The URL can be used to link to this page

Home My WebLink About3889-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z1~189 ..... Date .......... Apr:L1 ..... 19 .... , 19, ?~1. THIS CERTIFIES that the building located at .. W~B. 01d. Ha~ber. ll~ad... Street Map No...XX ........ Block No... XX ..... Lot No .... X~X ..... ltew .S~f~elk conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... 14ay ...... 17 ' 19.68 pursuant to which Building Permit No ..... dated .......... 14~]r .....l?.., 19 68., was issued, and conforms to all of the requir~ ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .P~lv~;e. ~e. £uil~'--dv~-l-illg ...................................... The certificate is issued to ...Vi~eent. J...¢~mni~gi~a~-&-W~e ......... .0~...er.~ .... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval House FOEM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES COMPLETION OF THE WORK AUTHORIZED) UNTIL FULL N9 3889 Z Permission is hereby granted to: pursua:n~ to application dated ....................... ~. ...... .].'~. ...... ;. , 19,...~.~, and approved by the Building Inspector. It b d~fflstlt for at to wldoFgtmlld ul~ · oeFtLflgate o~ tnfpeetieu apl~ml It b d4¢fle~% for Re to FefFa:LU from em~o~m~tn~ a~lelf ~n adJoo~LTof ~mtead ef faet~. Z~w em;per4.eneed Lo.~,,Ij f~mtz,lktinl de'h,~,e ~a eb~ a oeadd~i~ or app.*owl for a s~JupLo 100 Amp o~ae entl~noe, Tbs rollouLllf 18 · L~eeeed ~lr.~,~ - ~i~r, mm tmmm b~uld,'mm .t,9~.p~ 'fn.r,~) ~f I oould mb &p~omttm weuld notbe ~n ak~La f~ tuo ~b. 218 tho next fog da3ql ueu% to T~4~oo ~verhoed o~f~oe fe~ mpme~.fimmtlmmm for ~ttaLla~mb InstaLled o~mo that wOeko Li.Too f~o~d aim aiT~wd to ehook &nd found ~mtm~latiou OK but ! ant obta~ ~'.~. oeFtif~to before · L-y~oo e8~ bo mdo. ~em~en) - No lmpeete~ a~.woarod &m p~o~MOd. I eaIld ~o EabieM:Lj ted to mere the follou~nf nonLinf. &X. ~ ~' ~'ire U~4ea~a. ite~l Pa~e 2 a ba~ em ~ mt~x~l.~2t3m~ OX, bmee eo lda~% p*A,~eemm the eee'tAA'Xeate, J,,.~gemt, ed TOWN OF SOUTHOLD~3~c~ ' ~ ~ ~-' ,, 42.'/~co BUILDING DEPARTMENT ~,/ . ~ ~ c- TOWN CLERK'S OFFICE ~/~ ~'*'~ ~ ~' ~"~ S~TH~D, N.Y. _, / .~.~, ~ ~//~ ~ ........ ......... ^pproved-- --" 19...~.' Permit No. 3~. ~--'/~'/'! ~"~_ _d~ Di~pproveda/c ........ ~ ............ ~ ...... ,.~ ........ ;.... ~ ~ ~. ~.~ ~ ~ ~ ~ ~ , ~ (Bui~ing Ins~ct~) ~ . ~ PPL C TiON FOR BUILDING PER~IT /~- ~ . 19~:~.. ........... ................................ ~ ~ I N~TRUCTIONS a. This application must be completely filled in by ~ewriter or in ink and submitted in ~plJcate to the Building Inspector. b. PI~ plan showing location of lot and of buildings on premises, relationship to adjoining premiees or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is ~ of this application. c. The work covered by this application may not be commenced before issuance of Building Pe~it. 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 pr~ress of the work. e. No building shall be occupied or used in whole or in pa~ for any pu~ose whatever until a Ce~ificate of ~cupancy 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, housin~...~..cl~e, and regu_lotions. ............. ~ (Signature o oppli~% or nomo,~zi~ro~corporotion) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~.~ Nome 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.: ........................ /~ ! ---' ~; __~ ~ ~ Municipality"-~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy ........ ~ ................................................................................. 3. Nature of work (check which applicable): New Building................~" Addition ......... ........... Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ......... .X¢...~..,¢.~ ............................... Fee ...l ...................................................................................... (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 ............. ...'~....7....~... ..................................................... ~.: .......................................................... 6. If business, commercial or mixed occupancy, specifl/ nature and extent of each type of use ...... :......~...~ ........... 7. Dimensions of existing structures, if any: Front ...... ...~....O.. ............... Rear ......?~. f~...~ ............... Depth .~...~. .......... Height ......./. ................ Number of Stories ......... /. ............................................ ;/ ............................................. ! .......... Dimensions of same structure with alterations or additions: Front ...... ,.~..'-~. ........ , ............ Rear ...~...~.. ............... Depth ......... ...c~....~...I. ........... Height ......./..~..../. .......... Number of Stories ....... ?......~.~. .............. / 8. Dimensions o~.,,~, -~entire new construction: Front ....~__~..'."' ..................... Rear ....'-~...~'....'; ............. Depth ......~.. ~......~ ..... Height ..~..~.~Number of Stories ........... ./.__..2:.. ........................................................... =: ................................... 9. Size of lot: Fro~n~t"~ ~"_.'~..~'...~.,¢.Z./.~.... Rear ../.~....~...:...'~......~, ........ DePth ...... /.....-~..~..~.~) 10. Date of Purchase ...~.. '~.?...~../..~..~. ............................ Name_,~f Former Owner .~.- // f/'J ~ ~-~ w~ 11. Zone or use district in which premises are situated ......... V.. ................................................................ !2. Does proposed construction violate any zon~g law, ordinance or regulation? ...'7,<¢~....:....~ .................................... Name of Owner af premises 4/. s No. Name of Architect ..............~_____..~.__~,ddress ........................ !.