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HomeMy WebLinkAbout2149-zFO]II~ NO. 4 TOWN OF ,~OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No..~..'19~.9 ............ Date .......................... THIS CERTIFIES that the building located at ..... W./.$...~'..~h~>l?~..R~ac]. ..................... Street MAm~.~de~ Peco~c.]~v ~state~ ap ,~o ....................... ~,OCK i~C ....................... Lot No. conforms substantially to the Application for Building Permit heretofore fi~ed in this office dated ........................................ A~g~s~....~.., 19.65.. pursuant to which Building Permit No..2Z~gZ... dated ............................ ~S~.....l~...., 19..6~., 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 ........ ...... R~i~ate...o~e...~amil~..dwe.1 l&ng. .......................................................................................... The certificate is issued to ..A,~g~e~ ............................. 0~ ..................................... (owner, lessee or tena.nt) of the aforesaid building. H.D. Approval Feb. 2t~, 196~ 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) Permission is hereby granted to: l~m, .~fe~moz'e.....A,/~-..A.~r~'~t~t~'~e~· ........... · .G~.e en~-.~ ........................................................ to ...... .iS~.:L6..n~..o~te...~a~.~y..~.Z4z~ ................................................................................ at prem. ises located at ....~..~..~....~ ........ ~eeo.~t.o...3e~..~e~e~e~ .................................. ............................................ ~/f~ · .,..]~.- ~ho~'e · ~tc~tc~ ...................................................................... pursuant to application dated ................................ ~l~,~t,.....~. ....... 19...~.3, and approved by the Building Inspector Fee $" '~'(~.'00 ......... Building Inspector SCHD SUFFOLK COUNTY D£P.~kTIU~NT OF HEALTH Date February 24, 1964 Building Permit No. 2149Z TO ~OM IT MAY CONCERN: The sewage disposal facilities for a structure located at Peconic Bay Estates. 123.122.122A. Bay Shera R~. G~.nnn,*~ (Give deed location) ~ have been inspected by this Department and £ound to be satisfactory. FOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No..~*..'181~ ............ Date .................... ~.~.~. ......... .~..~. ......... , 19.6..~.... THIS CERTIFIES that the building located at .~/~.....~,~...~hDr.~..~(~d ....................... Street (w~ekham Park) conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................................ A~g.UB.~.....i~.., I~)~.... pursuant to which Building Permit No ..... .~...~..~..~..~. dated ................................. A%l,g.~s.~..l~., 19~..., wes issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ..P.r.i.vata..one...fam~l~...d:~e!ling ............................................................................................... The certificate is issued to ..... A,~..,..J~t]~lg~J~'.~' ......................... ~..~..~.e.~ .................................... (owner, lessee or tenant) of the aforesaid building. H.D. Approval ~eb 2~+, 1965 Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam'ned ............... Gl'" ................. ' Approved ........................................ , 19 ........ Permit No ................................. Disapproved a/c ......... ....................................................................... ....................... ............ ('~u'ilding I~sp~tor) Application No ............................. APPLICATION FOR BUILDING PERMIT Date 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 p remises, relationship to adjoining 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 application. 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 .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. . ordinances and regulations. The applicant agrees to comgJy with all applicable Jaws, ~./,..~~~(o~.~ (Sign.a u e o app 'c , or name, if a corporation) ....... ...................................... O/~ (Address of bl~plicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber,or builder. Nome of owner of premises ........ .~...,~..'.....~...d'~'~',~~.~'~,. .......................................................... If applicant is a 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: ./.~.~..-.../.~.~.. treet ond ..... 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 ond occuponcy ........ ~.~ .~o-~... .............................................................................. 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .............. Repair ....................Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost .... ..?...~'~.,,~..(2.f?.O. ................................. Fee ...................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... /. .................. Number of dwelling units on each floor ........................ If ggrage 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 ..........................Depth .......................... Height ............................ Number of Stories .......................................................................................................... Dimensions of same structure with alterations or (~dditions: Front ................................ Rear ............................ Depth ............................ Heighl' ...................... ; .......... N~nber of Stories ........................................ 8. Dimensions of entire new construction: Frant....i ........................... Rear .......O~...~....~....O~...../../.. Depth ..... ~..~.....~.'../..u~....f./.., Height ....... ..~,~..,.~ ........... Number of Slories ............. /~, ................. 9. Size, of lot: Front ...... ,Z.~.CR ................ Rear ....... ,/.~....(2. .......... Depth ........ ,Z~.~..