... O'OQ~a~ ........................................................................... '" ...........................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed .the said 'work aad to make and file
this application; that oll statements contained in this application are true to the best Of his knowledge and belief;
and that the work will be performed in t~l~e~t forth in the application filed therewith:
Sworn to before me this ~tg~ Pg~ll~, State of New York ~ ~ ~ ~ ,,
~. ~:~44~3, Suffolk County .~ / ~ ] ~ ~ ~/~ ~// ~
, , ......... ....................... . ....................... :.....