HomeMy WebLinkAbout2271-zFO~M NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMEtiT
TOWN CLERK'S OFFICE
SOUTHOL. D, ti. Y.
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES thor the building located at .~/~/S.......~..~.~.~..~...O..~....~. ................................ Street
Map No.......E~....X,.X. ........ Block No ...... ~-~.. .......Lot No. ;E~',~ .~.~.~.~.,l~.~.,O.~.t..t. ~.~..
conforms substantially to the Application for Building Permit heretofore filed in this office dated
............................. ~.~ .......... ~ ............... , 1~3.... pursuant to which Building Permit No...~.~.~..
dated ............................. ~.~.....~ ........ , 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 ........
~ivate o~e f~ily d~ll~n~
The certificate is issued to Edward Rovello ~ner
(owner, lessee or tenqnt)
the aforesaid building.
D. approval April 21~ 196~
FORM NO. 2~
TOWN OF $OUTNOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMiY
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED),
lq? 2271 Z
~ote'. ................. D~ema;be~..la... ............ , ~6,3...
Permission is hereby granted to:
t~t:Llta~.S,...8~.t~.~LZC..~a..~re;t;Lo ...........
........... ,.aou~;h~o:L~ ...............................................
to ~,~.~..ne~...one../~am~3,~...~e~3,J,t~ ............................................................... ~ .....................
ct premises located at ..,~l~l~Oi~,.,~.t, ................................................. : ............................................ ~...
................. : .............................. .O~.eenlzo~..tq.~. .............................................................................
pursuant td application doted .......................... ~)~.-e~......~. ..... 19~.~..., and approved by the
Building Inspector
Fee $..~LD.~O0 .........
Building Inspecto~
$-9
SCHD
SUFFOLK COU~@Y ,>;PA,~T. ,,~NT OF HEALTH
Date April 21~ 196h
Building Permit No.
TO ~tOM IT MAY COHCERN:
The sewage disposal facilities for a structure located at
Madison, Avenue~ Greenpor! (Rove,Ilo)
(Give deed location)
have been inspected by this Department and i~ound to be satisfactory.
District Engineer
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Exam,ned ....... , App"cot'on .........
Approved ................ LX .................... , t9 ........ Permit Mo .................................
(Buildin~ ~ctor)
APPLICATIO~ 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. p,tot plan showing location of lot and of buildings on premises, relationship to adioining premises or public streets or
areas, and giving o 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 shah 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 o 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 all applicable laws, ordinances and regulations.
(Signature of applicant, or name, if o corporation)
.................. .........
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.......... ;~¢,,~.Z.~..~..(..'z ............................................................................................................................................
Name of owner of premises 0
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: ....................
Street and Number ....~.~./.~¢4..~..'~...~..*..x~.......U...X..~C.~,R../,~../..... .....................................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ........//"~.~...~..~...C,..,4~'~.,~L,X~..../~....-~'. .....................................................................................
b, Intended use and occupancy ........... ~.Z..~.~....(~. ..................................................................................................
Nature of work (check which applicable): New Building ....../.I~........:. Addition .................. Alteration
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................
(to be paid on filing this application)
5. If dwelling, number of dweIling units ................ ./, ........... Number of dwelling units on each floor
If garage, number of cars
6. tf 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 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 ....... ~...,~.~ ............ Rear ........ ./....'~...'~..? ......... Depth ........ ./......~....~.. ...................
10. Date of Purchase ...... ~"~...~...~. ................................ Name of Former Owner
11. Zone or use district in which premises are situated..........,~'...~
12. Does proposed construction violate any zoning law, ordinance or regulati
13. Name of Owner of premises ..~...-~.JN'../~..Z~...~..../.~.~...~..~...~..'A~idress~....'..~.~.~7,~;;...! Phone
Name of Architect ........ ./ ................ i.' ....... :.....; ........... Address ......................... ~ ............. Phone No.
Name of Contractor .~../~/~/.~.~/..~.~.~"¢.~.A~..Z.~.?.~..~...Address`..~..~..x..-~...~..~....~..~. ............... Phone N .o~.~...-~..~...~.~.
PLOT DIAGRAM
Locate clearly and distinctly all 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
whether interior or corner lot.
STATE OF NEW YORK, . ) ~ ~
, .~./~.~...~.,,~/~,,,~/... be ng duly sworn, deposes and says that he is the applic
................... · ,/~': ' .~TT~ ' ,:-'": ............ :'"". .....................
