HomeMy WebLinkAbout2463-zFOEM i~0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
$OUTHOLD, N. Y.
CERTIFICATe OF OCCUPANCY
No. Z..._1.990 ............. Date .......................... OO~.J)e~'.....~.]...., 19.~.1¢-..
THIS CERTIFIES that the building located at ..J~N~l~,.n~...]~l,.~:...~n...~.~. ................. Street
Map No. ~§.~.'...~.....~..~.,°~l~, No ....................... Lot No. ~ .......... O{.oe~poy.:{;.t....I~,.~,,. .....................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
..................................... ~l'~[~r.....~'[ .......... , 19~... pursuant to which Building Permit No.
dated ........................... ~T.~.t.~.....,~..~ .......... , 19.6~.., was issued, and conforms to oil of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is ........
.P,~..i.v~..~ae,..~a.r~.i,l¥..~,~el$~r~ ................................................................................................
The certificate is issued to ....~q~t'k~;~C~.~...~l~O]~Yl~.l~ .......................... l[~'~{l~ ...............................
(owner, lessee or tenant)
of the aforesaid building.
H.D. Approval ~ept 28 196~ by R. Villa
FOItM 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? 2 63 z
Permission is hereby granted to:
~eaa~k.. Cen~tmwae~ ea....-A/i3.-ba~t £~)rd Thornhltll
.............. ~lO0..Saa~.~,~e~..th~y ...........................
........................ Xel.i.p ............................................
t o ...BAri ld.. ~Ae~.. ene..~ge~i-tF..d~e..3.]: i~g ...................................................................................
at premises located at ...I~t...%t ....... Ea,te~n..~hex, es ...................................................................
.............................. ll~arm..L~..&..Sutton.. Pl ...................... G~,eent~e~o .....................................
pursuant to application dated ................................ ~'~1~1,~ ....... ~ ....... 19.(~f.., and approved by the
Building Inspector
Fee $...~..O.,t., ,00,. ..........
FO]~M NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Yo
Approved ........................................ ,119 ........ Permit No, ~' [ ~ ~ ~
(Building 7pector)
APPLICATION FOR BUILDING PERMIT
Date ......... J. u3~:..9.1, ................................ , 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 propertymust 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 Inspector.
APPLICATION IS HEREBY MADE 1-o 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, ordinance?,,b,~ilding code and regulations.
($1~'~?'e";¥'~l~l~licant, or name, if a corporation)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.................... G.. e .o. ,,...C o.t3.'b., ......................................................................................................................................................
Santfo~d Thoruhill
Nome of owner of premises .....................................................................................................................................................
If applicq~_z~,rate~signat_u~ obduly authorized officer.
.......... .................
(~me and title ~4orporate officer)
1. Location of land on which proposed work will be done. Map No: ....... ~.~e~.~..~D.~.?.'... Lot No: ....~ ..............
, N fl ~C }~ ~ane & Sutton Place ~.fl~ ~ v
Street and Number ........... ~ ................................................................ ~ ..... ,...~ ......................
Municipality ~
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and ~cupancy .................. D.QD~ ........................................................................................................
b. Intended use and occupancy ....o~e..~.am.i.[~..~e~.ee .......................................................................................
3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ..................
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 ......... ff. ................
If garage, number of cars ........ /.....~....~...t.~. .................................................................................................................
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 ...............................................................................................................
· /o~' . .... .17.. .' ~.~'. .
Dimensions of some structure with alterations or additions: Front ...... ~..4~. .................... Rear .... ~. ...............
Depth ....... ;~..f, ................. ' Height ....../..~.. ................. ' Number of Stories ........../. .............................
8. Dimensions of entire new construction: Front......,..,.,...~/~ / r(.°........... '~ Rear ........ ~...~...~..../..~...;~. Depth ..... ~..~...~ .............
Height ........ /.~1.~..~ .......... Number of Stories .......... Z'. ................
9. Size of lot: Front .../....~...4~. ............. Rear ...... ~...~....q ............ Depth ....../...~.. .....................
10. Date of Purchase ...':~., .P.~...~....~ ....... ~'..~...~.~ .............. Name of Former Owner ,4~'.~.~.~..~'.xg........,~.~.~.g?.~E..-~. ............
11. Zone or use district in which premises are situated ....... 7~.~...,,~./...~.~.~'.~...~. ......................................................
12. Does proposed construction violate any zoning Iow, ordinance or regulation? ....... ,,5C~ .......................................
13. Name of Owner of premises~....'~'.A/~'.~'.l~..,~fL~.&.~. ........ Address .~'..~.~,...~.'.~...,..~'~¢~.~Wy~ff,,~.~hone No .....................
Name of Architect ...................................................... Address ............................................. Phone No .....................
Name of Contractor . .~-.~.~.,~.~......~.L.~.~..~...../..W....~-Address ,~/.~...°....,f'..'~.4z..e.z.,c.~=.../.ff~'Phone No.,~.~.,6...~.~,.~'
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil 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 ................................ ~ S.S.
................................................................................................. being duly sworn, deposes and says that he is the applicant
(Name of individual sign)~gg app~)...~
above named. He is the .............. ~...~...+...~...'..~..,~ ................................................................................................
(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 cpplicotion; that a 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 a~pli_catlon filed therewith.
Sworn to before me this ~~
............. ~ ......... dayof .......... ~,y ........................ , 19.~.~. ~/ _ _ ~
~rch 30, 19~
SUFFOLK COUNTY DEPARTMENT OF HEALTH
Date September 28, 1964
Building Permit Ne.
TO WHOM IT MAY CONCERN:
The sewage disposal facilities for a structure located at
Tasner Lane (Lot 33 Eastern Shores)
(Give deed location)
(Santford Thornhill
have been inspected by this Department and found to be satisfactory.
District Engineer