HomeMy WebLinkAbout1931-zFO~M NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATe OF OCCUPANCY
No. ~"~'~6 ............. Date MaT'e~ 3:.'1, 19~...
THIS CERTIFIES that the building located at Jf/~S""'J~,~,~"~O~.~ .................................... Street
Map No. ":X~.T~ .......... Block No. 'X~b~ ........... Lot No. '"'X~ ......... ~a'l~i.t~ek.....J~i..~i ...........
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.............................. 1~['6~'~,':~'".~.~' ........... , 1~. .... pursuant to which Building Permit No....,~.9.~
dated ...................... ]tO~'~l:)'~'""],'"'"' 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 ........
The certificate is issued to ....... (]M~. ..............
, ~ T4~p~'~ (owner, lessee or tenant)
of the aforesaid building.
H.D. approval ~an. 1~,
196~ by R. Villa
...... ~'"'(' ~t*-~"v'~ ............ "; .........................;I ..........
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.° 1931, Z
Dote ................. ~'O-~.e]~.l~. · · .1. ................. 19.~..
Permission is hereby gronted to:
Edwal4...Ab~ t~.....A/¢.. J~ha.. Mur.pl~. ...................
· ..Mat.t~.tuek. .......................................................
to ...%,~..tm:~Td..~l~,W...one...f.amTl7..d~eT1,.ng ............................................................................
ot premises Iocoted ot t~lth"~oad¥ .....................................................................................................
..................................................... ~ $,t .i.%uek. .....................................................................................
purs~o~t to opplicotio~ doted ........................... OC.~O~I~.....~. ........... lg..(y~.., ond opproved by the
Building Inspector
Fee $ *'10'.;O(~ ..........
Building Inspector
Subdivision
Lot
-"Ca~tain
Kidd Estate"
Lot 189
RUTH
ROAD
NOTE: ~l :MONUMENT
SURVEY FOR
JOHN MURPHY
MATT ITUCK
TOWN OF SOUTHOLD
SUFF CO., NIL
GUARANTEED TO:
SCALE: I% 40' SOUTNOLD SAVINGS BANK
INTER-COUNTY TITLE GUARAF~TY ,f~
OCT 25, 1962 MORTGAGE CO.
LAND SURVEYO'R~ N.Y.S. LTC, NO. 12:845
RIVERHEAD~ N,Y.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
E×om,ned ........ .............
Approved ........................................ ~9 ........ Permit No ...............................
Disopproved o/c .......... ~...
(Building Inspector) .
Applicotion No. /~ '~ !
APPLICATION FOR ~UILDING PERMIT
Dote....~.x .......:. ................... ../...~ ................ lY ............
/
INSTRUCTIONS
o. This opplicotion must be completely filled in by typewriter or in ink and submitted in duplicete to the Building
Inspector.
b. Plot p[en showing location of lot and of buildings on premises, relotionship to odjoining premises or public streets
or areos, ond giving o detoiled description of Ioyout of property must be drewn on the diogrom which is port of this Iocotion.
c. The work covered by this opplicotion moy not be commenced before issuence of Building Permit.
d. Upon approvol of this applicetion, the Building Inspector will issue o Building Permit to the opplicont. Such
permit sholl be kept on the premises ovoiloble for inspection throughout the progress of the work.
e. No building shall be occupied or used in whole or in pert for ony purpose whatever until o Certificote of Occuponcy
shall hove been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Depertment for the issuonoe of o Building Permit pursuant to the
Building Zone Ordinonce of the Town of SouChold, Suffolk County, New York, ond other oppliceble Laws, Ordinences or
Regu]otions, for the construction of buildings, edditions or alteretions, or for removo[ or demolition, os herein described.
The opplicant ogrees to comply with oil oppliceble lows, ordinonces gp(~ reguletions.
(Address of
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ..~....~..A.:..~,7. · ...... ~...~.....~...../~../.~/..k...~... ....................................................
If applicant is a corporate, signature of duly authorized officer.
1. Location of land on which proposed work wiJJ be done. Map No: .~Z... Lot No: ....................
Street and Number ....... .~.~..~,~.....~.....~.... ................ '...~...~t.f~-,~~..?,:'~,..,~.,., ...............................................
Municipality
'2. State existing use and occupancy of pr, emises and intended use and occupancy of proposed construction:
o. Existing use and occupancy ............................................................ ; ........................................................................
b. Intended use and occupancy ................... ~..~....~(r~...~.'...(.~..~..c.~. ........................................................................
3. Nature of work (check which applicable): New Building......~...: .......... Addition .................... Alteration ....................
Repair ....... i'. ........... Removal .................... Demolition .................... Other Work (Describe) ....................
_.-- ,
4. Estimated Cost ............. ,g...~?.j..~ ......................... Fee ..........................................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling umts ................................ Number of dwelling units on each floor ............................
If garage, number of cars ..................... i.~?..%~.,.?....' .................................................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..............................
7. Dimensions of existing structures, Jf any: Front ............................ Rear ............................ Depth ............................
Height ............................ Number of Stories .............................................................................................................
Dimensions of same structure with alterations or, additions: Front ................................ Rear ................................
Depth .............................. Height ..............................
8. Dimensions of entire new construction: Front ........ ..~....:..., .......... Rear ....... ............ Depth ............................
'2'
Height ........ }. ................. Number of Stories ..... ~.: .......... !
9. Size of lot: Front ........ /...~.~ ........ Rear ............................ Depth .............................
10. Dote of Purchase ............~..~..../~....~, ......................... Name of Former Owner .....~..:.,,~_,~...~...~./.~..~..~...~.....t. .............
,4.
11. Zone or use district in..,whic, h promises ore ................................
. situated ....................... "'""i ...............................
12. Does proposed construction violate any zoning law, ordinance or regulot?n~? ....................................................
13. Name of Owner of premises....~.~.~.~..~.~../.'~.~..~..~.~..C.~Address""" ~ *"-" --~ ...... ~./~;.~.~.~. .......... Phone NO....Z ..............
Name of Architectt ..................................... ~ ~.~/~9 ./~.. '~': ................. ~ '/~/'~ l/~Address ........................................ ~~ Phone NO. "~:?/¥'~',.~i ....
Nome of Contrac or......~.. .......................................... d(~'~ss .............. 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~.,~z"~ ) S S
-~'(~"~'~' ~'"~"'~'X:"'"": ................. being duly sworn, deposes ,and says that he is the applicant
(Name of individual signing aj;~t~licatj~n) .
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 are true to the best of his knowledge and belief;
and that the work will be performed in the manner set, forth in ,the application filed therewith.
Sworn to before me this '
........................ ~ay of .................................... ~,, ]9.,,~ ........ ~tft~.~,~,~(~g~r~of applicent)
~y ~. mmssmn ex fires Mar. 30,19 ~