HomeMy WebLinkAbout1590-zFOI~/~ ~0. 4
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD', N. Y.
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES that the building located at .....~./iL~;I,I~I...~QJJ.~t....(J~.~I~J~O,~.~. ..... Street
Map No...~?..~. .............. B loci( No ........ ..~..?.~ ....... Lot No ......... ..~..~..~.. ....................................................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.................................. ~.~.?..~.?..~....~..~ ......... 19....6~ .... pursuant to which Building Permit No. ................ '~ 1590
dated .......................OC~O~...~.~J....., 19.....~ was issued, and conforms to all of the requirements
of the applicable provisions of the Iow. The occupancy for which this certificate' is issued is ..........
This certificate is issued to .T~.~.~.~.~..~....~...~.~...~.L.~.~.~.~.~`..~.~..~1~.j.~.~.~.~.~..B~..~~
(owner, lessee or tenant) ~e~T~e,T~'~
of the .aforesaid building.
~ FOEH NO. ~
TOWN OF $OOTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 1590 Z
Date .................. .0.~.~?.~......~_~.. ~ ............ 19....~..]:.
Permission is hereby granted to:
Pa~.!...0..o. ~..~.~.~ ~..l~i.. ~;.. ~.C~n~ ...................................
......... (,zt-, r.:_l~.e ~ .t ...........................................
to · B~,~-ils... a ,.r~.~,,t. ,b~s:L~e~.s. ,.b'u:~ct.$n~...( .. ~t;~a~ e,,..~ a.~. ag.e.) ..........................................
ot premises located at .]~./.8 ~ain .P~as.ct (]~'2.~) ......................................................
........................ (~r~haz~omav(.ue ~ .... .G~aenpo~.~.~ .~.~L,~: .....................................
pursuant to opplicqtion dated .............................. .O..e..~O.}.q.%~i..,..~3 ........ 19...6.Z.., and opproved by the
Building Inspector
Fee $..~.0. ,~ .0.0. ..........
....~ .:.~.k.l. ~.,~z.....,~ .............. i.'i. ;.../....2';t ........................
Building Inspector/
FOI~M NO,, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ..................... , 19.,~.~..
^pproved .................. No ...... ....
Disapproved a/~~ ........................................
APPLICATION FOR BUILDING PERMIT
Application No ....... ./, .~..~...~ ........
INSTRUCTIONS
a. This application must be completeJy 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 mast 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 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 Lows, 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)
........ C~-:~.-.~..'~.....~-0.....(?.~c~.c~ ~.e .¢~s..c~c~ .p..p.,.i.c a~n t.F. ~.. L~... i~...I~.O...~...~
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
..........................................................¢. ..................................................................................................................
Name of owner of premises .....(~../'~...l~..{..~......~'..~.~ ..,~. .............................................................................................
If appli~agt is a comorate,,signature of duly authorized officer.
1. Location of land on which proposed work will be done. Map No: ~-~ Lot No: ....... ~ ........
Street andNumber~ ~ ~ ~ )~ ~.P ..............................................
~. Municipalit~ .......
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Ex st ng use and occupancy ~.~. ~ ~ ~.~.~. ~ . ,
t d s an o u anc ~* (1 ~1~ ............................................
b. n ende u e d cc p y ....... ~.:~.~.~..(~ ......... ~ .....................................................................
3. Nature of work (check which applicable): New Building ...~.. Addition .................. Alteration ..................
Repair ................ ~/Removol .................... Demolition .................... Other Work (Describe) ........................
4. Estimated Cost ..... ~;?.~,~ .~, ..~..,:...¥~.. .................................. 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 .......................... 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 ........... ...q?..~'~..../... Depth ...... ~..~.../. ..........
Height ........ .~....~.,.../. ...... Number of Stories....../.. ..........................
9. Size of lot: Front-- ...... ...~..~..~..~...O_. ........ Rear ..... k.~..~..6 ...... Depth ............. c~... ,~.~,(~.~...(,?. ....
