HomeMy WebLinkAbout3040-zTOWN OF SOUTHOLD
'~UILDING DEPARTMEI~T
'I"OWN CLERK'S OFFICE
SOUTHOLD, N. Y,
n£1~TIF'IBAT£ OF' onI~UPANnY
THIS CERTIFIES that the building located at . .~../.~....~..~.~.~..h.~...~.~.~.~ ...... Street
~ap No .... ~ ..... Block No .... ~ ..... Lot No..X~... .... .~?~.~.~.?::.?.:~.:. .........
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ........... ~q~72~...~. .... 19..~.6. pursuant to ~vhich Building Permit No..~..0!~.0.. ~
dated ............... .~P.~.!.~....~, 19..~..~, was issued, and conforms to all of the require~
ments .of the .applicable provisions of the law. The .occupancy f. or which this certificate is
"~iv~ one family, dW~l~.~g...
issued is .... ~.~.. · ~.~ ......................................................
The certificate is issued tO ~. ~l~ ~],e~. , J~/'J'i~
(owner, lessee or ~enant)
of the aforesaid building.
N~ R~
Suffolk County Department of Health Approval .........................................
..... Building Inspector
TOWN 0~: SOUTHOLD
BUILDING DEPARTM[NT
TOWN CL[RK'$ OFFIC£
SOUTHOLD, N. Y.
~UILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 30~0 z
Date April ~ 66
Permission is hereby granted to:
Robt. Hyatt A/C W. P~ul Allen
Southold
to Build an addition on an existing dwe~_ling
at premises located at E/~ Minehaha Blvd 8outhotdt
pursuant to application dated .[ ............................... ..&..~..~.J'...]:. ....... ?. ..... 19....0...~., and approved by the
Building Inspector
B.,ldinb I.sp;ctor '¥
FO~H ~0.1 ·
' ' ' TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
L:×ammea ........... .v. .......................... , 19 ........
Approved ........................................ , 19 ........ Permit No .............................
Application No ............ : .................
Disapproved a/c .........~,..~ · · .-¢~. · ~ .~.~. ............ ~...7-~..~ .......................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ................................ & i~';~:~- ....... LF ...... , 19-66 .....
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building
Inspector.
b. P at p on showing location of lot and of buildings on premises, relationship to adjoining premises or punic streets or
areas, and giving a deCaited description of layout of property must be drawn on the diagram which is part of this application.
c. The work cove~ed by this applicction 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 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, building code and regulations.
(Signature of applicant, or name, if a corp9ration)
.................. .~t~o.~ 4i ................................ ; ..........................
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Nome of owner of premises ..... ..~..:....~..~.~k ~.~e~ .......................................... ' ........................................
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.: ...Zd~..~/&t, eZ~i Lot No.: ........ ' ................
Street and Number ..l~.r,~,}~.~....~]~v~.-.-~O~.~:~ ......................................... ; ....................: .......... ~ ...............
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..... ~'~.eZ~$~,~ ..........................................................................................................
b. Intended use and occupancy ...... ~.~tte,..~.~.:k-~.4~t,~.t-~O~ ............................................................................. ..
4.
5.
6.
10.
11.
12.
13.
property lines. Give street and b~ock number
whether inierior or corner ~ot.
Natpre of work (check which applicable): New Building .................. Addition ...Xx,~ .......Alteration ....~ .............
Repj=ir .................. Removal .................. Demolition .................. Other Work (Describe) ........................................
j (to be paid on filing this application)
If dwelling, number of dwelling units ............................ Number of dwelling units on each floor .............. i ..............
/
If gbrage, number of cars ............................................................................... ................................................ ..............
If I~usiness, commercial or mixed occupancy, specify nature and extent of each type of use ............................
D~mens~ons of existing structures, if any: Front Rear Depth
Hei ht ........................ Number of Stories ..................................................................................................................
Din ensions of same structure with alterations or additions: Front .................................... Rear ............................
De~ th ................................ Height ............................ Number of Stories ................................
Din ensions of entire new construction: Front ............. 8 ..................... Rear ...... 8. ................... Depth ...1.1+... ..............
Hei]ht .................... Number of Stories ..qTke. ............................................................................................................
Siz~ of lot: Front ............................ Rear .................................... Depth ................................
Dar of Purchase ........................................................ Name of Former Owner ........................................................
Torte or use district in which premises are situated ........ ?.AJJ...c%is.t ............................................................ : ..............
Doei proposed Construction violate any zoning law, ordinance or regulation? ............ ne ...........................................
Nar~e of Owner of premises ..W...P..JL1.],ea ................ Address ............................................ Phone No ...... i ..............
/
Narpe of Architect ...................................................... Address ............................................ Phone No.
Na+e of Contractor ....... P~....Hy.a,t~ .......................... Address ................ E~ou, th~lcl ........ Phone No .....................
PLOT DIAGRAM
Locotb clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-back dimensions from
or description according to deed, and shaw street names and indicate
STATE OF NEW YORK, } c ¢
COUNTY DF ....S.uff. olk ........... ~'°'
............................. ]L:Loh~......H~.a.t.t ........................................ being duly sworn, deposes and says that he is the 9pplicont
Name of individual signing application)
above nan~ed. He is the ...............~O~.~Z'm.C.tOI' ................................................................................................... ; ..............
(Contractor, agent, corporate officer, etc.)'
of said owper or owners, and is duly authorized to perform or have performed the said work and to make,end file
this applicbtion; that all statements contained in this application are true to the best of his knowledge end belief; and
that the w~)rk will be performed in the manner set forth in the application' filed therewith.
Sworn to b~fore me this ~
.................]'...~.. day of ................. Apt.il .............. , 19.~6.. /~~// ~
Notary Public,~ ~~ount~;;';~t'~