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HomeMy WebLinkAbout1674-zF~RM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CEETIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...~...~..~..:..~...~.....~.....'~..~.?.~.~.&..~..~..~'.t~...e..~'.~...~...~..~..~[~met O~:Lent:~ N, Y, Map No ..... ..~.*.~ .......... Block No ............ .~..e.~ .... Lot No ................... .e...~.,? ............................................. conform~ substantially to the Apphcahon for Building Permit heretofore filed in this office dated .................... ~..~..~.....2..~.. .......................... , ]9...~.2. pursuant to which Building Permit No ........... doCed ......... ...~..F..C~...~..6. .......................... 79 ...6..~ was ~ssued, and conforms to a" of the requ~rement~ of the apphcable provisions of the law. The occupancy for which this certificate is issued is ........ BL~S//~ SS BUILD~G (owner, lessee or tenant) of the aforesaid building. Heath Department: Approval - 10/1/62 / / P. J. Ha~owf~c~, Sr. Sah~ary ~epec~or/~/ ~ ~ ........................... ....... guil~ng Inspector ~ FORM NO. 2 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.o 1674' Z Date ........................ J~LF~b,.... ~6 ............ 19..~. Permission is hereby granted to: ...g,,.. R'i aha~.d.. Keogh ...................................... ............... ~entt.....ll.Z. ................................. to )l~ve...~n..lms~nes s...l~t ~ ~ ............................................................................................... at premises located at ..O~'~tll~...l~o~d~..T.e..&./~en...Tl~ ............................................................. ........................................... O~-.~e~t ...................................................................................................... pursuant to application dated .................................. )/~1~.t~1[~.....~6 ........ 19~,..., and approved by the Building Inspector Fee $.1.0..0.0...1~ ..Cheek FORM ~O. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TO~N CLERK'S OFFICE SOUTHOLD, N. Y. ROT/CE OF DISAPPHOVAL File No..iDplieagicn //1/~ ........... Date .... To ~, ~ichard Keogh ............... ....... Ma. in Roa~ ............... 0~isnt, ./~,Y, ............. PLEASE TA/CE NOTICE that your application date6 .... lqS/~Oh ~.~ ...... 19 62. £or permit to construct ~usIness :bidg at thc premises located at ...t~/.~.,l~..n..R<t. &.W/S 0~ster POndS .L.a .......... Stree~ Orient~ N.Y. Map .... ~ .Block . ~ . . Lot returnect herewith and disapproved on the followinff ground, Insufficient setback. · .Emetese~-.~ew. ap~licatio~ Forms - holding fee. pending amm~nded, a~plfcati Building Inspector FOItM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved t' 19..'!.....Permit No.,~ ~/ ~ ~ ~ Disapproved a/c .~ ................... "'~'(B~g Ins e' APPLICATION FOR BUILDING PERMIT Date .............. ......... ...... 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 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 g~anted 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 reg~atio_ns. / __ (Signature of applicant, or narl~, if a colporation) ............................... i~ ~'] ~'~ ' ~ ~¢' '~ ~l~'j i ~ ~a ~ ~')' ....... ~/ ................... State whether applicant ds owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................................................. ............................................................................................. Name of owner of prem'ses 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 ...... .~...O..~..6.~..~......O...~........~.-..~./.~......~..°...~....~......~..~..~........~.(sV~.~..~..Z~ .~. Municipality ~/~-/?,5~ /~, ~,' ........................... 2, State existing use and occupency of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... ...~.~...(.//.~..~.~. .................. b. Intended use and occupancy ........ ~?.~/..'.~...¢'..~.~ ........ ]]'.i ....... ; ............................................................................ 3. Na~'ure of work (check which applicable): New Building ..... ,-~ ......... Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ............................. Fee .'-,f/....~(~ ...................................................................... (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 ..,~.~.~x.~.¢...x,,q. ........ 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 ....... ./.~.....4;. ......... Depth ......~..~. ................. Height ..... /~.....Z ........... Number of Stories .................................. ? 9. Size of lot: Front ........... ..7....,~..:. .......... Rear ......... .~..--~. ............. Depth ..... /.../.~.. .......................... ~. Dote of Purchose ............. ~ .......... .>, ......... Z ............ Name af Farmer ~ner .~.~....n...4::C~ ~.~: 11. Zone or use district in which premises are situated ........ /~..q~MC~...'~.~,E.~- ................................................................. 12. Does proposed construction violate an, y zoning [aw, ordinance or regulation? ..../~...¢~ .......................................... 13. Name of Owner of premises .~..~....~f.4~.'¢..¢2~...~...~.9.;~.Address ~./..h.../~...~.~.'~?...~..~.t~..o./.~..~.¢~, hone No.~..~.?../.Jr..~..~7' Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ...... ..~'.9...57......./~...~...z'...~..~.~..h .......... Address ~//..~..~:~ ~/9,.~/. Phone No~f.~.Z/.~....~../.. 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. STATE OF NEW~'-¥OI~I~, nh ) S S COUNTY OF ...~.~..'-=z.....) '' ....................... 5...~..~..~..~.~,.~% ........ .0...~.!.~. .............. being duly swarn~ deposes ond says thor he is the opplicont .(Name of individual signing application) above named. He is the (Contractor, agent, corporate officer, etc.) of~s, eid-f~cn~ 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 tk~is 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 ' / / ....... .... ,ayof ..... .. o Notary Public ,:~.~.' ~ ~.'~e~t~%:e~ .......... '~ '~ ' - ~'i'~'n"'¢"~ ~' ' ~l~'~t)' .............................