HomeMy WebLinkAbout1750-zNO. 4
TOWN OF SOUTHOLD
BUiLDiNG DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No .... ~... ~,7.~.~ ......... Dote ~ovembe:~ 4 19..63
THIS CERTIFIES that the building io~ate~ at~J~ ~..~.,.. ~k~.q~ .......... Street
Map No ......... ~.* .........Block No ......... ~.~ ........Lot No ..... .~ .......................................................
conforms substanhally to the ~pplicahon for Building Permit heretofore filed in th~s office dated
.......................... ~...~ ................ , 19..~.~.. pursuant to w~h Building Permit No. ...............
dated ................ ~..~ .................. , 19 ~.., was fssued, and conforms to all of the requirements
of the applicable prows~ons of the law The occupancy for which th~s cerhficate is issued ~s ........
~A~ O~ F~ILM ~LL~G
The certificate is issued to Barbara Ga!limore, ~er
(owner, Jessee or te~mt)
of the ofores~ld building.
FORH NO. 2
TOWN OF SOUTHOLD
BUILDING D~PARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERARIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N.o
1750 Z
Per~ ~msian is hereby granted to:
~r,,~ .~,,..~m~ .AZ.~...~t.~..a.....~...~.....~.....~...o..r...e. ......
........... .~.ttl.~ze~ .............................................
to .,~!a,~;] ~..:ae~..o~e..~:ae~t:I~....dw~.~g ..................................................................................
et premises located at . ..~/l~..I~l~'~Oll..J~&~. ................................................................................
.............. ! ............................... I~thol~ ..... L~:. ...........................................................................
pursuant rio apphcat~on dated ................................. ~ ...~,~_ ............ 19.6.~..., and approved by the
I
Building I ~nspector
Fee $I0.-.~ ...........
FO]~M NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N9 1750 Z
Date .............................. ...~........~..~.. ........... 19.~...~....
Permission is hereby granted to:
Irt ed. t....~o.o.r.e...~.g...l~t.b...r..a....~..a..i..1...l...~....o..r..e. ......
........... I~a.tt t. tu~k ...............................................
to. 2t~t ~1.. new...one.. £a~l~....d~.e 11~ ....................................................................................
at premises located at ....~/~...~$~;~1.,~)~ ..................................................................................
............................................... ,~o~thold t.....N.,.E, ..............................................................................
pursuant to application dated ................................. ]s~]r.....2~. .............. 19.~.., and approved by the
Building Inspector
Fee $ '1 0,,.0~. ...........
FOltM NO. 1
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ........... .~.(..~..~ ...n_~....., 19../¢....~..
Approved .............................. .t.h ...... , 19..¥...Permit No..~..(...~..~...~ .......
............................... ................................
Application No../...?.....~'....O.. ..........
APPLICATION FOR BUILDING PERMIT
Date ....................................................... 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 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 granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of o 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 regulatig~s. A
_ pp ' , , ' corporation)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.................... ...........................................................................................................................................
Name of owner of premises .......... ~.~r~.~ ........ ~..~.:~../.~...~../~/~... ....................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Location of land on w~nich proposed work will be done. Map No: ............................................ Lot No: ....................
Street and Number~/.~....~.~.......~....~....~ .......... ..~.....~....i.....:..~../.~)......~..44/_~....~ .............................
Municipality
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ............ V...~... ~ ..............
b. Intended use and occupancy ........... £~.!.Q ..~....~... .........................................................................................
3. Nature of work (check which applicable): New Building .... A ....... Addition .................. Alteration ..................
Repair .................... Rlfmoval .................... 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 .......................... Rear .......................... Depth ..............................
Height ............................ Number of Stories .............................................................................................................
Dimensions of same structure with alterations or additions: Front ................................ Rear ................................
Depth ............................ Height ................................ Number of Stories ........................................
8. Dimens ons of e/~t re new construction: Front ........ .~.....'~.. ........... Rear ......... .~¢.?/~. ......... Depth /-~ /
Height ..... ./~/.--.. ................ Number of Stories.....~/,~. ............. '.'.'.'.. ' ...........................
9. Size of lot: Front ........... /.....c~... ........... Rear ......... ~..¢~. ......... Depth ........ ..g~......~. .....................
/
]0. Dote of Purchase ....................................................... Name of Former Owner ........................................................
] 1. Zone or use district in which premises are situated ......................... . .........
12. Does proposed construction vi late any no aw, ordinance re u at on>
13. Name of Owner of premises ~J~...~....~..4/.(/'~-dd ess .....
Name of Architect ..............~ ........... , ........................... Address Phone No .....................
Name of Contractor ..... ~....~......~..~......Address ;;;;i~;~j;;i;;; Phone No./~....':-~..~/~..
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 ~.~P~ )
COUNTY OF .... ,)....l~..J~.....~_ S.S.
................................... ~......~. ...... ~ ................. being duly sworn, deposes and says that he is the applicant
(Name of individual signing/cl~ppl~_
above named. He is the ......................................~¥j1~.~... ...............................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or lqave 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 manner_jl~forth in the applica~t,~pn filed therewith.
Sworn to before me this
...~. ~,.~c~ ..................................................................
Notary Pub c, .~~.~ounty (Signature of applicant)