HomeMy WebLinkAbout3062-zFOI~M NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Ot: Occupancy
No. zl+3h4 ...... Date ........... &ligust.. ~ .... , 19.71.
THIS CERTIFIES that the building located at .~/8..Ner%h .Yea .Dr ........Street
Map No.. acxx .......Block No.. ~ ..... Lot No...x,~C ....SoUthold...I~oYo ......
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ...........Ape':L3.. - -22, 19.66 pursuant to which Building Permit No.. 3062Z.
dated ...........apr:L]., ~5", 19 66., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is . J~riYate. one. family, dwellir~ ......................................
The certificate is issued to . F~ed. ituhiman .~,. ;,.'A. fe ..... 0wner. s ....................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval
Underwriters ~ N896551
House ~ 2250
July.. 4.,. 19~1.. by..R,..V, illa ....
: .,.c.... .............
Building Inspeq~or
FORM NO. 2
TOWN OF SOUTHOLD
~UiLDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORE AUTHORIZED)
N? 3062 z
Permission is hereby granted to:
................ gr.¢~ ~z~.q~. :f. ..........................................
ct premises located at ..... ,~./..~......]'].e.]~.},t...~.~a....~.~..~.Y..e.. ................................. ~.: ...................................
........................................... ~..o.~.~g:.¢]..,.......~?.:.~.: ............................................................ .............. i .........
pursuant to application dated .............................. .~.P?...~......~.~. .......... 19.~ , and approved by the
Building Inspector
.0.0
Fee $. ~,.0., ...............
FOI~M 1~0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
'~'OWN CLERK'S OFFICE
SOUTHOLD, N. Y.
TEMPORARY
I]I~RTIF'IOATE OF' O00UP~NOY
No..~..3.:~.4.0. .... Date .. Dec.embmr .... 16, .......... ,1968..
THIS CERTIFIES that the building located at ~Or.th. ~.ea. Dl:;t,v.e ........... Street
Map No ............. Block No ............. Lot' No..~.O. II.t:;l~o,~d,..i~W..¥.o.17~ ...........
conforms substantially to the Applicati,on for Building Permit heretof.~re filed in this office
dated .... .A.p.~.i..1...2..2., ......... 19~.. pursuant to which Building Permit No. 3062.
dated .... .~l~..r.i.~....2.5. ~ ......... 19.6..6, 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 . .]p.r.i..v.a.t..e..O..n.c...~.a.m..i.ly...d.~.e..1.1. i. i~l.g .........................................
The certificate is issued t.o ...P.~.e. ql. gt~h,l,ma, r~ .........................................
(owner, lessee or tenant)
of the afore.said building. -~
.Suffolk County Department of Health/xipp~oval De.october..13~..1~68,..James..FI..
Building Inspector
S-9
SCHD
SUFFOLK COUNTY
DEPARTMENT OF HEALTH
,ate ~d /?ri
Bldg. Permit No.
TO WHOM IT MAY CONCERN:
The sewage disposal
facilities for a structure located
have been inspected by this department and found to be satisfactory.
Chief of ~eneral Engineerfng Services
c ~ _ c TOWN OF SOUTHOLD
.... BUILDING.DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
........... ^pp" ,on ......
^pproved ...r ...................... :~ ........... , 19.: ...... Permit No......~......~.....~.....~.........~-'
~Disa rove~ ' '' ~ ~'~'~- ~-"/ ~/0~9' ~-,
pp o o,c .... ~ ............ ~ ...... .~ ....... ._._.~..~ ..~,,.,~
-' APPLICATION FOR BUILDING PERMIT ~o/~ ~
~,~' ~ 4/22/ ~
~te ............... ~_y_/..= ....... ~ ......... ,.,..., ~.~. .........
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 port 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 Builc[ing 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, c/f/for removal or demolition, as herein described
The applicant agrees to comply with all applicable laws, ordinance~eguJations.
'-~-'-- ' -~ , ~' / (Signature of~/applicant, or nome, if o corporation)
\ ................. ...............................
State whether ~nt~ner, lessee, agent, architect, engin~r, general contractor, electrician, plumber or builder.
..................................... ...... :.:......:.: ........................ ...................................................................................
~om~ of owner o{ pr~mi~es .~.~.~.g~d.~.~.~..~ ................................................................................
1{ ~plicont i* a co,orate, ~i~n~tura o{ duly outhori~ed
(Name and title of corporate officer)
Location of land on which proposed:walk will be dpne. Map NcX: .-- Lof No.: .2..'. ..................
Street and Number ........... .'..7 ........ ~O/~Jl..~..J~)'JCJ,'~.O.,..~.g~W~,~ ~ ................
Municipality
State existing use and occupancy of premises and intended' Use ~n~] occupancy of proposed construction:
a. Existing use and occuDancv-ga, cnn~ ln~d
b. Intended use and occupancy residence ..........
3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ..................
Repair .................. Removal .................. Demolition ......... :.,~,,~ Other Work (Describe) .F~,.o..Y~F~..d..'~..e..1..l~.n.g.~;..o..
~..~ site
4. Estimated Cost .. ~ ...... ...'~... ............................ Fee .~..1.~..0...0. ............................................................................
(to be paid on filing this application)
5. If dwelling, 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 ............................
' ~'~'~'~:~.pe c1)
7. Dimensions of existing structures, if any: Front ............... ~J5 ......... Rear ......... ~.'. ................. Depth2.?.'.
Height ............ .~.~....,, Number of Stories ne
Dimensions of same structure With alterations or addJtions: Front ..................................,. Rear ............................
Depth ................................ Height ............................ Number of Stories ................................
8. Dimensions of entire new construction: Front .................................... Rear ..... ....... ................ Depth ........................
Height .................... Number of Stories ......................................................................................................................
9. S~ze of lot: Front ............. ,1,.0.Q!. ...... Rear ...... ~a.~i^J~! ................. Depth ...~.8.EL~....~ ...............
10. Date of Purchase ...................... .4;.~;~.~/..1~.~ ................ "Name of Former Owner ]~:..~.~..~.c!....a..~..d....~_~.....:~'~..p....~. ........
11. Zone or use district in which premises are situated ..................~..~.~,~.~;,~), .............................................................
12. Does proposed construction violate any zoning law, ordinance or regulotion?~..°. .........................................................
13. Name of Owner of premises ........................................ Address ............................................ Phone No .....................
Name of Architect ...................................................... Address ........................................... ~ Phone No .....................
Name of Contractor .................................................... Address ............................................ Phone No .....................
PLOT DIAGRAM
Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all ~et-back dimensio.ns from
property lines. Give street and block number or description according to deed, and show street names and ,ndicate
whether interior or comer lot.
184.10'
L88.72'
35'
-3 5 ' -
27' 24'
12' 23'
~ ~\.~,
35'
STATE OF NEW YORK~ 1 ¢ c I
COUNTY Oi:_.,S.U'~.F.O.J.~ .......... I~'~'~-
North Sea Drive
............................. .S..a...m...u..e...1..~:....G..~.c..k...m...a..n.. ............. . .......... :~.~ei_ng du~!y s?orn, deposes and soys that he is the oppl~com
(Nome of individual signing opplloetion) ~
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 sold work and to make and file
this application; that oll statements contained in this application ore true to the best of his knowledge and belief; and
that the work will be performed in the manner set forth in the oppfication 'filed therewith.
Swam to before me this ~
........... ..... ...................... ...... , .... .
-- -. .... .............................
~ota~
Public,
N~ 52.2093890