HomeMy WebLinkAbout1700-zTOWN OF SOUTHOLD
BUILDING DEPARTMENT
~'OWN CLERK'S OFFICE
SOUTHOLD, N, Y.
O£RTIFIOAT£ OP O00UI~ANOY
THIS CERTIFIES that the building located at i~.Y.$...~.e.~oh .~:oad ............ Street
Map No...~.. ........ Block No..~L~.. ......... Lot No. ~ ..... ~r~el~l~t~ .~.,y, .......
conforms ~'substantially to the Application for Building Permit heretofore filed in this office
dated .. ,' ..... .A.I~?.~ .... ~. ..... 19~2. pursuant to which Building Permit No.. iI.~.0O. ~
dated .... " .~..~.f.~. Il 19.62. was issued, and conforms to all of the require-
ments .of the applicable provisions of the law. The o~cupancy for which this certificate is
~Pivate O~e f~milv
issued is .~ .......................... d~Gllir~g ........................................
The cert~lcate is issued to ...Q~.~.glt~ .]~le~ ............. t~Ile~. .....................
~ (owner, lessee or tenant)
of the/?foresaid building.
Suffoll~ County Department of Health Appr. oval ..... .~.~..~.~(~6 .........................
...... Buildin~ Inspector ....... '"~' '
FORM NO. 2
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS I~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N.° 1700 Z
Date .................. ~-J~L1. · .. · .J~, .................. 1963...
Permission is hereby granted to:
............. ~.t... Jat~s ...............................................
to. l~uilc%..new...one...f, alJ~ l.~..~lwett, tll~ ....................................................................................
at premises located at .S/S...]~4~'1-.~.,O~ ..........................................................................................
........................................................... O~e~np.o~.t, ~ ...K..'Z~ ..................................................................
pursuont to opplicotion doted ................................ A]~':~I ....... ~ .......... 19~.., ond opproved by the
Building Inspector
Building Inspector
FOIt~lVI NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, 1'4. Y.
TEI~PORARX
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES that the budding located at ...~.~ ..... l~e~[g...~.o.f~ .............................. Street
Map No .... ~ ........... B~ock No ...... ...:...... ,at No ~ .............. ~.e..e..92P..~?'..,.......~.:.~.'. ..........
conforms substanhally to the Applicahon for Building Permit heretofore filed m th~s office dated
................................... Ap~J.]l, ...... ~t. .... , 19 ~..2.. pursuant to which Budding Permit No.l..~..0...0...~..
dated ......................... .'~]g.?.~..~. ..... .]:..~..., 19....~..2., was ,ssued, and conforms to all of the requ,rements
of the applicable provisions of the law. The occupancy for which th~s certificate ~s issued ~s ........
.... . ..~. $.?.a.~...9. p...e.....2..a..m..~ ~.v .. ~.~.~ ~.~k ~..~. ........................................................................................
The cerhficate is issued to .~,~,%.~],~. ..... ~:~.~-.~.T. ................ ~.m..?. ......................................................
(owner, lessee or tenant)
of the aforesaid building
FOI~M NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined .....
........ , I9 ........
0 o
Approved ........................................ , 19 ........ Permit No .................................
................. ...............................
Application No....(..~..~ .........
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewr, iter 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 o 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, os herein described.
The applicant agrees to comply with all applicable laws, ordinances and regulations.
(Signature of applicant, or name, if a corporation)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
........................................... ~l~r. ........................................................................................................................................
Name of owner of premises Oswald Meier
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 .......... ..B~..a..c..h...~9.~.~,....G.?..e..e..n.p.9..zt..t.,....L.:..I.:.~ ..N.:.~:
Municipality .............
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ............ .~'~,~l~'if~.].~ ................................................................................................
b. Intended use and occupancy Resident dwelling
3. Nature of work (check which applicable): New Building ....... ..~. ........ Addition .................. Alteration ..................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................
4. Estimated Cost ............ .~..~..~.?...O9.. ................................. Fee ..........................................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ....... .o..q~ ................. Number of dwelling units on each floor ..... .o..n.~ .................
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 ......... .6..~.! ................. Rear .......... .6..~.~. ............ Depth .....~..I..~t. .............
Height ........... .~.? ........... Number of Stories ......... 9p.e. ...................
9. Size of lot: Front ...... ]-.0.~.,.~,~. ............. Rear ..... .Z..0. Q....0. ............. Depth ....2.~.~..:..0..].. ........................
10. Date of Purchase ...... .0..o..fc..o..b..e.~...1.~..6..]... ......................... Name of Former Owner ........................................................
11. Zone or use district in which premises are situated ..................... ~ ...... ~.~.i ...............................................
12. Does proposed construction violate any zoning law, ordinance or regulation? ...... ..q.o. ...........................................
13. Name of Owner of premises ....q.~.~.]:..cl:....M.e.~.e.~ ............. Address .3]~.,~_~$.~-.~?~....~.e.~.o.~cll:Jhon~ No. CA..1.-.232,~...
Name of Architect ...................................................... Address ............................................ Phone No .....................
Name of Contractor ....N...e~.....~...n~ ,~...cl:..~.°..~..e..q,...~.n..q.'....Address ?.~.~.9~.°...~.~.e.,...~.'.~.~..e.~%ne No.A..N...~..!~!J!J.0....
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 YO~K// ~,/ )
COUNTY OF .... ~...) S.S.
.............. ~'....~..'..~.~.i~Z.~,~.. .................. :..: . '. be ng duly swam, deposes and says that he is the applicant
(Name of individual signing application)
above named. He is the ......... ~~ ................ ] ..................................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner o.r. 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 true to the best of his knowledge and belief;
and that the work will be performed in th~[~anner set forth in the application filed there~'ith.
Sworn to before me this JUOlTlt-,T-'te%~ i'lew york ~ ~ ~ .... ~ ~ ~ -
........... /z. ..... d of ......