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Home My WebLink About3054-zFORM 1~0. 4 TOWN OF ~OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N, Y. CERTIFICATE OF OCCUPANCY No. ll. 11511 ..... Date ......... AUgUSt; .31 ......... ,19..66 THIS CERTIFIES that the building located at .SOIlt:I~ .St,de. ~$~O~. $~,,.. Street Map No. ~ ..... Block No...~ .... Lot No...~ ............ $~O1~..~ ~O~k conforms substantially ~o the Applicati.on for Building Permit hereto~e filed in this office dated .......... ~V~.13 ..... , 1966. pursuant to which Building Permit No. 3~54~.. dated .......... ~..~ ...... , 19.~f, was issued, and conforms to all of the require- ments .of the .applicable provisions of the law. The .occupancy ~or which this certificate is issued is .... n~. one..[~t1~ .~elllng ............................................. The certificate is issued ~o .~0~.~ .&..~ .P~I .................................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Appvqva~9~t. ~.0,..~9~ ...................... ' ~.~:~.~ ~-..4f... ~' ~ / /'/ . . .~.,~/.. -- Building Inspec~ TOWN OF SOUTHOLD BUiLDiNG DEPARTMENT TOWN CLER~('S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST DE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK. AUTHORIZED) N? 305~l Z Date ..................... ~,~Z,~ ....... 1~.+. .............. , ~9...6.6 Permission is hereby granted to: Robe.~..&,,.:~e.le~..,..Fa~.g~ ..................................... .... ~.~...~eek..~ .............................................. ........... · G~,~.den..,C~t,~.,...Jf...g' .......................... to ]~ , ~ · ~2d"~e~¢ d~e ~%~5r tt~e%~; ................................ at premises located at -..~/~.....~GG.t4DLrit...]D~. ........................................................................................ ................................................... 8 e~t,t, heZ.¢l..~......~',~.,-~: ~ ............................................................................ pursuant to application dated ............... , .............. -A'~"JL']k-'-"~ ......... 19..(~6., and approved by the Building Inspector Fee $..1.~ ,.Q0 .......... Building Inspect~ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. TO WHOM IT MAY CONCERN: at The sewage disposal facilities for a structure located (GiVe deed location) ~ have been inspected by this department and found to be satisfactory. Dis%rio~ Er~J nsen District Engineer S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located ; (Give deed l~Zcatio'n) have been inspected by this department and found to be satisfactory. DisZri¢% Engineer District Engineer FORM 'NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TO~VN GLERK'S OFFtGE SOUTHOLD, N. Y. Application No ............................. APPLICATION FOR BUILDING PERMIT Date ........................... . .~...M...~....~.~T...../....~.~....., 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 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 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 reaulatio/~ (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 ........... ~..~. .......... ;: ................................ : ....................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and tide of corporate officer) ¢d~-s? ~o.~,~(,~6ow ~o~,.~,~ 1. Location of land on which proposed work will be done. Map No.: ~,~..A,.z~4m~z ....... Lot No.: .~.....(~. .~( Stre~P on~ ~uu,o~. ; ................. ~ ...................... ~ ........ ~ .................. ~ .......... ~unici~lity 2. St.te existin~ use ond eecupancy o{ premises ond in~ended use ~nd occupancy o{ propose~ construction: o. [xistin~ uso ~nd occuponc~ ...~.~ .................................................................................................................... b. Intendod use ond occuponcy ~ff~/~ ................................................................................ 3. Natu,lre of work (check which applicable): New Building '// Addition Alteration Repalr .................. Removal .................. Demolition ............. :.... Other Work (Describe) ........................................ ., ~oo ~ ~/~ 4. Est'~ated Cost ............................................................ tee .......................................................................................... i (to be paid on filing this application) 5. If d~elJing, number of dwelling units ........... .J. ............... Number of dwelling units on each floor ............................ if go, rage, number of cars ................................................................................................................................ i ............ 6. If b~siness, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dim~.nsions of existing structures, if any: Front ............................ Rear ............................... : Depth ........... ~ ........ Height ........................ Number of Stories .................................................................................................... i ............ Dim~ nsions of same structure with alterations or additions: Front .................................... Rear ................ . Dept ................................ Height ............................ Number of Stories ................................ 8. Dim, ~sions of entire new construction: Front .....~..O...f ........................ Rear ,..,~-..~.,~ ................. Depth ....~....~...: ............. kleil ht ..... .~'..?....