~. ................. Phone No ..................... Name of Contractor ........... ~..~. .............. Address ........................ ./.( ................. Phone No ..................... PLOT DIAGRAM Locote clearly and distinctly all buildings, whether existing or proposed, and indicate all set-b~ck dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE-'~NY~ l/I, }'SS COUNTY OF.~ ....... , ' ' ....................... J.,.....~..~..~.~.........~~,--being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the .....................4:~,~.e~...r......~..-~e~e.'..~..."..~,.. ........................................................................... (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 application; that all 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 fohh in the application filed therewith. Sworn to before me this .................. ~. day of ............ ~.%:, ............. , 19.~~ ~ ~ ~~ ~ ' ~~' I ............ Z....~.....~ ....... .......... N~ ~8100 Suf¢oJ~'Count ~omm~sslOO Expires March ~0, 19n~.~ ?O~VN OF SOUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N, Y. Examined ~. ~ 1 9.. : Approved ........................................ , 19...L:.. Permit No ..... ~...~.~i' .... . Disapproved a/c .............................................................................................. ....................... ~ ........ ~ ...... .~.-,~ ................. ':1 ................................ (Building Inspecto~) Application No....~-~.~Z.~L.t4 ......... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building [nspector. b. Plot plan showing location of lot and of buildings on premises, relatibnship 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 issucnce 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 througl,out the progr~s of the work. e. No building shall be occupied or used in whole or in part for any pu~rpose whatever until a Certificate of Occupancy shall have been granted by the Building inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the i~suonce of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New Yprk, and other applicable Laws, Ordinances or ...... ...... ......... (Address of applicant) iff State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ... ,.i~.~.~.~C~.~:.~ .~21 ~.~......c..~.~.~..~...~..~.~......~., !..~~.- .~......~..~...C~....~. ....................... If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which prgposed work will, be done. Map No.: ...... ................................. Lot No.: ........................ Street and Number .................................. ~.~: ....... ,.~......:.....-. ....... .~ .................. ...~..'.ff/~/. .................................... . Municip;~t~ 2.St~:te existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing useandoccupancy .......... 77~..~ .~.~ .~..7.....~..~'~''~' .................................................................. nte ed end occupancy ....... ......... .............................................................. 3. -~Noture of work (check which applicable); New Building ...... ~ ...... Addition .................. Al,.teration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ............ ~.,~...~ ........................... Fee ~0 (to be paid on filing this application) number of dwelling units ......... ../.. ............... Number of dwelling units on each floor ....~...~..~"~/ 5. If dwelling, If garage, number of cars ..... ..~..q..~.. ........................................................................................................................... 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 ....~=~Z2. ................... Depth ..~.4~2. ........... Height .......... Number of Stor es ......... ./. ................................... , ................................................................ Dimensions of same structure with alterations or additions: Front ...~...0. ............................ Rear ....~;,..'~....~2.. ............ Depth ...'.'~..~ ...................... Height ..,~.. ................. Number of Stories ...... ~....~;;~ ................ 8. Dimensions of entire new construction' Front ...~.~ ................. Rear ..~.~. ........ Depth ..,..~..~] ............ Height .......... ~.(.~urnber of Stories ......... .~,....,~-- ......................................... ~ ............ , ....................................... Size of IOt'p~rchaseFrOnt ... X..~']~..~..7...~. ,,~~;, ...Rear .//..~...~...' ~. ~ Depth ~.....~... ,~,.,,.~.~ Date of Zone or use district in which premises are situated .......... ~ ........................................................... Does proposed construction violat9 any zoning law, ordinance or,'erZZ ZZ ....... ........................................ Name of Owner of premises .~,.~.AOdress ~..~¢M~..:. Phone No. Z..~...?.~..~z~5'- Name of Architect ........... ~.............~ ..Address ......................... :¢ ............... Phone No ..................... Name of Contractor ........ ~ .................. Address ............................................ Phone No ..................... 10. 11. 13. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEVt~ZO~, /lC ~cc COUNTY OF ...~r:5~/¢.~.%:7~.......,)' .... .f . .Z. ..... ......................... ~,.~.,,.~..~,.~ ........ ~%~.~mg duly sworn, deposes and s~ys that he is the applicant (Name of individual signing application) 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 m~ke and file this application; that ~11 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 application filed therewith. Sworn to beforef~me this ~"' ' 19 ~ ~f~RED CHAPMAN ~ ~ ' " ~ARY ~BLIC, State ( .... M No. 5Z-0618~00 Suffolk Countyz