HomeMy WebLinkAbout3783-zFOI~M ~0. ~
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES that the building located ot ~/..~......~.<~....~.,~.~..~.~......~.,~. ................... Street
...................... :X~ ~outho~ld ~, ,,
Map No. ~ Block No....,~ ............. Lot No ..................................... ~. ................................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
........................... ~.e~ .......... 26. ................ , 1~. .... pursuant to which Building Permit N¢~.~.~...~. .....
dated .............. ~.e~ ......... ~,8. ................. , 19~...., was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is ........
Private one famil~ ~ellin~
.............. .~.~ ......................................................
(owner, lessee or tenont)
The certificate is issued to
of the aforesoid building.
H.D,Ap.Droval April 2~,
TOWN OF SOUTHOLD
BUILDING DEPARTMEN?
'TOWN CLERK'S OFFIGE
~ SOUTHOLD, N. Y.
BUILDING PER~!T
(THIS PERMIT MUsT BE KEPT ON THE PREMISES UNTIL FULL
coMPuzI'ION OF THE 'WORK, AUTHORIZED)
pursuan¢ to application dated Yeb ' .~' : 1 .~...~i.., and approved by the
Building Inspector.
CONRARDY
SOHD
SUFFOLK COUNTY DEPARTMENT OF HEALTH
Date___ April 2~_~68
Building Permit No,__
TO WHOM IT MAY CONCEPd~:
The sewage disposal facilities for a structure located at
S, LS Jockey Creek Dr. 1,273.39' E/O Main Road
Sou~hol_~ ,Ne~ York
have been inspected by this Department and found to be satisfactory.
B,~ilder-Clarendon Construction Corp"; .......... ~)i~trict Engineer
i
t
77,z /e AYe. ~,° -.5' 7._.a.¢-~
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ...... !.%~'4..~. · '~.~. ;. ............... 19.(?...~. ·~·
Approved ............. ~..! ..................... , 19.. :....Perm't ~;~"~7 ~ ~
No. ..........
Disapproved a/c .............................................................. ~ ..............
(BbilcJlng I nspec~-~
Application No. ~- / ~" ~'z
APPLICATION FOR BUILDING PERMIT
Date .............................. , .....
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 Buildi0g 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)
~ W, ~ee~nset Hw¥, Port Jeffereon
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.............
remises ~. Joee~h Co~z~¥t 125 F~ra~t
Name of owner of p ..............................................................................................................................................
If qpph~t? o cor~r~s,gnature of duly author,zed officer.
.......................
c~" ' (~ame and title of c~fficer)
1 Location of land on which'proposed work wdl be done Map No: .: .......................................... Lot No: ....................
Street and k~. ~her~Z~ ~OO~eE ~ee~ ~.[~,~ ~/0
Municipality
2. State existing use and occupancy of premises and intended use and ~cupancy of proposed construction:
~. ~x~sting ~se ond occ~po~cy ...................................................................................................................................
b. ~nten~e~ ~se ~n~ occupancy .................................................................................................................................
3. Nature of work (check which applicable): New Building ....X. ........... Addition .................. Alteration ..................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ......................................
0,000,00
4, Estimated Cost ............................................................ Fee ..........................................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ..... ..O..~...e. ............... Number of dwelling units on each floor ............................
If garage, number of cars ...... .~WD ..............................................................................................................................
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 ...............................................................................................................
Dimensions of some structure with alterations or aad'tions Front ................................ Rear ................................
Depth .............................. Height .............................. Number of Stories ........................................
8, Dimensions of entire new construction: F'ront ...... ~. .................... Rear ........ 7~.? .............. Depth .....3..~..I. ................
Height ]'6t Number of Stories one
9. Size of lot: Front .......... ~.~.0..I. ......... Rear.........Z~.0'................,. Depth ......... ~..0.~ ..............
z9.6 N
10. Date of Purchase ........ ~.O...,~....~.?..~.i:. ......................... ame of Former Owner ........................................................
