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Home My WebLink About1391-zF01~i~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY conforms substantially to the Application for Building Permit heretqTore filed in this o~fice dated .............................. ,[~j,~ ........... ~ ................ , 19,~.1. .... pursuant to which Building Permit No..:,.q~I~.g~... dated ................ ~a'~'""" ....... ~: ............... , 19.(~.~:.., was issued, and conforms to all off!the re~u~('e"~ents of the applicable provisions of the law. The occupancy for which this certificate i! issued is~,. ........ This certificate is issued to .............................................. ~0171/~' 0~/~//.~.~' (owne~'~ or tenant): ....... ;'" .......................... \ ~" of the a.foresaid building. H.D, Approval 8A o/6z Beckman & Villa .......... ....... ITM] .... BuTl~in~g Insp~'o~' ~ FOPoM NO. ~ 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°. 1391, Z Date ....................... ~:~ ....... ..5 .................. ~9.6:L.. Permission is hereby granted to: Four ~ t ar....P1orae,~. · ·/~ZC...~L~o s...C ~ s c,~.d~z ............... · .B. ay...V, ie'~: ..~Lx~e ................................................ ........ O ~:'.e e.]~ p.z,~ ¢. ~. ·..~ ~ .~. ~,. ..................................... to, .~i.~d-..ne~.. one..£ar~..I.i~...d~e.]:ii.ng .................................................................................... at premises located at .E/8..,..Ba.y...Vie~...Ave.,.~.~.~...$/S...S~?,~me:~la~.v. en,..8ab~. ................ ................................................................... C~r~ eta:;.-~:r'.?, ~....i~.,.~..~ .......................................................... pursuant to application dated ................................. ~),:' ....... .~ .............. 19.6~.., and approved by the Building Inspector Fee $1~0..00,..P.d.-,,¢heck Building Inspector/ FORM NO. 2 TOWN OF $OUTHOLD 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.° 13§1i z Date ....................... JJ~ ........ $ .................. 19.63... Permission is hereby granted to: Fora- ~tm,... ~o~s ..&t.C..Tho ~..C~ s~,d.~ ............... ..Bay...~.e~..~v.e ................................................. ....... ~l,e e~l~z,~, t....R ~ .~.~ ..................................... to..]~a:J.ld...ne,,e..ol~e..ff. ~ 4 .'t-y...d~e.]..t .t.~ .................................................................................... at premises located at .~/8.....]~y..¥$ew..Av®...~.../,J.$..S~merha~n..S~fl~lzL~,~ .............. ................................................................... greellr~l,.t ~...N,.~., .......................................................... pursuant to application dated ................................ ~ ....... .~ .............. 19.6~.., and approved by the [3uiJding Inspector Fee SXO. ~:~0.. ~.d,,,eheek vudding Inspector/ FORM NO. 1 TOWN OF $OUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×om ned ........ Approved ........................................ ]9 ........ Permit No ............................... Disapproved a/c ~ , ~ (Building In~r ' APPLICATION FOR BUILDING PERMIT, Application No../...~,.~...1 ............. Date...~.~ft ~r...5 ............................................ 19.6.]~.. 4.. 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 buddings on premises, relationship to adjoinin9 premises or public streets or areas, and giving a detailed description of layout of property must be drawn an 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 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 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, ad6itions 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) Box 787 Shirley (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................................... ~.uild~r. .............................................................................................................. Name of owner of premises .......... ~Q~.~...Oa.~/LC~· ........................................................................................................ 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: ............................................ Lot No: .................... Street and Number ...~.~..~.Le.~..A.v..e....A~.she.~o.~aq. ue...L'2a~....a~....~p.~A~.~.¢.) ......................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................................................................................... b. intended use and occupancy ........ 9.~.~...~,~.~'...ql,~.~,~Z~ ........................................................................... 3. Nature of work (check which applicable): New Building.....~.?.~ ........ Addition .................... Alteration .................... Repair .................... Removal .................... Demolition ......... .,~ ........ Other Work (Describe) .................... 4. Estimated Cost ....... ~..0...0..0..~..0..0. ....................................... Fee .~. ................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........... .o...~...e. .............. 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 ...... ~..~..! ............... Depth ..2..~.~..~.~! ............... Height ...],,5.! ................... Number of Stories ..... C~e ................. 9. Size of lot: Front ........~.f).0.~ ........... Rear ..... 8.0.~. ................ Depth 10. Date of Purchase .....~.p..~.J...~....2.~.~.~..~.~ ..................... Name of Former Owner .~.,...[,t~.V.~'.~..~.g,l~'...&...~. 11. Zone or use district in which premises are situated .....~.~.~..~.q..q~.g...~.~'..a..~...~...~..~.~..~.~kq~.$.~k ........................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ....... gO ........................................ 13. Name of Owner of premises..~.~q.~/g~t~...~P.°.~9.