HomeMy WebLinkAbout3787-zNO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No...Z..,,~25.0 ........... Date ......... A~l~.~...~l.g.. ....................... , 19...6.,.~..
THIS CERTIFIES that the building located at ~/~...¢ozaer...~&~x£n~..Pla~e..A .......... Street
Snuq Harbor Road
Map No ...... 3511 ........Block No ....................... tot No....~4~ ................. ~ ~a~t Ma~.~on~_.N.Y.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
........................ ~a.£~.~...~ ....................... , t9....6.~ pursuant to which Building Permit No.~.?..8...?...~....
dated .............. ~a~.¢~...~, ..................... , 19..~.8.., 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 ........
....... ~r £~a.te...one ..~a~ 1~ .. &~ el 1.in~. .......................................................................................
The certlficote is issued to ........... .Ch~,:~.le~..~.l~, ............................................................................
(owner, lessee or tenant)
of the aforesa,id building.
Health Dept. Approval, July 17, 1968, Robert V~11a
.............. ~ ..... ..........~.,... .................... ;..L~ .............
Building Inspector [
FOKM NO, ~'
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 3787 Z
Dote ............. ~ ......... ..~ .................. , 19...J~.
Permission is hereby granted to:
Lmm.. ~ ..~ ..lz~e..A,,~.. gh~3,~...e~tt
..... ~'i~...lt~ ................................................
.......... I~l. Zp .. T.e r.~.ace.....~.,,1~.,. .......................
to .J~,.. Z~l~ .. ~e...~il,~lr.. 4~1~1 ~ ~J~ ...................................................................................
at premises located at J,J~.....J~.~ ....... ~,~4J~J~j..~.t.....jj&p...3J~J ....................................................
.......................... I~ta~e .. P~e~. & · ¢~ber ..lle~ ......... -~.~ ..............................
pursuan¢ to application dated ........................ J~L ...... .~ .............. , 19...1~, and approved by the
Building Inspector.
Fee $.lJO.00 ...........
SbE~FOLK CODI~I~ DEPAP~tENT OF HEALTH
Bldg. Permit No. 3787-Z
TO WHOM IT NAY CONCE~:
The sewage dispesal facilities for a structure located at
North oast corner Snug Harbo~ Boad and Marine Place,
...... ~ee~ocation) ....
East Marion, New York
have been inspected by this Department and found to be satisfactory.
Owner-Charles Guhl
Builder- Law Brothers Homes, Inc.
District Enginee~
DistriCt Engineer
H dG° 87'/o" ~r5
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291968.
TOWN OF SOUTHOLD
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ,.,,~~ ............. , 1~~ ........
Approw~ ........................................ , ~ .......~rm~ No .............................
, Applicx~tion No, -:~ ~ ~ 7
Disapproved a/c~ ....................................................... .-~.-.-..- .-.-....
/- ' (Building Inspectd~)
APPLICATION FOR BUILDING PERMIT
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 thi~ 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 Pen'nit 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 o Certificate of Occupancy
shall have been granted by the Building Inspector.
The applicant agrees to comply with all applicable laws,
ordinances, buildin~code, housing'code, and regulations.
............. ................
(Si~notu're of applicant, or name, ~_o corporation)
............................... i',~d d res" '~'"'~ '~ '~'l~ii'~i' 'p ........................
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
........ ....................................................................................................................
Name of owner of premises .......................................................................................................
If oppiicont~j~ a corporate signature of duly authorized officer.
........ ........... .........
(Name ~nd title o{ corporate officer)
I. Location of land on which proposed work will be done. Map No.: ..... :~...~,~,ff, .................. Lot No,: ,,.~:~ ...............
Street ~nd Numbe~ .....................~ ................ ~ ............................ ~ ........... ~.:..~ ................................ ,~ ........ ~ ......
/ / Munici~lity /~~/~,,~/'
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ......... ~ ................................................................................................. ' .......
b. Intonded use ~nd occuponcy ........ ~ ...... ~ ...............................................................
3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ..................
Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................
4. Estimated Cost ............................................................ Fee ..........................................................................................
(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 ............................
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 .....~.~.~ ................. Rear Depth ..m.~ ..............
Height ....~ ........ Number of Stories ........ ~:: ...................................................................................................
9. Size of lot: Front ......... ~ .......... Rear .~ ............... Depth ................................
~0. Date of Purchase ........................................................ Name of Former Owner ........................................................
