HomeMy WebLinkAbout1411-zFO1ZNI NO. 4
TOWH OF SOUTHO~.D
BUILDING DEPARTMENT
TO~VH CLERK'S OFFICE
SOUTHO~.D, H. Y.
CERTIFICATE OF OCCUPANCY
No ........ Z-127/,.....; Dote ..................... ~'~t~=¥..23 ........... , 19.~i~..
THIS CERTIFIES that the building located at .~,~J~...~'~..~4,.~..~[~l~O~U~ ........ Street
Map ' J'l~m~lock No. ~/~ 40
~ o.~,.~1~~ ............................... Lot No .....................................................................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
............. ~JL~...~O. ...................................... 19..~,1.. pursuant to which Building Permit No. ~..~J..
dated ..J/~'...~0 ................................... , 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 ..........
............. t~ .~VA~ri~. · ~l~t~R..~.~..D~l~j& ~ ....................................................................................
This certificate is issued to ............ ~E~.**jJ~[*i**;(~/'/l~t~' .............. : ........ :: ................................
of the aforesaid building.
Building inspector
FOI~IV/ 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.° 1411' Z
Date .............................. ~'"'~;~0 ..........196~'"
Permission is hereby granted to:
Geo~e"HeJe'~ ........................................................
......... Pine,, Tree,. J~o~d .....................................
................. Cu, teh~g~ ..........................................
t o Bu~ ti" an-. ldti t~'on" on.. ~n...exi~t ini "dwe .1.l. in~ ..........................................................
at premises located at ..Tot;..~l;O.,j...jj.~l~.~.jit~..~lj~.1~lllJl ...........................................................................
...................................................... ¢~t,~hog.u~ .....................................................................................
pursuant to application dated ............................ ~y"'"'~O ................... 19.6.'1..., and approved by the
Building Inspector
F~e $..,1~i00 ...........
TO~N OP $OUTBOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
.......... ......
Approved .......................
Disapproved a/c ............... ~~..:~.~.~.:: ....
...................... .................................
Application No. ,/...~...(.( ..................
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and su~omitted 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 location,
c. The work covered by this application may not be commenced before issuance of Bui!ding 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 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 issuanc.e of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southofd, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or a Iterations, 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, p)umber or builder.
owner
Name of owner of premises G~orge Hese.~ ...........
If applicant is a corporate, signature of duly authorized officer.
............... C~,[~'r~-~'~r~d title of corpo'~¥~' ~"i'~;~i '"
Na~sa~ Farms
1. Location of land on which proposed work will be dane. Map No: ............................................Lot No: ....................
Street and Number ..... ..P.~..~.?:..,~:~?......~...o.f...c?.~. .......... ~.~.~.~.~o.g.~e ..............................................................................
Municipality
2. State existing use and occupancy of pr,emises and intended use and occupancy of proposed construction:
d~l]_ing
a. Existing use ond occuponc¥ .....................................................................................................................................
b, Intended use and occupancy ....... .d...w..e...Z..]~.$.r.,tg...W.~,.gh...a~...ad.di.ti.~ .............................................................
3. Nature of work (check which applicable): New Building .................... Addition ....................Alteration ....................
Repair ....................Removal .................... Demolition ....................Other Work (Describe) ....................
4. Estimated ~-o~t i~OOPiLt~s ~ ~.00
(to be paid on flung this application)
5. If dwelling, number of dwelling units ................................ Number of dwelling units on each floor ............................
If garqge, number of cars ............................................................................................................................................
6. It business, commercial or mixed occupancy, specify nature and extent of each type of use .........................
7. Dimensions of existinfl structures, if any: Front ........... ~,~ ............ Rear ........2.8 ............... Depth ..... ;~.~. ..................
Height ............................Number of Stories .O~e ..............................
Dimensions of same structure with alterations or additions: Front ................. 3.~ ..........Rear .........3.~ ..................
Depth ..... 2~ ....................Height .............................. Number of Stories ........... e.zae ..............
8. Dimensions of entire new construction: Front ...... ,8, .................... Rear ........ ~. .................. Depth , ~.~. ..............
Height ............................ Number of Stories ........ DJ~¢~ .............
9. Size of lot: Front ..... ~.~ ................... Rear .......... ~..3 .............. Depth ....... .~..OC~ .............
10. Date of Purchase ........................................................Name of Former Owner ........................................................
I]. Zone or use district in which premises are situated ........... ~!~.!!...C~J, 8~.J~.¢,~ ........................................................
12. Does proposed construction violate any zoning law, ordinance or regulation? ......... ,,'q.q ......................................
13. Name of Owner of premises.....G..~,~.~e& ................ Address ............................................ Phone NO .....................