~. ...... Number of Stories ...2 ............................................................................................................... 9. Size of lot: Front ........ (.~ ................ Rear ....... ~.~.'. .................... Depth ..~.~.~ .................... 10. Dot. of Purchase .a~.~Kff.CZ..(~.~..~.~ ....................Name of Former Owner ~R~.~..~...~Zx~.~.g. ....... ] 1. Zon~ or use district in which premises are situated ..... ~.L~.~6f~.(...~ ................................................................. 12. Doe proposed construction violate any zoning law, ordinance or regulation? ...~ ...................................... ............. 13. Nar~e af Owner of premises .............. , ....... ~..~.....~ ......... Address ...................................... ~... ~hone No ................... Nar~e of Architect .~.~ ............................................ Address ........................... ~ ............... Phone No ....... ~ ............. PLOT DIAGRAM kocat9 clearly and distinctly all buildings, whether existing or proposed, and indicate all set-~ck dimensions fram prope~y lJ~nes. Give street and block number or description according to deed, and show street names and~ indicate whether jn~erJor or comer lot. I STATE NEW. SJO, P,~ , , 1S S COUNT' !OF ..:/~...~.?..,?.,,'55,..~.,...f'' ................................................................................ being duly sworn, deposes and says that he is the ~pplicant (Name of individual signing application) ~ above nar'~ed. He is the ...~...u:?...~..~..~...~ .................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said o~'ner or owners, and is duly authorized to perform or have performed the said work and to makei and file this appliiation; that all statements contained Jn this application are true to the best of his knowledge and belief; and that the, Ork will be performed in the manner set forth in the application filed therewith. Swam to Before me this ~ ~ ........ ............... Nota~ PdbJ~:~..~~?¢t~~ ~ (Signature of applicant) " I ~ ~ ~'~' ~' FOEM NO. I TOWN OF $OUTHOLD I~UILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ......... , Approved ,t 19.? ...... Permit No. APPLICATION FOR BUILDING PERMIT Date ................... ................ , .... INSTRUCTIONS o. 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 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 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, build?ng code and regulations. (Signature of applicant, or name, if a corporation) ........ r ..................... ........................... State whether applicant is owner, lessee, agent, architect, engi'neer, general contractor, electrician, plumber or builder. .............................................................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) = 1. Location of land on which proposed work wilt be done..Mop No.: ............... : ......................... Lot No.: ........................ Street and Number ....................................................... ~ ................... ~- ........................................... ~ Munici~lity 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....~.~ ................................................................................................................. b. intended use and occupancy ...~.,~.~.~.~(.fL~ ................................................................................................... 3.Nott re of work (check which applicable): New Buitding .................. Addition .................. Alteration .................. Re.."ir .................. ;~emoval .................. Demolition .........,:,.'~' ...... Other Work (Describe) ........................................ (to be paid on filing this application) 5. If d~relling, number of dwelling units ......... / ................. Number of dwelling units on each floor ..,.....--,.....] / If g~ rage, number of Cars.../~.¢...~.~.. ................................................................................................................. i ............. 6. IF Business,/ commercial or mixed occupancy, specify nature and extent of each type of use ....E. ..................... 7. Dim[enmons of exmhng structures, Jf any: Front ............................ Rear ................................ Depth .......... r ......... Height ........................ Number of Stories ................................................................................................... ] ............. Dimj~nsions of same structure with alterations or additions: Front .................................... Rear .............. ; ............. Dep;rhrr. ................................ Height ............................ Number of Stories ................................. 8. Dim!ensions of e, ntire new construction: Front ............ .~..~....' .............. Rear ........ .?....~.. ........... Depth ...?....~,. ............. ..... ....... Number Stories ..... .............................................................................................. : .............. 9. Size'of lot: Front ......... ./..~...,O. ........... Rear .............. ,/.~.O, ............. Depth 11. Zon~e or use district in which premises are situated ...... /~....../~..~/.~..zT.~..x=......~ ..................................................... -- 12. Doe proposed constr~ction va ate any zoning aw, ordinance or regulation? ..... ¢. ....................................... , .............. Nar ~e of Architect ...................