HomeMy WebLinkAbout1893-zTOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No. Z 1766 Date l~ovem]~er 4 19 63
THIS CERTIFIES that the building located at Old JUl~ La, ,. Mattitu~ek Street
Map No. ~* Block No. ** Lot No. **
conforms substantially to the Application for Building Permit heretofore filed in this office dated
................................. .~~...~...., 19..~.. pursuant to which Building Permit No.
~893
dated ........................ ~9~9~.*.~.~..*I 19...9.?., was issued, and conforms to Qll of the requirements
of the app[icable provisions of the law. The occupancy for which this certificate is issued is ........
The certificate {s issued to william E. Young, owner
(owner, lessee or tenant)
of the aforesaid building.
Building Inspector
FOI~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)
N? 1893' Z
Date .............................. ~lj~l~lb;~...~j~ 19.6~...
Permission is hereby granted to:
John' J~U~'"" ~/C" ¥i~l'X~" E ;'" Y~i~ ........... .... Cu%elxogue ......................................................
to ..]~t.t~.. ~v..one-.-f'am~..ly-..d~.l.~.rrg ....................................................................................
at premises located at '0t'd'"~'~t'~"'~*llff ............................................................................................
..................................... ~ t.~i4;uek.i...~.~.¥¥ .......................................................................................
pursuant to application dated ......................... ~'~'~MI~"""~)' ....... lg.~....., and approved by the
Building Inspector
F~e. $'1_,(~.,00. ............
'Budding [h~p-6ctor
I~RM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ..... ,.~,.,, .,[).... ,,~. ~,~( ...../ ....... , 19..(~..~,,
Approved .................... ~.~ ................. , l~)....:...Perm~l No. ~_________________~,~......~..(....~ ......
Application No..../~...,Z....~ .........
Disapproved a/c ............................................................................................
l v '-(Building InJ~pector)
APPLICATION FOR gUlL. DING PERMIT
Date ..........~../..~....../....~.. .............., 19...~....~:
1 NSTRUCTIONS
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 Jot 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 drown on the diagram which is port of this applica-
tion.
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 pa rt for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MAiDE 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, alterations, or for removal or demolition, os herein described.
The appUcant agrees to comply with all applicable laws, ordinances and regulations.
(Signature of applicant, or nome, if a corporation)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, genera~ contractor, electrician, plumber or builder.
.................................. .........................................................................................................................
~ame of owner of premises ...... ~ ....... ~ ......... ~ ............... ./.....~]]--.-.: ...... ~..~ .....................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title oF corporate officer)
1. Location of lend on which proposed w'~k will, be done. ~Ma~o.: .................... ~ .................. .Lot Np.: ..... . ................
Street and Number '"'~'"~:"~'"='"~' '''~'':2'''~:':''''''' '~'''~I~'~?''~~ Municipality~?~'~'--~'~':'-
2. State existing use and occupancy of prem,ises and intended use and occupancy of proposed construction.
a. Existing use and occupancy .............................................................................................................................
b. Intended use and occupancy ............................... .~ ..............................................................................
/
3. Nature of work (check which applicable): New Building ....... ~. ........... . Addition .... ...... ........ Alteration ..................
Repair .................. Removal .................. Demolition .................. Other Work (Describe) ..................
4. Estimated Cost ...c~..~.)....~...~....~.....~.r..~: .............. Fee ..../.0..:.5.? ...................................................................
(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 ..................... ~.a...:'. ...........................................................................................................
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 ..............................
Height ..............................Number of Stories ..............................
9. Size of lot: Front ................ ~..~,.~, Rear
10. Date of Purchase .........................................................
C/ x '~~. '~w'''-~ .................. ~' ..................
~. Zon~ o..~.,i~,.~, , w~ ~, ,,~ ~,,~ s,,~,.,....~.....~=~.~ ...... ~.~~ ............
12.Does proposed construction violate any zoning Jaw, ordinance or regulation.;) ..~ ........ ~......~ ...........................
........
,3. ~ o~ ow,~, o~ ~mi.~s
Name of Architect ................................................... .~..~...__.. Address Phone No. ~..~.~5;.5...
Name
of
Contractor
PLOT DIAG~M
Locate clearly and distinctly ali 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, ~corner lot.
STATE OF N~ Y~I~ ) S S
COUNTY OF~.~.~ ......... ) ' '
................. ........................
~ ~ i~ividual signing application)
above named. He is the ............... ~~ ..........................
(Contractor, agent, corporate 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 ~re true to the best of his knowledge a.nd belief; and
that the work will be performed in the manner set forth in the application filed therewith.
.wo.r,.o.efo.eme.h,s
........................ doy of ............................................ , 19 ........
~ot~t'y Public County ~: ~ .......
............................................................