10. Date of-Purd'~ase- ........ .................... Name of ~rmcr Owner .~¥.../..~../..,~.~..~...S.~...~..~ ........
11. Zone or use d str ct n whch prom ses are s tuoted'- -- ~-'). t.,~...?L_-.......(/.' C3 ................... ----" --~'// '~ -- --~....,...~'~..1~_..~_...~..~..~...-~...-~.~ r, / , ........
12, Does proposed construction violate any zoning law, ordinance or regu at on~
Z.~'~.~.-----~.~..~..~. Address ,~.~.~.. ~:' ,~. ~'~.~'~'~(~'~'~ .......................... ......................
13. Name of Owner of premises ..... }?.~. ................
Name of Architect ...................................................... Address ............................................ Phone No .....................
Name of Contractor .............i ...................................... 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, end show street names and indicate
whether interior or corner lot,
STATE OF N~:W~).P,/I~'~ X ~.,~,
COUNTY OF~....?F/¢~.~... S.S.
....... ~.~..~~.~.......~,, ................... being duly sworn, deposes ond says that he is the applicant
(N~e of indivi~g ap~cation)
abow,' named. He s 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 that the work will be performed in the md~f ~et~h in the application filed therewith.
· Public, State of New Yor~
Sworn obef re me this .....
~ ~ ~ ~,,. 52 ~44963, Suffolk County
of ................. --
Not ,
y ', ......... _ y ...................
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
APPLICATION FOR BUILDING PERMIT
Application No ..... . ./.~.~....~./..~.. ........
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 p remises, relationship to adioining premises or public streets or
areas, and giving a detailed description of layout of property must be drown 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 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 name, if a corporation)
........... ............. .....................
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Z ~ ~..9 .....................................................................................
Nome of owner of premises ........... ...~..~./../:...~...~.......~.¢r ............................................................................................................
if appli~c, qnt is o corporate, signature of duly authorized officer.
...... ............................. ........
(~[~lame~U~*~*~a~d:~title c~ corporate officer) /
1. Location of land on which proposed work will be done. Map No: ................ .~ .......................... Lot No: ....................
Street and Number ......~:.~.~.:. ...... ~.~../....~/....~).~..,..,..... ~..~....~.~../.~/./.~.~..~ ..............................................
/ Municipality /
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
o. Existing ,use and occupancy .......................... ~.TL..~.~r~.~...../..-~.z.~.. .........................................................................
b. Intended use and occupancy ~L~''Z..¢, ~ '~./~/~
3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ..................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................
4. Estimated Cost ............. ... ...... 'r~ .~.OO'. ........ J............,......,........ ~ee~ .~.~,?~. ............................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units .............................. 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 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 ....~.. .....................
Height ........ Z~...~ ............. Number of Stories .............. ./, .................
~.. '
9. Size of lot: Front.. ..... .......~"f ...... tz~ . ......... Rear ....... .~...~.~..~.~ ........ Depth ....~,.~....~.,4.~ ' .......................
10. Date of PuF¢.-h...as~ .............. ~.~,~C~. ....................Name of.~Ferm~r Owner CC)..~.L"~..~..~....~..~..~...~.~.. ....
, .....
11. Zone or use dstrct n whch premses are stuated .......................... ~..z~......Z..~. ............ ~z'..i..,~...~..~..~.. .......
12, Does proposed construction violate any zoning law, ordinance or regulation? .............. .z~..~ ..................................
13, Name of Owner of premises ..... .~.Z.~f.r.......~..~./.~.. ....... Address .....~:..~cn~.~?.~..~.~..z~......Z~z~.~. Phone No .....................
Name of Architect ...................................................... Address ............................................ Phone No .....................
Name of Contractor .................................................... Address ............................................ Phone No .....................
PLOT DIAGRAM
Locate clearly end distinctly all buildings, whether existing or proposed, and indicate all set-bock 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 NEW,,,~fOI~K/ ~ z~ ) S ~
COUNT of . / 7 7
....... ~.~~....~. ....................................... being duly sworn, deposes and says that he is the applicant
(N~me of i~Nidual s~ni~application)
abow~ named. He is the ........... ~f~.~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 Jn 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.
Swam to before me this INDIT~ T BO~EN
........................
MAP
OF LAND
CHARLES
A R ,~l-IA.t,,/10 N,4OQ u~,