~.. ................... ,~ 10. Date of Purchase ....-~...u...I.~..../..O...~....~..~..~..~. ............. Name of Former Owner ..... 1 1. Zone or use district in which premises' are situated .......... ~ ..................................................................... -- c/ /--~/ ) / 12, Does proposed construction violate any zoning law, ordinanc_e/or regulation? ........ ,z/4¢4':) ................................. · ,-¢ ~J/~;t~/e/, ~: '7-' ,4'u~, ' ..... 13. Name of Owner of prem.sesff,~...K~l.~.~.,¥~'J~Z(/.~.~.....Address ..,~,d-.,C-/~m:.~.~,C....~. ,.~ ........... Phone No ................. Name of Architect ...................................................... Address ............................................ Phone No ................. Nome of Contractor ./.,"~..'....../.~....z~/.~..~,.4.~z"4~...Address ...~..,xJ°__~...,~....~..~..~.z~.~.... Phone No, PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions f property lines. Give street and block numbers or description according to deed, and show street names and indic whether interior or corner lot. STATE OF NEW~OF~,, / Z ) ......... ,.~...~....../.~.(..~f..,~.'.~.../~...~..Z(~,~4~ ................................... being duly sworn, deposes and says that he is the applice (Name of individua signing application) above named. He is the ................ ...~....z~../~...~_?..~./J~... ......... ..C~.~...~'...,~...~.../~...~..~ ,~...~....~.. ............................................................ . (Contractor, agent corporate officer, etc.) of said owner or owners, dnd is duly authorized to perfarm or have performed the said work and to make and this application; that all statements confair~[~)clr~jnTtJ~L~pplJcation are true to the best of his knowledge and belibf; and that the work will be performed i~01f~epm~pm~tr~ ~e~lef~¥~ in the application filed therewith. J Sworn to bJefo~re me this ~0 52-0344963, SulloJk C0unW/.~' ~ /) l ......... ...... J Notary Pul?lic~.~...,~~~~ ............ (~"gnature of ~ ~'~:t'i ......................... I"' / FORM[ NO. 1 TOWN OF SOUTHOLD BUiLDiNG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No. ¢'~ j L./, ~' APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application m~st be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of ~ot 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 drawn on the diagram which is part of this application. 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 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 part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building ]nspector. 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 ogrees to comply with all applicable lows, ordinances and regulations,m ...... .................................. ~~of ap~ hi, if a;orpor.iii.i.i)..' ........ ~;~dd r ess ' ~a'~',ic~ ................. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................ ............................................................................................................................................... Name of o~ner of premises .... ./. .... ~ .................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) .,~..~ .~... 1. Loc.orion of land on which proposed work will be done. Map No: ~r~.~:.~ ............ Lot No:/~c~T7/.~...~.. Street and Number ~/~ Municipalit¢.,,/ 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ¢~/.~..~. ...................................................................... b. lntended use ond occupancy ............... ~.~ .~.... ...................................................................... 3. Nature of work (check which applicable): New Building ..... '.~...,....... Addition .................. Alteration ............. Repair ............... C~ Removal .................... Demolition .................... Other Work (Describe) ........................ 4, Estimated Cost .....,Z"..C~..~.(~.O. c3~ ................................ 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 ............... ,,~-',-~.,c~ ......................................... 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 some structure with alterations/oF'additions: Front ................................ Rear ............................ Depth ............................ Height ................. L.~..;..,.,:;Number of Stories ........................................ Height ........ ./...~...~ ........... Number of Stories ............ ./, ................... 10, Date of Purchase ....~...... .... /...,O.t...J...cJ..~.~, .......... Nome of Former Owner. . 11. Zone or use district in w~ch premises are situated ~ 12. Does proposed construction violate ~ny zoning law, ordinance or regulationP Name of Architect ...................................................... Address ............................................ Phone No. PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-bock dimensions property lines. Give street and block numbers or description according to deed, and show street names and indi, whether interior or corner lot. STATE OF NEW. COUNTY OF ..~) ........ ~.~......,..../...~(.~..~/,dr/...~/. ,/...~'K/..d/.Z2..~ ........................... being duly sworn, deposes and says that he is the applic, (Name of individual signing application) ~ above named. He is the ................................... ~d.,~4-,~_z,~...~ .... ~"~~~.....~ ......... : ................................................... ' (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 f chis application; that all statements co~tain~B }.h~plJcation are true to the best of his knowledge and beli~ and that t¥ work will be performed i~r~,~,~f~(Bkin the application filed therewith. Sworn to b~f~e/me this ~ C..mh~s;mt Ex~l~j'~s~ar~h 3~?~ ~ ~ ............. ........... . ) i r/ . . ~ ~>~"~ ............. ~..~~ ...................................