HomeMy WebLinkAbout1935-zFO~M NO. A
TOWN OF SOUTHOLD
BUILDING D~EPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, bi. Y.
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES that the building located at ...W./(~.....~.f~...AT.f~ .................................... Street
~d' I..Tuthill
pqqo ....................... Block No ....................... Lot No ..... 1.~..&..16.~ ....... La~.el ........................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
............................ · No;~em'De~'......~ ........... , 19.~2. pursuant to which Building Permit No..~Lg~...
dated ........................... ~O.~..~t.~e,~,......~., 19.-62, was issued, and coni~orms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is ........
............... ,~.,tt&~t e...o~e...~.aml~.y..~wel~tng ................................................................................
The certificate is issued to ...~T.Q~.~..~..~.Q]3~.~....~.~. .............. .Qtt~.e.~.~. ....................................
(owner, lessee or tenant)
of the aforesaid building.
H.D. approval May
31, 1963
by R* Villa
Bul]Ldmg 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.° 1935 z
Dote ................... ~O.V~bOF......~. ............ 19..6~,.
Permission is hereby granted to:
...~.o.~.e..p..h....~.,... ~;.e..n..~ ...........................................
........ ]~.a~...A~o.t.L~tlrel...N-, .~., ........................
to...~l.~],d., neY.. o~3e...f - ~;tly...ct~e]_t :Lng ................................................................................... -
at premises located at ...Lot..l.~l~.-..G,.l.,.T',itb$.tt..~, .........................................................
........................................... B~a~.. J~r~t ....... 3,a~r~l~...~...~., ...........................................................
pursuant to application dated ............................. ~I~V~II]~I~......~. ........ 19..~i~., and approved by the
Building Inspector
Fee $...],0~,.00 .........
Building Inspector
NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMEF,~T
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Approved
........................................ , 19 ........ Permit No .................................
Application No .............................
Disapproved a/c ............................................................................................
APPLICATION FOR BUILDING PERMIT
Date 'c;'~'~
.......................................................
: INSTRUCTIONS
a. Thb application must be completely filled in by typewriteF 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, end giving a detailed description of layout of property must be drawn on the diagram which is port of this application.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approva~ of this application, the Building Inspector will issue a Building Permit to thb 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 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 or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with alt applicable laws, ordinances and regulations.
.......... i ' .........
............................................. ............ ................
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.................................. ,,~. :~?, x,~..>..~ .........................................................................................................................................
Nome of owner of premises ...~7~./.'~......~. ..... ...........................................................
If applicant is a corporate, si~ature ~f duly authorized officer.
(Name and title of corporate officer)
1. Looation of land on which proposed work will be done. Map No: ......~....~...! ........................... Lot No: /.~...~...!..?. ....
Street and Number ................... ..~/¢ ........................... Municipality .....
2. State existing use and occupancy of premises and intended use and occupancy oF proposed construction:
a. Existing use and occupancy ......................................... ~ .........................................................................................
b, Intended use and occupancy .......... ~r:f~...~.'~
3'~ Nature of work (check which applicable): New Building f AddJtlon ,/dteraf~on , ~ ~
Repair .................... Removal .................... 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, Jf 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.....:.O~../ ~'. .............. Rear O~'/ ~'~-
............................... Depth ...~....~...".~ .............
Height ...... _ ,¢r./..O...i.i_ ........... Number of Stories ........ ./. ........................
9. Size of lot: Front ./.~..Z~ ~r Rear /.OD /z'-r Depth ...... /....~...¢...F...'.~.. ................
10. Date of Purchase ....~.....cr:...~...~..~..Z...~....~..-- .................. Name of Former Owne'~.~.~../~..~~
11. Zone or use district in which premises are situated .................................................................................................
12. Does proposed construction violate c~ny .z~ning law, ordinance or regulatien? ..... ..A~....d. ............................
13. Name oF Owner of prem~~~j~.~..Address ~....~/.~.~ ....... Phone N~.'~..2.~'.~.".~.~/'/
Name of Architect ..... .~...~.IF'~4'...k~..J~..d..~¥,.~..~',C.......Address ..K~Z/fr~......'C:7.. ................... Phone No
Name of Contractor ~..~.'....~..~ ......." 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.
STATE OF NE~f'OR/K~ , /)r ) ~ ~
~ - bern du sworn de oses and sa s that e ,s I t
..................... ~.........? ............ :...... ..................... ' g y , p y h ' the app ican
above na (m eNd~' s i ~Fd~'~/i..d. ~. ~.1.. ~,.~...n ~.1 ,c..~..~i ~I .................................................................................................................
(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;c/~..'' me this~~~'~' ~~.~~.~
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