HomeMy WebLinkAbout1928-zNO. 4
TOWN OF SOUTHOLD
BUiLDiNG DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES that the building 1ocated at ..... ~'l~.~O~.~..P.t..~O~ ............................... Street
Map No ....................... Block No ....................... Lot No..~'~ ..........~&t:L~,t,:~t~ .............................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
................................. 0~3.tO.T~eZ'......].~ ...... , 19.6~.. pursuant to which Building Permit No..,~.9.~.8.~...
dated ........................... 0~-t~be~......2.~., 19..~., was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is ........
..... ~. ~,V. at,~...~n~ .. £~m~ ~... ~w.~lL~n~ .........................................................................................
The certificete is issued to ..... J'~h~..~.~.~.~,~.~ ................ O~c~ ........................................................
(owner, lessee or tenant)
of the aforesaid building.
H.D. Approval May 3t, 1963
by R.Vllla
Building Inspector
FORM 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.° 1928 Z
Date ..................... I~ .t-,~b~ZL ....29. .......... 19.6~..
Permission is hereby granted to:
Edwal..Abi.tz. Jb/~..,lobri..~/l~;~.s ..............
.......... 14a ~.~ i.t,~.. ~. - -~-, :f., ..................................
to ...B~i.],~t .. i~ew., o~e...Fm, i.l.y...d,,,~ t.l.i~g ...................................................................................
at premises located at '"l~/~'"'"~.ittp~o'rl'.'Pt."i~o'al~ ............................................................................
.......................................................... ~'~ *,.tA. ~o~, ................................................................................
pursuant to application dated ............................... ~)~.t~t~r...~l,.].. ........ ]96~...., and approved by the
Building Inspector ~UbJeC~; to removal of existing dwelling from premises.
Fee $. lO..OCt ..........
Building Inspector /
FO~M NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Approved ¢"f '~ ?' 6 L~ ~/~ ~
........................................ , 19 ........ Permit No ..............................
............ ............................
....................... .........................
Application No../. .........................
APPLICATION FOR B'UILDING PERMIT
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 drown on the diagram which is port of this applica-
tion.
c. The work covered by this application m~y not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector wilt issue a Building Permit to the applico'nt. 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 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, as herein described.
The applicant agrees to comply with all applicable laws, ordinances and regulations.
......... ~d~a~d.. 'Ab~t~'"' :A~"~" '~o~;'Wimters'" ': .........
~Jgnature or appucanL or name, ~r a corporation)
t,°,aaress or applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pIumber or builder.
Nome of owner of premises ....... ,..TO,~:lt~..l~/~b~.'~.~ ................................................................................................................
If applicant is o, 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.: ...~.~;~¢~., .....
2, State existing use and occupancy of premises and in~ended use and occupancy of proposed constr~ction.
b. Intended use and occupancy .......... d~e.l)-&~g..~..G~r~e .................................................. t ...........................
3. Nature of work (check which applicable): New Building ...... ~ ......... Addition .................. Alteration ..................
Repair .................. Removal .................. Demolition .................. Other Work (Describe) ..................
4. Estimated Cost,..~.l...O~...O.. ............................................. Fee~.0. ....................................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ................ ..O..~.~ ........ Number of dwelling units on each floor ............................
If garage, number of cars ............................................................................................................................................
6. If business, commercial or mixed occupancy, specify nature ~ond 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 _..~.0.. .................... Rear ........ .~...0. ................. Depth 36
Height .............................. Number of Stories ....O...~..~. ....................
9. Size of lot: Front ..... .~.~.~. .................. Rear ........ .~..~..9 .................. Depth 96~798
10. Date of Purchase .................... .~.~.~.~ ............................ Na,m~ of Former Owner ........................................................
11. Zone or use district in which premises are situated.
12. Does proposed construction viol.ate any zoning taw, ordinance or regulation? ............ .~...O. .............................................
13. Name of Owner of premises'.....~..~.~....~..~.~..~.e.~ ..... Address ................................................ Phone No ...................
Name of Architect .................................................... Address ................................................ Phone No ...................
Name of Contractor ..~.~..~..,....~b..~.t..~ ........................ Address ......~..~....~....~..~.~..~. ...................... 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.
lC/.
. 4/
S~)~TE OF NEW ~fOR_K,, ,, )
COUNTY OF ..... ~.~.~.~....1~........) S.S.
Edward Abitz
................................................................................................ being duly sworn, deposes and says that he is the applicant
(Name of individual signing application)
above named. He is the ~o~tra~tor
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or hove 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 aqd belief; and
that the work will be performed in the manner set forth in the applic, gp/:i~p flied therewith.
Sworn to before me ,this
1 1.. 19~ItJ~. '' --' ';~' // ~ '
................. day of ...............
· -~,~ , .,z (c:k~,,~'.~j~l~. st, t,.~..'r¢~.,,,~....:.....~:~.....~.. ....... .~,...~ ~.<~,.../..~/.~,,:[ .....
Notary Pub c ~...~...~ .................. f'~ ' ~'"*~n~z" . i~.03~z80osa~f.lk c*,,t~ (Signature of appJicant) ~/.z"v .........
~ t, omrmssio~ Expires March 30, ~1~)~ ,