(Name of ~nd~wdual signing apphcat~on)
abow,~ named. He is the
(Contractor, agent, corporate officer, etc.)
of sa d o~ner or owners, and is duly authgri~.~,,to perform or have performed the said work and to make and
this application; that all statements coqt~ime~ :j~vt~is application are true to the best of his knowledge and bel
and that the work will be perfo~me~i~.,b,~ ~/~r{'~t,J~n~' ~j:th in the application filed therewith. ,
Sworn to before me this Com%~s~ ~×p~ ~' ...... ~ ~? ' /7
..... ...........
×:,~ '1 / ~:.'~ ':.~. /1 ' , ......... ,~ ................. ~ ..........;,7~'~,~. ,,~ .....
Notary Publi; . ~---~,>.¢/_.,,,~....,,~('~.' .~..;~'c~,,-~r,~.]. u t ' (Signature of applicant)
I~OI~lV[ NO. 1
TOWN Of SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Approved ................ ¢.~ .................... , 19 ...... (.Permit No .................................
Disapproved a/c~..~i~ .............................
............... .......................................
(BuildingTector)
APPLICATION FOR BUILDING PERMIT
Date ~ ' , 19..
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 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 o Certificate of Occupancy
shall have been granted by the Building inspector.
APPL. ICATION iS HEREBY MADE to the Building Deportment 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 all applicable laws, ordinances and regulations. __
(Sign.ature of applicant, or name, if a corporation)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.......... ............................................................................................................................................
Name of owner of premises ....~....'~/~....~...~......~?.....?. ........ ~.....0_....~..~..../'7...~ .O .......................................
If applicant is a corporate, signature of du~y authorized officer.
(Name and title of corporate officer)
1. Loc.arian of land on which proposed work will be done. Map No: - Lot No:
Street ond Number ....................................................................................................
Municipality
2. Store existing use and occupancy of prem~es ond intended use and occupancy of proposed construction:
a. Existing use and occupancy ....... .~..,/~..~7~..~..~ ./.....///~ ......................................................................................
b. Intended use and occupancy ........... ~...<~! ......................................................................................................
3. Nature of work (check which applicable): New Building ...... Addition .................. Alteration ..............
Repair .................... Removal .................... Demolition .................... Other Work (Describe)
4. Estimated Cost ..~...~...'C../~r'~ 6 ~ Fee ...'~..~...~.~
(to be paid on filing this application)
5. If d~,elling, 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 .......................... 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 ........ ~....~... ............ Rear ........ ~/.....~... ........ Depth .........~:.....~. .......
Hei~lht ...... ~......~.. ............. Number of Stories .......... .~, .....................
9. Size of lot: Front ....... ~....~..~...~ ............ Rear ........ ./....'~.,..'~,~. ........ D~pth ........ .'(.....-~,..,,~. ...................
.¢.....z..
10. Dote of Purchase ...... .~.'~.k...~....~... ....... ............. Name of Former Owner
/
11. Zone or use district in which premises are situated.........../~...~..~.....: ...................................................................
12. Does proposed construction violate zoni~ Iow, ordinance or /r'z/~
13. Name of Owner of premises Phone
Name of Architect '"~'~;"~'"':///~/-z'~ ....... ~i~...Address ..~.,~..~..g.~ ............ Phone No.
Name of Contractor~b~.,..~r.~.~.r~.Z .................. Address ............... Phone
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr
property lines. Give street and block numbers or description according to deed, and show street names and indic
whether iqterior or corner lot.
STATE OF NEW y, Ij~lg, l~,z ~ ) ~ ~
COUNTY~ OF ..~...) ' '
........................................................ being duly sworn, deposes and says that he is the applic
(Name of individual signiDg g~_~lication) ,
above named. He is the ........... ~ ...................................................................................................
(Contractor, agent, corporate officer, ,~tc.)
of said owner or owners, and is duly authorized to De, rearm or have performed the said work and to make and
this application; that all statements contained in, ~]~J~ ~]p. plica~ion are true to the best of his knowledge and bel
and that }he work will be performec~in,,the :mcir~it~,[~, ~t,~for,~b~in the application filed therewith.
Sworn to before_me this / / uo~,~m,s~,~, Lxi),,os ~i~l~ 30, t,~&(~- x · //