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locot~ clearly and distinctly all buildings whether existing or proposed and indicate ail set-back dimensions from property lines. Give street and block number or description according to deed, and show street names andl indicate whether inferior or corner lot. STATE O~ NEW YORK, (Name of nd v dual sig~ing opplicot on) (Contractor, agent corporate officer, etc.) of said o~ner or owners, and is duly authorized to perform or have performed the said work and to make cnd file this appli4ation; that all statements contained in this application are true to the best of his knowledge and belief; and that the wbrk will be performed in the manner set forth in the application filed therewith. Sworn to ~efore me this ~ I ~ J~OTARy PUBLIC, S~ate e~ ~,~,w rV~r~' l'~O. §2-3233120 Suffolk ,Term Expires March 30, FO~M NO, 1 'I'OWbl OF SOUTHOLI) BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTNOLD, N. Y. Application No..:..~.'..?.'..~.~.~... ...... Disapproved a/c ......... ;~, .~..~ ............ .5:.:,~,,~::', .............. ~ .............................. ............... ii ...... ...... .......................... ......................................... (Buildi~'g Inspector) INSTRUCTIONS a. This aPplication must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin9 Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or punic streets or areas, and giving o detailed description of layout of property must be drown 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 to the Building Department for the issuance of a Building Permit pursuant to ~he 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 taws, ordinances, build~j~ code and regul,~igns. (Signature of applicant, or name, if a corporation) ........................ ............................... State whether applicant is owner, lessee, agent, architect, en,a. ineer, general contractor, electrician, plumber or builder. .... ................................ Name of owner of premises 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.: ........................ Street and Number ,~';~4, ~)£ ,¢'~ r~ / ~'~ ~-- 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 and occupancy ......... ./..~..~.../~..(.~.~ .................................................................................................... 10. 11. 12. 13. Locat~ property Ii whether in~ Natqre of work (check which applicable): New 'Building .................. Addition .................. Alteration ....... ........... Repa~ir ................... Removal .................. Demolition .................. / Other Work (Describe) Estir4ated Cost ......~. .............................................................................................................................................. ~ (to be paid on filing this application) Ilc dwelling, number of dwelling units ........ ./. .................. Number of dwelling units on each floor ............................ If gdrage, number of cars ............................................................................................................................................. If b~siness, commercial or mixed occupancy, specify nature and extent of each type of use ............................ Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Haig;hr ........................ Number of Stories .................................................................................................... r ............ Dimensions of same structure with alterations or additions: Front ....................................Rear ............... ............. Dep!h ................................ Height ............................ Number of Stories ................................ D m ns ons- of entire new canst .ct on: F o.t .......... .................. Rear ........ ............. Depth .....E.Y.... .......... Height ........ f. ......... Number of Stories ...................................................................................................................... Size of lot: Front ....... ./.(..~.. .............. Rear ....... ./..~..~.. .................... Depth Dat~J of Purchase ~.C~//7~.~.../.~/..~.¢/~/,,~ ,~__ __Name of Former Owner ..~.~ ......................... : ..................... / Zon~ or use district in which premises are situated ../~.....~..(.~;/...~.,(..~...~../..~....z: ................................................................. Doe~ proposed construction violate any zoning law, ordinance or reg, ulahon? ..~ ..................................................... Na Je of Owner of remises ~f~£~/' ~' ~'/~Z~'x~', ?..~.v> Address /22 ~z'~. ~'~,~r?/f/f/Phone No ~ ,/' ?..~.~.~. NonCe of Architect ...................................................... Address ............................................ Phone No ....... ; ............. PLOT DIAGRAM ~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from ~es. Give street and block number or description according to deed, and show street names and indicate erior or corner lot. STATE OFI NEW YORK, '~ c ¢ COUNTY,DF ................................ ,f ................ .~L.~.L/~..~.~.~,./~...:.../.x:f:~..~,~. ....................................... being duly swam, deposes and says that he is the bpplican, ;(Name of individual signing application) ' .............................................................................................. : above na~ed. He is the ......................................... (Contractor, agent, corporate officer, etc.) of said o~ner or owners, and is duly authorized to perform or have performed the said work and to make~ and file this oppliqation; that all statements contained in this application are true to the best of his knowledge and belief; and that the w~prk will be performed in the manner set forth in the application filed therewith. Sworn to b,-'efore me this .......... .Z'..Z~'.. ....... day of ........ ~ .................. , 19....~..¢ '~,~ EL~_~/'~ /,~¢/~.~ ' '--- , ? ~ z'~ ,,,,~ ............... ~..~.~.~...'.:..~....(-::..../....~' ......................... L .............. Notaw Pu )lic, .~.~..~.',¢¢~m~.....~.,....~...~./,~...~.. County (Signature of applicant) ~o. 52-3237,120 Suffolk ~erra Expiles March 30, FOP~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ..~.-~......,(....~?.~' ........ , 19.6. .... Approved ........................ I..~. ............ , ]9.~.~.... ~ermit No ............. ~ ............... Disapproved a/c .~~:.~...~2...~...~...~...F.....5..~ ..... ................................................. .............................. (Building Inspector) Application No ............................. INSTRUCTIONS a. This applicalion 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 ~,hich 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 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, building code and regulations. .......... ......................... (Signature of applicant, or name, if a corporation) ....................... ....... State whether applicant is owner, lessee, agent, a~chitect, en.qi'neer, general contractor, electrician, plumber or builder. . ..................................................................................................................... Name ofownerofpremises %,~F,'ZK :.~, d 4'xW~ ~ ~-~_ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ?*~z~ /~3~ " " z'~z~'~"~'Z'/~'~'z;"z"~"7£~FL4'' 'No' .~.5 ~ ~ ~'~ ]. Location of land on which proposed work will be done..~wap ~No.: ........................................ t_or ...................... 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 and occupancy .......... ./.~.~ ............................................. 4. 6. 10. 12. 13. Locat, property Ii whether in1 Natqre of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repc~ir ................... Removal .................. Demolition .................. Other Work (Describe) ............................ ............ Estin~ated~ Cost .....~.~..~. ~..o. ............ ....... Fee ..... .~..(..~. .............................................................................. J (to be paid on filing this application) ff d~elling, number of dwelling units .......... ~ ................ Number of dwelling units on each floor ............... ~ ............ If gqrage, number of ~rs .................................................................................... ......................................................... If bk~siness, commercial or mixed occupancy, specify nature and extent of each type of use ............................ Dimbnsions of existing structures, if any: Front ............................ Rear ................................ Depth .................... HeiCht'l' ........................ Number of Stories .................................................................................................... ~ ............ Dimensions of same structure with alterations or additions: Front ....................................Rear ............... ; ............ k Depth ................................ Height ............................ Number of Stories ................................ Dimbnsions of entire new construction: Front ...~.~.'. .......................... Rear ...~g.; .................. Depth ..~..~..; ............. Hei~ qt ....~.~./. ....... Number of Stories ~ ................................................................................. ~... Size ~f lot: Front ............................ Rear ...(.~. .......................... Depth Dar, of Purchase ..~2:¢?Z(Z..?~.,..?.~ .....................Name of Former Owner ........... :....~ .......... ~..~(~ ...... Zon or use district in which premises are sffuated ...Z~.~4~.(~.~..~ ......................................................... ' ............. Doe: proposed construction violate any zoning law, ordinance or regulation? ...~q .................................................... Na~e of Owner of premises .............. : ......................... ~aaress ................. . ........... y ........................ Na~e of Architect ....... ~ ............................................ Address ............................................ Phone No. Nar le of Contractor .~ ............................. ~ .......................... ~o ~o~ Phone No. y~/, PLOT DIAG~M , clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from ~es. Give street and block number or description according to deed, and show street names and;indicate erior or corner Io~. L ~£ TO~ STATE OFI NEW ,YAORK, } S.S. ................. .~.~.~.~.~....~.,..Z.~.~;~. ..................................... being duly sworn, deposes and soys that he is the applicant (Name of individual signing application) (Contractor, agent, corporate officer, etc.) .' of said owM or owners and is duly authorized to perform or hove performed the said work and to make ~ond file this application; that all statements contained in this application ore true to the best of his knowledge and be:lief; and that the w~rk will be performed in the manner set forth in the application filed therewith. Sworn to b~fore me this