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Home My WebLink About1387-z TOWN O1' ~OUT~OLD BUILDING ~t'OWl~ CLERIC'S OFFICE $OUTIClOLD, CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..~/.~.. l~..~tl:le'~..~)~. ...................... Street Map No...iX.?..~.'. ............. Block No .......... ~ .......Lot No ...... :~.....}~'¥~i.~11Olt1 ........................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .................... A.]~}~2.i~.....2~. ...... 19...~.~ pursuant to which Building Permit No..~.~7. ..... dated ................... ~.Y~.~?.~ ........ ~ ......19..6...~._, was issued,, and conforms to all of the require- me~ts of the applicable provisions of the law. The occupancy for which this certificate is ~ssued is ...... P~.~:¢~?4.~.. O~...,~S~i~? ..dX'l~[:~g ............................................................................. This certificate is issued to ..... 14.~,.~'~Li~a~..J:~....C.],aZ'k .............................. O.~:~e~. .................... (owner, lessee or tenant) of the aforesaid building. Building Inspector '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? 1387, z Dote ...................... ~.~-i~.--.,~.~ .............. 19..6.'1.. Permission is hereby granted to: ~iil.li~..,~ ~...C3~ar,.k ................................................ .,. 2.8 ~).. ~'d. ha.], e~eak.. D~ .i~ e. ............................ .............. i~le.r.r.i, cl~ ~...... L,..I., .................................. to .......... ~ui. td...new., one-. £.ami t'.V .. d.we!, t.i.n~ ............................................................................ at premises located at .......... '~ft8.....~z',l. it~e..'"~bane ....................................................................... ............................................................... Mat t. it~e'k'~'" ' · ~ ;' ¥;- ........................................................... pursuant to application doted ........................... ~.~l~i:.~.....~8 ................ ]9..~.., and approved by the Building Inspector Fee $ ...... tO~O0'"pO - Cheek Building Inspector ] TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved .............. ,I..~. ...................... 19,.,!,..,Permit No, APPLICATION FOR BUILDING PERMIT Application No../.?.....~..~...~ ......... Date ........... $~.~.;l, ~,.....~ ............................... 19..~..1 ...... " INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector, b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this location. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premisee available for inspection throughout the progress of the work. e. No building shah be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein ~described. The applicant agrees to comply with oil applicable laws, ordinances and regulations. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. O~ne r Name of owner of premises......~.'.z..1.,1.$.,,a~,...~:...0.~.m.~.~..~...~.~.t:'.[3.~1~. Q~.~k if applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number ...... ..~.~.~.?..a.?...~?..~..e..'....~.~..~.9~.[.~..~...~.e~.e.~.~.~.~.e....~.~...~.~.~.~.~.~.~].t~.~R~..~ .... Sou%hold Town Municipality lis. in Road) 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............... ~.s'..9-m~..~ .......................................................... : ............................................... b. Intended use and occupancy.......(~..?..':'~..a~..,~..1.~'.....D~.,e..]:.]:~..~ ................................................. : ................................... 3. Nature of work (check which applicable): New Building.....~ ............ Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated ...................................... Fee ....... .(.. ................................................................ (to be paid on filing this application) ,5. If dwelling, number of dwelling units .........~i~.~ .................. Number of dwelling units on each floor ............................ If garage, number of cars .............. 9~ ........................................................................................................................ 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.,./t..1..'..-O.~'. ............ Rear 41~ Oe Depth 2~' O" Height 20t Number of Stories 0~e & & 9. Size of lot: Front .....,1.q.0..~. ............... Rear ....~..0~...! ................ Depth 1~~ 10. Date of Purchase ..........~.~.~..~....~.~ .................... Name of Former Owner .~.~.~.~...~..~l~.[~.~..g.~......~. ...... tl. Zone or use district in ~which premises are situated ................................................................................................ 12. Does proposed construchon violate any zoning taw, ordinance or regulation? 13. Name of Owner of premises..~:...~:....~...~.b,~ ........ Address ..~.8.~.....~....~.~.~.~.~.~.,,~.K?,.....Phone NO. u-ar~ Merric~ N. ~e Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor .................................................... Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-back 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.Y.O. RK, ) S S. COUNTY OF ............................ ........ i .................... ~.~..~....~."....q~.~.?.~ ............ being duly sworn deposes and says that he is the applicant (Name of individual signing application) is the ............................................................................................................................................................. above named. He o~er (Contractor, agent, corlborate afficer, etc.) of said owner or owners and is duly authorized to perform or have performed the said work end to make and file th s application; that all statements contained in this application are true to the best of his knowledge and belief; and that the wark will be performed in the manner set forth in the application filed therewith.,- ,, Sworn to before me this ¢ .,,'~.,~ x/ .......... ~.8..~ ...... day of ...~,~.ll .......................... 19..~.1,.?.°.?rY Pu~l,c ,,~,~ ~'/~r~o~re of applicant) No. 24-6232~50 ~ ~ /~ U QUalified n Notary Pub Jc,~..~.,..:..,.' ' ~- ...... , ........... ~o ~t~,. ,~,s~on ~,,.,.,~('"~s~..~c°un~ FORM NO. 1 TOWN O1: SOUTHOI-D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19 ........ Permit No ............................... Disapproved a/c ......l:'"'~"'"'~'-,' ~ ........ ~,-'~'~'"::~, ......... ~ ....... -~'" '~<'\ ...... .......... '~::~'¢ '\ ................................. ........................................... .............................. ........................ ................................. / Application Ne ............................. APPLICATION FOR BUILDING PERMIT Date ........... Ap~.~l..28t ................... ' ............ 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 location of lot and of buildings on premises, relationship to adioinlng premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the didgram which is part of this location. c. The work cov. ered 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 part for any purpose what,ever until a Certificate of Occupancy shall haye been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursubnt to the Bud ng: Zo0e Ordinance of the Town of Southold, Suffolk County, New York, and o~ther applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or a Iterations, or for remova~l or demolition, as herein tdescnbed. The applicant agrees to comply with ail applicable laws, ordinances and regu(ation~. (Signature of appliF.~, or name, if a corpora?on) ~aleaeoM ~lw, .............. .~9.~.~.~.~, ~.~_ ~(~l~.'. :. (Add~:ess of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owne~ af premises....~..~....~...0..X.~r.~...~..[~.~lL.~l~k' .................................................................................. 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 dane. Map No: ............................................Lot No: .................... ........... ~'~ ~i~' .................. Municipality 2. State existing use and occupancy of pr. emises and intended us~ and occupancy of proposed construction: a. Existing use and occupancy .............. ~.~.-~...~.-....~ .................................................................................................... b. Intended use and occupancy.....0~..?.'..~.~.~.~......l~..~.~.~ ............................................................................ ; ......... 3. Nature of work (check which applicable): New Building...J[ ............ AdditiOn: ................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost....~lt,~00~O0 ...................................... Fee ...... /.':~'~...; ........ (. .......................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........mae .................. Number of dwelling units on each floor ............................ If garage, number of cars .............. Olltll ........................................................................................................................ 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.,...~-.!.,0.". ............ Rear ....... .~J.!..O.? ......... Depth ......27.!..0.~. .......... Height ......~.0.! ................ Number of Stories 9. Size of lot: Front .....~0~!. ............... Rear ....J(~.~. ................ Depth ...[,~.! ................. 10. Date of Purchase ......... &ll~l.t..~.m..t~6~. .................... Name of Former Owner ~J%ol~.&..Jt, tte~,~.J~m..Oei~mall, ..... 11. Zonb or use 8istrict in which premises are situated .................. ?~.?. ........................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ....... ~lo ........................................ 13. Name of Owner of premises.~..~t...~.:...~..~.~..e.[ ........Address ..~,.~l~.eBe. e~.,0~., ...... Phone NO, !~...~...2J~/.. Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor .................................................... 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 indicate whether interior or corner lot. ~'/ ARLEI"IE k A HE STATE OF NEV~,'I~{~[~J~, ) S S. COUNTY OF ............................ ) ................ ,~.~.[..[.~.,a~.. ~...q.~,.l~,l~ be ng duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He ~s the ................................. .~ ................................................................ (Contractor, agent corhorate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sa d work and to make and file th s app cation; that alt statements contained in this application are true to the best of his knowledge and belief; an~r~h~--,~ ~. ,~ ,,,~ ,..,~~o~be performed in the manner set forth in the application filed the~ew]~.~ , ~ · ....................... ) No. 24.6232650 ...... .. ,. K,.,s Co --X ,.o .Z~' I *' o .f .-