HomeMy WebLinkAbout1697-zTOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLDo N. ¥.
CERTIFICATE OF OCCUPANCY
No ..... ZIDtt.9... Date ........... At~Uit~'" '2t~ "19"62
~[HIS CERTIFIES that the building located at ']gy~8'"i~hi]~al'd' LaTI~ ......... Street
Map No.:y~ ........... Block No .... ~c.~ ................ Lot No, ~ ..... ~a{~.~ ]/l{~lO~l~ .~,~, ..
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ....... A]~i-], '9 ........ 19~... pursuant to ~vhich Building Permit No. Z'~6~'
dated ........ Apri.1....];0 ..... 194~~ , was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is ..... Private..one f,amit¥ dwelling .........................................
This certificate is issued to ,~Ot~..& (Il.a:[1-t~]~dle(ov~'eri'lessee-(Y~l~e~or .......... ten~)
of the aforesaid building.
H.D, approval Aug 23~ 1962 by P.
Ma~kowski
Building
FOB~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)
1697 Z
Permission is hereby granted to'
~"aet 0~,... ,a,/~ J~..l~oI~e~.& 'd;L.t~ ..........
to ;B~.~4..new..o~e...t. ~..~.. &uel~ .................................................................................
at premises located at ..... ]~/~.....~h~-]~l~'4 -~ ......................................................................
pursuant to appticabon dated ................................ ~ ....¢) .......... t9(:~., and approved by the
Budding Inspector
Fee $.~O,,,00 ..........
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Exo mined.....~....t...O. .......... 19..~...~.
Approved ........................................ 19 ........ Permit No ..............................
Disapproved a/c
........................ i'l~'~'i'l'~l'i'~'~ ..........................
Application No....~.~.....?..Z ...........
APPLICATION FOR BUILDING PERMIT
Doe .......... /.-._~=.:......~... ..................... 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 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 co,~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 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 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 regulations.
(Signature of applicant, or nome, if o corporation)
(Adc~ess of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
£ - .....................................................................
(Name and title of corporate officer) .~..~ Z...r.~....~.
2. State existing use and occupa[c¥([of premises and .nMt~nn~C~c~a~s~ and occupancy of proposed construction:
o. Existing use and occupancy ....... ~-m~.....~ ..........................................................................................
3. Nature of work (check which applicable): New Building ............ X ........Addition .................... Alteration ....................
Repair ..................{l~emoval .................... Demolition ....................Other Work (Describe) ....................
4. Estimated' Cost .......... .~....~ ................................... ,r,,~ Fee .........~. .............................................................................. o
(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 ............................ 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 .... ..~.....~...~..~...~..x. .....
Height ! ~ !
....................... Number of Stories
9. Size of lot: Front .../.....~........f ......... Rear ........ ~':....~.........~.... Depth ..... ./...~....-~¥....~ .....
s '~ ~ ~'' ?' r e/' 'r~fs~ '~a';~' :; .N.a.~.r~..m..e~ aZ e ~' '~"~
10. Date OlrP~rch~ :;.,
11. Zone o ue d'sr.i ' ' p ' ' . ........................... ~...~...~. .............................
12. Does proposed construction violate any zoning law, ordinance or regulatRS, g?...;...z:..~¢~... ........................................
13. Name of Owner of premises./,J~J~../(.~ ........ Address JiJ'.~.l~..:.~' ............ Phone NO.~ ...................
Name of Architect ............... .v ............. ~ ...................Address ......................................... [..Phone NO .....................
Name of Contractor..~..~~:.Address ...~.~,..~...~hono NOP...~....-..(;..~..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.
r, tJ0
STATE OF NEW)¢glji_K,~ / ) S S
COU NTY/Xj) F
__
· -..~-.: ................................. being duly sworn, deposes and says that he is the app cant
........... (Name o~'"in~vidual sigl~ing application) ':
above named. He is the .......... ~r-¢~-,,~,~ ............................................................................................................
(Contractor, agent, corlSorate 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 tFue to the best of his knowledge anH belief;
and that the work will be performed in the manner set forth in the app]Jqation filed therewith.
Sworn to before me this ,'~ () ~ ~ /') "~
//'~'~ ~.,, ~f ~ 19~-~---~ ........ (Signature of applicant)
......... ~ ............ ~y~.~ ..... :'"'. .......... ~"~:~""~'" [ '~/" ' ~'~_'~4~I)ITN ~
~, /~ / ./] ~-./~ ,/"~'~-~/-~ ~ ] ~i~ ~lic State of New York
r, lotary Public, ..,~rf~-~-cl¢~..~-Z-.~-'"'i"CK~tr~2-O344963, Suffolk C0un~,
~' Corem,ss,on Expires March 30,