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2015-z
TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z 1668 Dote AUgUSt 13~ 1965 19 ........ THiS CERTIFIES that the building located at ..'.~,./..~......,.~.O...'~...a.....¥..~.?...~...?..¥.,e. ....................... Street Mop No, .~ ........... Block No. ~ ............ Lot No..~ .......... .,J~....~..~.~..~...U:.O..~..t..,~?,~? ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................... ~..D:.?.~.i.~. ....... ..~.~...,...., 1c~..~._. pursuant to which Building Permit No....~...0,.~...~'..~... dated ........................ .J~.~.~..O..~ ....... 3,0. ........ , ] 9..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 ........ ..... .......................................................................................... The certificate is issued to ...~.~.~,~,~.@..~..~....~.~...q.O,,.~.~ ............................. ~.~..~.. ................................. (owner, lessee or tena,nt) of the aforesaid building. N.D. Approval August 9, 1963 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? 2015 Z Oote ............................ 1~.o1~....30 ....... ~9.63.. Permission is hereby granted to: ~mer le an" t~ome s'"Oon~t' eo"Ine '""~/C...l~l.~-stb~th Jaeobs ..... 2.1-06.. ~ el,.~.eho...T, pk .................................... to .. bu~.td...neqt. ~ne" fam~ ty" d~):t~ll~ ................................................................................... at premises located at "Ii/~)'""S~Ul~d'"V[t'~'"Jk~'e ............................................................................. ............................................. l~a~ti.tuek.j...lf-~.¥.. ................................................................................ pursuant to application dated ............................. l~'~h' ......'~? ........... 19.6.~.., and approved by the Building Inspector Fee $...1-0,.00.. ])d.. SUFFOLK COUNTY Dv~PARTMENT OF HEALTH Date May 1.31.. 1963 Building Permit No. £015 TO WHOM IT MAY CONCEPJ~: The sewage disposal facilities for a structure located at N/S/O,,,,Sotmd¥%,ew Ave· 558' E~ Reeve Ave. (Give deed location) .... Matt$.t. Bck~' Southhold, L.I.., have been inspected by this Department and found to be satisfactory. ~ !strict En~eer z~.,~_~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~ Application No. ~....~..~'..)....~... ....... Approved ........................................ 19 ........ Permit No. Disapproved a/~ .Building In~ector) '~ APPLICATION FOR BUILDING PERMIT -'' INSTRUCTIONS a. This application must be completely filled in by typewriter or in inl~ and submitted ia duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adioining 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 location. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval at.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 Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuanc.e 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable laws, ordinances and regulations. American Home ConstP, Co.s Inc. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises.....~tZ~.'~.e~;]~...~.aD. Ql~.~ ......................................................................................................... If applicant is a corporate, signature of duly authorized officer. .................................................................................... ..~.~..e.~ id eat (Name and title of corporate officer) 1. Location of land on which proposed wgrk will be done. MaD No: ............................................Lot No: .................... Street and Number ..... S~uS....'~.~G~t..~,v~e ....................................................... ' ....... .~.L~...i..i../ ............................ Municipality 2. State existing use and occupancy of premises and intended use and oCcupancy of proposed construction: a. Existing use and occupancy ...... ~.OI~B ........................................................................................................ ~ ............ b, Intended use and occupancy ........ ql~.~...~.8~J,~k~...~e]~,'t~ ........................................................................... 3. Nature of work (check which applicable): New Building....~ ........... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe} .................... 4. Estimated Cost .......... ,~,~,,~.,,9.~ ................................... Fee .......................................................................................... (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 .........~.g~,l~ ......................................................................................................................... 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 ....... 60 ................. Rear ......... 60 ............... Depth ....2~. Height ....~1,6,,~,e~ .......Number of Stories ......... .~. ................ 9, Size of lot: Front ...1},Q.I ................ Rear ...],eL0. ................. Depth~.~,.~.8..l..,.~....JJ-..~.8-8?! 10. [)ate of Purchase ..~p~:l,Z...l,.,...3..~.6'! ...................... Name of Former Owner 1], Zone or use district in which premises are situated ......... ~. ..................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ........ ~l'.O ....................................... 13, Name of Owner of premises,,~3,:J,&~.tl~tl~..J~e~l~,Address ~.0.-.,,~J.i,....],gk~.j].~jrt~j~...Phone___,___ NO Name of Architect.,..'r,G.-vr~,e,~c.e...J[o..3~,t,hi'~ .......... Address ~,,18.6...,Iez'.;~(3'no...T;9]~..Phone NO, ?~0..~.?..c).0.~O Contractor...,~rtf)Zl.J.O.an~.ozr~0.~ia~,ddress~, ~. ~ ..... ?! ............. .u,~..~..O..~..!!....,Phone NO.,..........,... Nome PLOT DIAGRAM Locate clearly and distinctly oll buildings, whether existing or proposed, and indicate ali set-bock 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. COUNTY OF ............................ ) ......... Icts~.~..~...~.~,~;~,.~...~.e.~.~l.~.~; ............................. being duly sworr~, deposes and says that he is the applicant (Nrame of individual signing application) ' '' above named. He is the .................. ~),'t.~,l~. ......................................................................................................................... (Contractor, agent, coqborate 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 ali statements contained in this application are t~u~)~to the best of his knowledge and belief; and that the work w be performed in the manner set forth in the application filed therewith. Sworn to before me this ......... ~..~h ..... day of ...=,~!.9~-...~-~-,.-~,, ...~...~. L /7 ~T J £L/ZABFTH JACOBS I I 7-- / ©/\1 II C) .I I--7 L~-4 I d -1 "i LEFT SIbE 1, U I V, TIONS