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HomeMy WebLinkAbout1513-zNO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOL~, N. Y. CERTIFICATE OF OCCUPANCY No. ~ ~J3 ................. Date .................... THIS CERTIFIES that the building located at ..JB/~...L~te~...D~'.t. ve .......................... Street Map No..X...~..~. ............... Block No ....... 2iXX ........ Lot No. ~ ......... l]~11.~'t~e'l.~l ................................ conforms substantially to the Application for Building Permit heretofore fired in this office dated ........................... A~U,S.t ......... .9 ............. 19.6~.. pursuant to which Building Permit No. Zl~.~... dated ..................... ~.~.~......~ ......... , 19...6~, 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 .......... ....... P. r.i,v.a.t.e...~n~..£amil:y...d.we.l.l&ng. ....................................................................................... This certificate is issued to .tlai~..&..t~ie....li~m,~k. (owner, lessee or tenant) of the a.foresaid building. H.D.Appr oval Nov 28~ 1961 by Vil2a Building Inspector FOR,M 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) 1513' Z Date ..................... ~.Ug~s~ ........ 9 ............. 19....6..~ Permission is hereby granted to: Har old.. ~e~d~...&..S.~ns......~..C...Aloz~,..~..,~,~ z e B~rck ............ Box...~ ................................................... .................. Setde~.s..-...L,.t, ................................ to ..... B~i3bd..~e.~..o~e...£a~ily...d~el&ing ................................................................................. at premises located at ..S/~.....',~re.to~"~W ....................................................................................... ......................................................... $o~u~-'.holg ~..N.,.h ........................................................................ pursuant to application dated ................................. /~/~S.~....~ .........19.~.., end approved by the Building Inspector Fee $......10~.0~ ...... -- Building Inspector~/ ' .... / FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. Approved ........................................ ]9 ........ Permit ............................... APPLICATION FOR BUILDING PERMIT ote ........... ........................ ...... 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 o detailed description of layout of property must be drown on the diagram which is port 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 o 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 p art for any purpose whatever until o Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuonc,e of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other oppllcable Lows, Ordinances or Regulations, for the construction of buildings, additions or o Iterations, or for removal or demolition, os herein described. The applicant agrees to comply with oil applicable lows, ordinances and regulations. ......... ................................. (Signature of opp~cant, or name, if a corporation) ........................ ........... ........... / (Address of applicant) "Y State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bu)lf]er. Name of owner of ~ro...,ses...Z~./'.0. l.,X.....~....~/"~.c..~. ............................. ~ .................................................................. 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: .:~../.~.~.~T~(J...~..~./~..d..~..~u..¥~.. Lot No:?..(.,~..~...~..~'./. Street and Number ........ ~...~V~. ................................................................................................................ Municipality 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............ ~r~& ......................................................................................................... b. Intended use and occupancy ........... ~¢~,~[. .................................................................................................. 3. Nature of work (check which applicable): New Building.....~.... ........ Addition ....................Alteration .................... Repair ....................R~moval .................... 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...~..~.d./.: .............. Rear ............................ Depth ............................ Height ............................Number of Stories ............................................................................................................ Dimensions of same structure with alterations or additions: Front . ..~..~...W'.~...~ ................. Rear ................................ Depth ..............................Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front ............ ..~. ............. Rear ........ .~.~...,~.,/. ........... Depth .~...~.~...~....~..~.~. ..... Height ......... ./.~..~ ........... NumBer of Stories ..... /.. .................... 9, Size of lot: Front ..... .~..~/.~.~..~.. ........ Rear ...... ~'.~'..~..~.. .......... Depth ..~q.~.f ............... 10. Date of Purchase ........ '/~.(-'.~,.q~..?...../....~..~,../. ................. Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ................................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ..... ..~..~.. .............................. ;. ....... 13. Name of Owner of prem.ses~....~/.~.~.../././~,~-./M..P../?~/Z,...Address .~.n¢,.~:~.~.~,~.~..~.'.../~..~..Vh°ne NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor,...~.~¢~./~..~..,..¢C...~.4(..~.:.....Address ..~//~:~.~.. '~'".~'. .............. Phone NO~"'4~.~¢.~..~..'...~..?.o PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate aH set-back dimensions from property lines. Give street and black numbers or description according to deed, and show street names and indicate whether interior or corner d STATE OF NEW YJD~K,~ COUNTY OF. ' ....... ~~ .......................... being duly sworn, deposes and soys that he is the applicant (Name of indi~,~p~l~on,), above named. He is the ......... ~/~... .......................................................................................................... (Contractor, agent, corlborote officer, etc.) of said owner or owners, and s duly authorized to perform or have performed the said work and to make and file this application; that ali statements contained in this application are true to the best of h s knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ....... ~.... ..... dav/'of ..~ .~..... ...... 19~../..~.URIETTk F. CAI, f. PORA' a r~ew ¥0rk(Signatu~e of gl~plicar],t) FOP~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No..../.,~:~/-.3 ......... APPLICATION FOR BUILDING PERMIT Date .......................................................... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and su/amitted 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 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 buildlngs, additions or a Iterc~tions, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. /,/ ./ (Signature of aplCHcant, or name, if a corporation) ....................... ~z'"(~dress of applicont) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... ~.....c~...../.'~.~..~.:.q. .... .~..C...~.....-...:.~....~.?..d9 If applicant is a corporate, signature of du~y authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: .......................................... : ................... Street and Number ........ ,w/..~..~.......~...~P.r ................................................................................................................ Municipality 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: Existing use and occupancy ............. ~Z.~-, ........................................................................................................ b. Intended use and occupancy ........... ~C~,~a~.~ .................................................................................................. 3. Nature of work (check which applicable): New Building.......~..... ........ Addition .................... Alteration .................... Repair ................... .Rem, oval .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ....... ...'~'..~.~..~.O..:..O...O. ................................. 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....~...~ff'/..'. .............. 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 ......... .~.~. .............. Number of Stories ..... /.. .................... 9. Size of lot: Front ..... ~.~.~' ......... Rear ...... ~...~,..~..0. .......... Depth ..~..0..O. ................. 7- / a 10. Date of Purchase ....................... N me of Former Owner ........................................................ 11. Zone or use district in which premises are situated ................................................................................................ ruction violate an zonin law, ordinance or regulation~ 12. Does proposed const Y g ~ ..... ~"'";;4:"~ ........... ;;/'?~'"~:'~.~ 13. Name of Owner of premises../Z..~,:f~../(./d..~..~f~../~..~.~.¢.~...Address NO ..................... Name of Architect ........................... ~2, ......................... Address ........................................... Phone NO ..................... Name of Contractor ............................ ...~..~..~..~..j.~....~..~ ..¢-...~.~..,~.5.......Address ..~..J~f.~/~..~...'Y,. ............. Phone NO..~..~...~..~...~..'...~...~P PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate a] set-back dimensions from property lines. Give street and block numbers or description according to deed, and show!slreet names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ............................ SS. .................................................................. being duly sworn, deposes and ays that he is the applicant ................ i'~'~ individual signing application) above named. He ~s the ................................... (Contractor, agent, corporate officer, e~c.) ' ' of said owner or owners, and s duly authorized to perform or have performed the said Work and to make and .fiFe this application that all statements canto ned in 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. Sworn to before me this rK day of /'~,~ .~. ....... 19 ............ (Signature of 'applicant) Notary Public, . ........................................................... County ~,~JI LL~xg-'D l/c/~- p/~ ~ '~ ¢'