Name of Architect ........................................................ Address ............................................ Phone NO .....................
Name of Contractor .................................................... Address ............................................ Phone NO .....................
PLOT DIAGRAM
Locate dearly 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 shaw street names and indicate
whether interior or corner IotJ
STATE OF NE~5/ ¥OR~,, )
COUNTY OF~r" - ,.,.k~...z,.O..~t~. .......... )
SS.
.................................... .~,~:~.~fl..~.~e.~ ............................... being duly sworn, deposes and says that he is the applicant
(Name of individual signing application)
above named. He is the .......................... .q.~[~9.~ .............................. : ........................................................................................
(Contractor, agent, coqborote officer, etc.)
of said owner or owners, and is du~y authorized to perform or have performed the said work and to make and file
this application; that all statements contained in this application ore true to the best of his knowledge and belief;
and that the work wil~ be performed in the manner set forth in the appllcotion ~fUed therewith.,~
Sworn to b~fore me this , JUDiT~ T. BOKEN ~ ~7./, ~, ~
dov Of ~ ~ 1 9 ~ ~449~3 Suf o k Co~ ty (S gnoture of appl cant)
........................ '%
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
$OUTHOLD, N. Y.
A roved ~ 19 ~' Permt No.
Application No./..~J..LI. ..................
APPLICATION FOR BUILDING PERMIT
D. ~ay ~0 19 6~
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 streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this location.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approvbl 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 granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bullding 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 constr~ction of buildings, additions or a Iterations, or for removal or demolition, as herein described.
The applicant agrees 'to comply with all applicable laws, ordinances and regulations.
;
Pine tree Road~ Cutchogu~
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
If applicant is a corporate, signature of duly authorized officer.
(Name and title of coFp0rate officer)
1. hocctio~ o~ ~c~8 o~ w~*ch ~o~e8 wor~ will ~e 8o~e. ~c~ ~o: ............................................ hot ~o: ....................
P~,~e tree Ro~.d~ Cutchogue
Street and Number .........................................................................................................
2. State exlsHng use and ocq~p~c~ o~ pr,amUses c~d ~ende~ use a~d occupa~c~ o~ proposed construction:
~. ~x$s~nG u~e ~nd occupenc~
~ dwelling ~.th an addition
b. [ntende8 use end occupancy
Locate clearly and distinc
property lines. Give street and
whether interior or corner lot.
3. Nature of work (check which applicable): New Building .................... Addition ...~ ............ Alteration ....................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....................
(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 ........... ~,8 ............ Rear ........ ~ ............... Depth ..... ~6 ..................
Heigh't ....................... L,..Number of Stories ........ ~ .............................................................................................
Dimen§ions of same s~tr~du~e with alterations o'r additions: Front ................. 3.6 .......... Rear ......... 3.6 ..................
Depth .....~6 .................... Height .............................. Number of Stories ...........OI~ .............
8. Dimensions of entire new construction: Front ...... ~. ................... Rear ........ (J .................. Depth .......~. ...............
Height ............................ Number of Stories'..i.....~ .............
9. Size of lot: Front ..... ft/.~ ................. Rear ..; ....... ~/~ .............. Depth ....... ~(~g .............
10. Date of Purchase ........................................................ Name of Former Owner ........................................................
11. Zone or use district in which premises are situated .......... .I.l~.~...~i~ll.~ .........................................................
12. Does proposed construction violate any zoning law, ordinance or regulation? ......... ~ ......................................
13. Name of Owner of premises.....(~..~.~.~ ................ Address ............................................ Phone NO .....................
Name of Architect ........................................................ Address ............................................ Phone NO .....................
Name of Contractor .................................................... Address ............................................ Phone NO .....................
PLOT DIAGRAM
ly all buildings, whether existing or proposed, and indicate all set-back dimensions from
block numbers or description according to deed, and show street names and indicate
STATE OF NEW YORK, ) S S.
COUNTY OF .8~'.~,~ .......... )
..................................... I~.~O~.~..};l~l~ ............................... being duly sworn, deposes and says thor he Js the applicant
(Name of individual signin~ application)
above named. He is the ..................... ~.....~1t~'. ......................................................................................................................
,,i '~ (Contractor, agent, coqborate 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 kr~owledge and belief;
and that the work will be performed in the manner set forth in the application f?~, ,zfl th~r~with. ~/
Sworn to before me this . -'
~0 , · it~ l~,~t~r~'O'il~t~c, s?te ,~ ~e~ ¥or~ (Signature of applicant)
........................ aay~ ....
Notary Public,/,~-4¢~.~/.:~c ......,4'...'..!/:~...,..;~..:;.~<. ....... k/,Q~n~y ' -