11. Zone or use district in which premises are situated .................................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation? ....~Q .............................................
13. Name of Owner of premises ~.:...~.°..~.e..P..~.....C.P..P.[.~..~'..C~rddress ..}L,...J~ll,~r,l~ .................. Phone No. ~..~9~.~.~...~..
Name of Architect ...................................................... Address ............................................ Phone No .....................
Clarendon Home~ Inc. ~- Por~ ~ef£er~on ~a.~- No ~73-3130
Name of Contractor ...................................................... aaress ............................................ ~none .....................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-bock 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 .
COUNTY OF ......... £..~_'4.~.~ ........... ~ S.S.
Joh~ ~T, ~1,~ .................. being duly sworn, deposes and says that he is the applicant
(Name of individual signing application)
tot
~ove ~med, He ~s f~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 t~monner set forth in the application filed ~rewith.
Notar Pu bi i~. Xt ~) -"~~~5~~6~'*'?;~, ........ ;: ............................
. ] . .~' 52-38252~
..... ~lS~, E~,ir., .arc, 30,
Examined .................... ~. .................. , 19 ........
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Application No.....~...?....~.~-..~.. ..........
Approved ~ ~ ~ .~,. 2 .~ .,~..~,, .:'~ ..
........................................ , 19 ........ Permit No .............
Disapproved o~~~Z ...................................
APPLICATION FOR BUILDING PERMIT
Date .............................. , .....
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 o detailed description of layout of propertymust 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 o 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 pa rt 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)
4 W. Nesconset Hwy. Port Jefferson Sta.
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
bu~14 .e_r. ................
,,revises S...Joseph Conrardy, 125 Farragut Rd.t N. Babylol~t N.Y.
Name of owner of ~
If apglicant is a col~drate, signature of duly authorized officer.
.........................
~-~ ~ r?~me and titl~corporate officer)
1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: ....................
Street and ................
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 o~e
3. Nature of work (check which applicable): New Building X Addition A~teration
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ......................................
$20,000. O0
4. Estimated Cost ............................................................ Fee ..........................................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ..... .O..~..e. ............... Number of dwelling units on each floor ............................
If garage, number of cars ...... .~.W~ ..............................................................................................................................
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 ...............................................................................................................
Dimensions of same structure with alterations or additions: Front ................................ Rear ................................
Depth .............................. Height .............................. Number of Stories ........................................
8. Dimensions of entire new construction: Front ...~.3..e. .................. Rear ........ ~..." .............. Depth .....~.~.1 .................
Height 16' Number of Stories one
9. Size of lot: Front .......... .]:..~.0..e. ......... Rear ......... 150'................... Depth ......... ~...~,.0..t. ..............
10. Date of Purchase ........ ,D.e.?...e~....~..?~...~..,~.,~. .............. Name of Former Owner ........................................................
11. Zone or use district in which premises are situated .................................................................................................
12. Does proposed construction violate any zoning Iow, ordinance or regulation? ....~.9. .............................................
13. Nome of Owner of premises .~........J..o..~.e..P..~.....g.O...~..r...~..~...C~ddress ..~.,...~J~...~2/'],9~ .................. Phone No. ~..~..'..~.~.~...
Name of Architect ...................................................... Address ............................................ Phone No .....................
Olaren~on Homes Inc .... Por~ Jefferson S~a.-- No ~73.-..3130
Name of Contractor .................................................... ~aoress ............................................ k'hone ....................
PLOT DIAGRAM
Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all 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 Jot.
E
STATE OF N W S.S.
cOUN~ OF ................
~O~. ~. ~0~ ................................ bei~ duly sworn, deposes and'says 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 hove performed the said work and to make and file
this oppiicat on; that all statements contained in thi~application ore true to the best of his knowledge and belief;
on that the work w' e performed i ,~r ~t forth in the application filed therewith.
Sworn to befor
..................... ........ ........ ............ ........................
(S ~.ture of app ca~-
Notary P u b I i ~~~
,~. L,/OSEPH A~,a ~L EAA~
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