] ]. Zone or use distrJc¢ Jn which premises are situated
12. Does proposed construction violate any zoning [aw, ordinaece or regulation? ....~ ...............................................
~. ~me of Ow~ of p~s~ :d~'~-- ~ . A d~e~-- ~::~ ~ho~e
Name of Architect ..................................... ~ ............... Address ~Z;:~.>~7,.~;~::... Phone No .....................
Name of Contractor ~~3 ~..7~..Address ~/; >'
......... ~ ....................... Phone
PLOT DIAG~M
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 NEW~.DgI~...~,,~.~.~t
COUNT~ .~ ... · ~ .~ .?...7..v......,~ ....
......... ~~..'.~ .................. being du~y sworn, deposes and says that he ~s the app,oent
(Name of individual signing application)
above named. He is the ........ ~:.~.~::~,,-,~_.2~..~..~ ..............................................................................
(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.ake and file
this application; that all statements cant.dined 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 file, d,'fherewith.
Sworn to before me this
................... of .......
.............................. . .~.~_ ~>..d.:g..d~,~.%~-,~. ............................
Nota;~--~bl~', .t~.....~..,...L/'..'.~.~... County ' (Signature of_applicant,
,~er~ I'xl)i,f'~
FORM NO. !
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined .......~....~.~.....f./.i ............. , 19..~...C
Approved ........................................ , 19 ........ Permit No .............................
Application No. ~ ~ ~' ?
Disapproved a/c ....~.~':...~. ........... ~ ............ ~ .......... .~
.........
............. ......... ................................
/ (Building Inspectc~)
APPLICATION FOR BUiLDiNG PERMIT
.,.,..?// ///
rote ......... ................... , i9
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, buildinfl., code, housir~/code, and regulations.
............. .................
(Signature of applicant, or name, ,'~ a corporation)
(Address Zf"~l~plicant)-
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ...............~ .......................... , ........................................................................................................
If applicant ~ 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.: ..... :~,:~'.~t~ .................. Lot No.: ....~ ........
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
o. ExisHn~ uso ~nd occupancy ......... ~ ........................................................................................................................
b. Intended use and occupancy .... z ....... · ~: ".4.:.~ - ..
3. Nature of work (check which applicable): New Building ..... ~ ........Addition .................. Altero¢ion ..................
Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................
4. Estimated Cost ............................................................ Fee ..........................................................................................
(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 ............................
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 ......~...,:...~..z.. .................. Rear
............................ uepth ........................
Height ....~..~ .~.. ........ Number of Stories ........ ./..:~u..~.~. ..................................... ~,~.~ ......................................................
............................ /~'~ e~t~_ /
9. Size of lot: Front /'%"~'~--~'-' Rear .................................... D u n ................................
10. Date of Purchase ........................................................ Name of Former Owner ........................................................
1 I. Zone or use district in which premises are situated ................................................... ;, ................................................
12. Does proposed construction violaS,_ ~'/-a, nxY zo,~g law, ordinance orz/,~/j ,' ~ ', r~,~r:~-~l,~Ji°?'~'''~'~:'~'' .................................../,,,/~ ~,c~./-~"~'
13. Name of Owner of premises .~.:7"?..~..~.'.;'::;~.~.f~?:.:... ...... Address .:::.:...'~:'.:~..~..":'...;:..::. ........... Phone No.q.:.:_..:...-¥..Z -
Name of Architect .................:;:,) ............. ./Z ....... LLZ....Address ~'~,,~,~,,.4-,~....~-~,.<... Phone
Name of Contractor ..~..~../.~...4'....'J~....~.1~..~..~..~..Address ~/.~..~.. ,~'~e~¢4t: N°'~'"~'L"~
........................................... Phone No .....................
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 NEW TORK.~.-~,~. ~ ~,'~.'1, S S
COUNTY OF/,......~,,..~:::~<.~.iZ",.'.~.t.]~.,f ' '
................................................................................................ Demg duly sworn, deposes and says that he is the applicant
(Name of individual signi~ ap~ication)
abow~ 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 ~o make and file
this application; that all statements contained in this application are true to ~e best of his knowledge and belief; and
that the work will be performed in the manner set forth in the application~t~erewith.
Sworn to before me this , ~ ~//' ~
J( day of '"~A (,..,~ c~.~ , 19 (~ ~' ~/'~ ~
................ · .......................... ..................... .
No ry ............................. ;' ............................
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