HomeMy WebLinkAbout1933-zFO~ NO. 4
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CE:RTIFICATE: OF OCCUPANCY
No. Z...~OO~. ............. Date .......................J:)~t.~Q'D~......~. ...... , 19.~.~....
THIS CERTIFIES that the building located at ..C[.oI:t~;,'IL:LD,..I~..~..~.~, .............................. Street
~op~?..t~...~.~?~,oc~ ~o...~ ............... ,or ~o, .z~,..~..z~.....~.~..~.~.~.,...~.,,~., ..........
conforms substantially to the Application for Building Permit heretofore filed in this office dated
....................................... ~2~..~1b~....~..., 19..6~,. pursuant to which Building Permit No..,.1.~....~.
dated .................................. i~V~he~'...919.62.., was issued, and conforms to c~o~he requirements
local
of the applicable provisions of tl~ law. The occupancy for which this certificate is issued is ........
...~r.i.v.a .t.e .. o~e...f~il~...d.~.e lli.~g ..............................................................................................
The certificate is issued to ...... ~.O~¥1..~i.~.Q~ .............................................. ~.e.?. .............................
(owner, lessee or tena,nt)
of the aforesaid building.
FORM NO. 2
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N.° 1933 z
Date ......................... ]ll~'/~]l~e~ ...C). ........ 196~...
Permission is hereby granted to:
..Jehn-.*81do~ ......................................................
....... ~t *,l. tuek. ...................................................
to · .l~v~ · .a~.. ®xi.s t,l. ng...d,~e.l.t.$n~...t~ .. ~,~i.s. · .loea.tion .....................................................
at premises located at ....0~rd~n...He:~i.t~l~...l~ts...tcj...&..t8 .......................................................
................................... Conltl&n...Ro~d.. &.. CR~.7...®~t~nti. o~ .......................................................
................................................................ ~%ti.~ek ...........................................................................
pursuant to application dated .......................... NOVelgb~:I'...'.~. ........... 19.~2.., and approved by the
Building Inspector
Fee $ .'l O,~ · -.pd-.. I:~-]~. ·
..... Building Insp~'
TOWN DF SDUTHDLD
OFFICE OF BUILDING INSPECTOR
TOWN CLERK'S OFF~CE
SOUTHOLD, N, Y.
Mr. H,F.Bishop
Commissioner ofPublicWorks
Suf~lk County
Yaphank Ave., Yaphank, N. Y.
In accordance with Section 239K of the General Municipal Law of the
consolidated Laws of the State of New York, this is to notify the Commis-
sioner of Public Works of the County of Suffolk that ......
........... ~[a .Lt.i .¢.uc k, ...N.,.Y ..........................................................................
has applied to the Town of Southold for a permit to construct a building
on ...C.o~klim..Ro.a~..&..Co.umty... ~d..2.2 ,.....~a.t.ti.tuck .................
as shown on the attached plot plan, submitted in triplicate, dated ................
We shall withhold further action on this application for ten days or os
otherwise provided in the aforementioned Section 239K.
Very truly yours,
Building Inspector
Town of Southold, N. Y.
,pLoT pt~, d- IS'f
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN GLERK'S OFFIGE
SOUTHOLD, N. ¥.
Examined ........... ~....~....., 19.~...?~'.
Approved ..........~/,~ /~)_ '~ ~'-~ ~'~""'" 19 ........ Permit ldo.....~......~...~.....~.....~... ....
....... ....... .............................
Application No.....~..~....,'~,..-%... .........
APPLICATION FOR BUILDING 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 plon showing location of lot and of buildings on premises, relationship to odjoining 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 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 a Building Permit to the applicont. 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 part 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, alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances and regulations.
(Signature of applicant, or name, if ~ corporation)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
................................................... .O...~..~. ................................................................................................................................
Name of owner of premises ..~TID..N.~..~,~,C~. ..........................................................................................................................
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.: ........ .G...~.?..~.e...~....~,.,t¢.~ ........ Lot No.: ....~..~....~.....]-...~...
Street and Number ....~.f~l~.:J,D..~D. fLr] ~..CO. tZD.t,~ .,~]...2,~.~ ....... ,~,~,~;~.¢~1~,~:. ..................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction.
a. Existing use and occupancy ....... .~.~.8....D..~...~..~..~.C~ .............................
b. Intended use and occupancy .......... ~)~f~...~l~J~...c].~e:]~ ..................................................................
3. Nature of work (check which applicable): New Building .................... Addition .................. Alteration ..................
Repair .................. Removal .................. Demolition .................. Other Work (Describe) ..~,lg,J~l.c],::j.~-g moYec].
4. Estimated Cost .......~.ID.Q..~./.]~ ...................................... Fee ]LO
(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 ...... 2.8.. ................. Depth ...... ..LI:~. ..................
Height ............................ Number of Stories ..1.~r .........................................................................................................
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 ..~Q.Q .................... Rear 100 t 12~
................................. Dep h ..............................
10. Date of Purchase .................. 1.9.6~ .............................. Name of Former Owner Terrz. & Hill
] 1. Zone or use district in which premises are situated. "JL"
12. Does proposed construction violate any zoning law, ordinance or regu at on;~
13. Name of Owner of premises ....... ,To..~_~..S.:Lcl. D~. ....... Address ................................................ Phone No ...................
Name of Architect ............................. ? ...................... Address ................................................ Phone No ...................
Name of Contractor ....... D~I.I~O,..~O.y.~.~. ................. Address ......... ..~.~..~..~....t~.. ...................... Phone No ..................
PLOT DIAGRAM
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 or corner lot.
STATE OF NEW YORK, )
COUNTY OF ....~LU~.t'.OI~ ....... ) S.S.
........................... ~TD. bJ3...[~J.C].o~ ............................................. being duly sworn, deposes and says that he is the applicant
(Name of individual signing application)
above named. He is the ...... Q:~n.e~. ...............................................................................................................................
(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 a,nd belief; and
that the work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this 4 ./~
.................. ~'.... day of ................... No.'zemb. 1 62... v//,
, f2 .......... .... .....................
Notary Public Y,~ Publm st~ ~/~ (S~ natur
No. 52-{}:~67830