~.:~.d~Address~P.~r~e~1.e~k...P~d~.g~ne NO. Name of Architect .................................................... k..Address ............................................ Phone NO ..................... NaMe of C~ntract~r.~..~.~]~...~'~.~...g.~.~..~.~....7'~.*...Address~.~2~...~..~.~...~.~ .......... Phone NO.~.~.~..~.-..~.8..0..~ PLOT DIAGRAM ~ Locate clearly and distinctly all buildings, whether existing or propc~sed, and'indicate all set-back dimensions from property lines. Give street and block numbers or description a,ccording t~ deed, a~gd show street nam,es and indicate whether interior or corner lot. ,~ ¢~ c~ ~ C~ \1' \ \ STATI: 0[: NEW YORK, ) S 5. COUNTY OF ...... ~..~,~ .............. ) .......... ~~'~"" h be ng du y sworn deposes and sa s that he s the a cant ........................ '~i ..................... ' Y ' PP' (Na~e of individual signing app 'ca 'on) ~/ -- above named. He is the ............ ~.~f/./.(~....~f,~mL~. .................................................................................................. ~ f ~I// (Contractor, agent, car[borate officer, etc.) of said owner or owners, and is c~uly authorized ~o 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 manne~ set fc~rth in .the Swam to before me this -._ ............. of ........................... ...... Noto Pub,,c, FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT~ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved .............. : ........ .~,.: ............. 19..~.~..,.Permit No. ~.,./..~...~..! .......... Disapproveda,c: .......... .... ........................ /.., ............................... (Building InspectS' APPLICATION FOR BUILDING PERMIT Application No. ~/...3...~..l ............. IF~'STF~JCTIONS .~.:, a. This, application must be completely filled~ir~ by typ~ewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of Dui!dings 6ri 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 b,e cam menced 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 puroose whatever until a Certificate of Occupancy shall have, b~en 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 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) Box 78? Shirley (Address of applicant) State whether, applicant is owner, lessee, agent, architect, eDgine.erf general contractor, electrician, plumber or builder. ..................... ' ~Zl~,lL~r. ................................................................................................. Name of owner of premises ........... r~.~.~l%~.~l....0.~$~.~(t~.r ........................................................................................................ If applicant is a corporate, signature of duly authorized officer. ................... L ~ .~..a,..$.~. ~.~. ~,1,~ ....... ~z'.ca, ......................... (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................Lot No: .................... ......... Street and Number U..~.J..t/..~.. .~ ...... /~.~i. $ .9.,~...h~.9.~.Mc~...~..~...¢~. ..u~....h....~...k......~.?....~r..~.~... D.J ~ "! Municipality ~/ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................................................................................... b. Intended use and occupancy ........ ..0..~,.~..,,.~.~,~...~.~,~...~.~.~.~...~....~ .......................................................................... . ~/'®11 i ' 3. Nature of work (check which applicable): New Buildmg .................... Add ban .................... Alteration .................... Repair .................... Removal .................... Demolition ........~ .....Other Work (Describe) ................ · 000 O0 ~' ~ ' '"' 4. Eshmated Cost .......~. ...... ~' ............... Fee .~.~.. .............. (to be paid on filing this application) it 5. If dwelling, number of dwelling un s ................................ 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 ...... ,~ .................... Depth ~.t...~.~ .............. ~ oB.e, Height ....~.~ ..................... Number of Stories ......................... /' ......~...0...! ............ Depth /~. f~.. M~ .~ .,..~....~.... 9. Size of lot: Front ..... ./.D.O ................ Rear 10. Date of Purchase ..~J~..~...~../....I...~..~..I ................ Name of Form~er Owner ..~..,...I...~..~....~.{'.(,U. 11. Zone or use district in which premises are situated~/~r.~/`~.j.~.~k~.L.~w..?...~..~.~.~....~\~!..~.~.~.~?~L!~.~t~.L~ ............. .~. .... 12. Does proposed construction violate any zoning law, ordinance or regulation? ,~..0 ............................................ 13. Name of Owner of prem,ses.T~,.c,5..I.....~?.s..,~.~..~.}...b~..,Address ~?..I.~.%.~.¥~c.~..¥$.P,..~..'..~.e.l~....Phone NO. ,,q..O..,.5., .q ~ A.~.. ~ Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor.~.O..~..~.~.a.~.~...~.'~..`e.~..~...Address~.~..~.~.~.?....~...~..~...~.~..e~. .......... Phone NO~'.~.~'..],..'..?~.~ PLOT DIAGRAM Pw~ >ePt~l~ci~!i~!i~r~ri~Yre i!rrdene!irSatl~ntdlt~yl°~ bn~im~enrgss~rw~eetshcerirpt~.~tiancgc~r~Ji~nr;~t~sedd~eadn~d~nnddicsaht~e~}tsreete~banc~n~n~li°ir~sdif~tr~ COUNTV~~.~.~Z,._ -~OF .......... ~ ....... -..~.}-> .., i. ...~~-'~-....' ................................. being duly sworn, deposes ond says that he is the opplicant .....-- (No~ of indivic]u~ signing opplicotion) ,, ,he .... ................................................ ............ n o*or* e,c. of said owner or owners, ond is ct61V outhorized'fo perform or have performed the sold work and to Toke and file this opplication; that all stotements contained in this opplication are true to the best of his knowledge ond belief; ond thor the work will be performed in the monner set forth in the opplication f~ed th_er~with~, Sworn,,t,o b, efore me this . ~0~"V ........................ ~ ~_.~..;_..~_~.. o,, ~L "~,,~' ~,~;;-',,,~, NotaW Public,. ' .~--~--~,.,~ ountv