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HomeMy WebLinkAbout3479-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z~.~62 ...... Date ............ t~y .... ~ ...... , 19 ~t3 . THIS CERTIFIES that the building located at t]ol'®y 'Creek-Rd' '('P;fT') .... Street Map No. Kok® .... Block No. . .Lot No. '~' 'Sou~hold. · ~. ~ o conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... gay...~ 0 .... , 19.6~. pursuant to which Building Permit No.j~gZ... dated ............ 14~y .... $0., 196~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Pr&vata .one..l~amily .dwelling ........................................ The certificate is issued to .. l~u~e~. ~. H®.~en. ltoPart.land. · · OYn®~,e ............. of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant) · .. See.' np. C/C. 10/ 8/68 ....... UNDERWRITERS CERTIFICATE No .................................................. HOUSE NUMBER..~.0~ ........ Street... Co~oy C~It..t~oos~..(.t~V~-) .................... " Building Inspector ...... /' ' ' FOH~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3479 Z Permission is hereby granted to: ............. ~,..~...~..~~ ....... .................... ~~......a..:.~.~ ........................ to ~d n~ o~e fa~ly ~X1Z~ at premises located at ............................. ~.~.,.....~.-.~.,. ............................................................................................... pursuan,t to application doted ............................. ~ .........~.~. ........... , 19..~..?.., and approved by the Building Inspector. NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. TI~POI~RY CERTZFZC~TE OF OCCUPANCY CERTIFICATE OF OCCUPANCY No....Z...3.30~ .......... Dote ............ .l~.t.~}~,~,:l{...~,,~,, .................. , 19.6.~... this CERTIFIES that the building located at .... Ma:l.n. JBa}~,~t.:l,e~..RO&d ........................ Street Map No ....................... Block No ....................... Lot No.$.C~/ath~ld,...~ft1~...~.q~ ........................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................... ~¥.....1.0, ........................ , 19..~.~... pursuant to which Building Permit No......~..~..?.?....~ dated ............ M&y.....lO., ....................... , 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 ........ ...pr.l.~..~n~.. far~Ll.y...c~elltng. ........................................................................................... The certificate is issued to ..... F~u~l.e~..g~ar.tlan~l, ...................................................................... (owner, lessee or tenant) of the aforesaid building. Health Dept. Approval, Sep~tember 19, ~ $,968.f.?Robert Villa ........ ..... Buiiding Inspector $-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Bldg. Permit NO. TO WHOM IT MAY CONCERN: at The sewage disposal facilities for a structure locatedt /(*ive dsed ~.ocation) have been inspected by this department and found to be satisfactory. District F~]gineer District Engineer FOl~l~I NO. 1 'rOWN OF SOUTHOLD BUILDING DEP.~R. TMENT TOWN CLERK'S SOUTHOLD, N. Y. ~ .......,L..~.~.~>..~....~.EZ..., ~ ........ Approved .................... f...(.: ............. , 19..'.: .... Permit No.. D~sapproved a/c ............. ~ .......................... ~ .................... ~ ..................... ~ ...... ............................. C ...... ~.::~,~:~. ......... ~z ...... hz~:~ .......... ~ .... . ......................... ~'~'~J~'~'~"i~f~'~B' ........................... APPLICATION FOR BUILDING PERMIT Dote ........................... ~ .... //~ 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 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 Deportment 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~j~erein described. The applicant agrees to comply with all applicable laws, ording~ce~building code~gd regulations.// -~g fb~lic~ , , it o po atio .Y (Address of applicant) // ), ~--~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......................................................... ~fk..~-q .~ ..................................................................................................................... Nome of owner of premises ....: ............................................................................................................................................... If applicant is a corporote, signoture of duly authorized o~ficer. (Nome and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ..... ~-z ............................. Lot No.: ........................ Municipality 2, S~a~e existing use and occupancy o~ premises and intende~ use and occupancy o~ propose~ construction: a. Existing use and occupancy ................ ~X~.~.X~.~ ......................................................................................... b. Intended use and occupancy ....... .~:..: .... :~J.6:..K ......... ~:~.~L.:K..~ ......................................... property lines. Give street and block number whether i,nterior or corner lot. 3. Nature of work (check which applicable): New Building ..... ~ ........Addition .................. Alteration .................. Repair ~ ................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .............................................................. e .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........... ./. .............. Number of dwelling units on each floor ....... ../. .................. If garage, number df 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 a. lterations or additions: Front ............................... Rear ............................ Depth ................ ~ .......... Height ............................ Number of Stories ................................ B. Dimensions of entire new construction: Front ............ ;~.-~.( ............ Rear ........ .~.~.-. ........... Depth ...~-...~. ~ ........ Height .../......J.Z.. ..... Number of Stories ...................... v .............................................................................................. S ze of et' Front ;/z-/~.! Rear y y~, ~ Depth 10. Date of Purchase ........../.~v..~..~,~...i.~l~'~l~. .............. Name of Former Owner '"?~.._~....l~v ........ ~ ................ 1 1. Zone or use district ir6ffvhich p~emises are situated .............//:. ..................................................................................... Does proposed construction violate any zoni,ng law, ordinance or regulation~ ~:~ 12. . -7 , ' ................. '_' ............................ '_'""7 .... Name of Architect ..................... .~..~.~.z~.¢~/~......~...~L.~..~.P..~..~.''-'Z'' ............................ Address .................. ~ ~-J - ,~::~/~/~ ....................../,)~C Phone Nozz~,~:':.~ .......... ' ~';~ ~:~'5~"~'~' TC~'"' ]/:"~ .................. PLOT DIAGRAM Locate clearly and distinctly oll buildings, whether existing or proposed, end indicate all set-back dimensions from or description according to deed, and show street names and indicate STATE OF NEW YORK, [ S S COUNTY OF ...,,~'..~,..~y;,~,,./~.....,[ ' ' . ........ ~Z.~.,~...~?~V../~ ..... .fl.).C c~..'~.~:.~6t..Z/(t~ ................. be.ng duly sworn, deposes and says that he is the applicant u'~ame o~ inaJvidual signing appucanom above named. He is the ........................................ ~m:~'~-~-:'~¢4 ............................................................................................ (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 t ~hi~~Zff-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 forth in the application filed therewith. Sworn to before me this ~-~x ~ / ............ day of ..... ..................... ........ _L; --. . ~ r ....... :... ~.. .. .. .~ ........................................................ v. ...... Notary Public,~.~....~..:..~.~~.... C~ ^ REGE~T ~'~ture of ape'S;;)' .... (,/ NONT~ARY PUBLIC, State ol New York No. 52-3233120 Suffolk Term Expires March 30, 19 flOTE: ~ = MONUMENT SURVEY FOR EUGENE J. ~ HELEN A. McPARTI_AND SOU THOL D TOWN OF SOUTHOL D SUFFOLK COUNTY,, N.Y. SCALE: 1%40' JUNE f6,1966 gUARANTEED 1"0: HOME TITLE DIVISlON~CHICASO TITLE INSURANCE COMPANY. EUSENE aHELEN MCPARTLAND. LAND ~IRVEYOR §0.0' NOTE: m =MONUMENT 0 = PIPE SCALE: 1~% 40~ JUNE/6~ 1966 SURVEY FOR EUGENE J. ~ HELEN A. McPARTLAND $OUTHOLD TOV,/N OF SOUTHOLD SUFFOLK COUNTY~ N.Y. GUARANTEED TO: HOME TITLE DIVISION,, CHICAGO TITLE INSURANCE COMPANY. EUGENE E~ HEL EN MCPARTL.4ND. LAND SURVEYOR N.Y.S. LIC. NO. 28725 RIVERHEA D, N.Y. SOUTHOLD, N. Y. Approved 19 ........ Permit No..~...~....-~.. ............ Disapproved a/c ~~ .................................... ....... TOWN OF SOUTHOLD ' .'~,r~,,~:;~, ~ BUILDING DEPARTMENT 4 ,,o,.~.,~*7,~a"~"~'"~ TOWN CLERK'S OFFICE a,/~ ~ T/c .o ~ '/l~/b ~ z ,o. 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. Plo. t plan sho.win.g. I,oc.ation of lot and of bu_ildings On premises, relationship to adjoining premises or pub c streets or areas, aha giving a aetailea aescription of layout at 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 Building Perm t pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicab · Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for remova or demolition, ~ here n described. The applicant agrees to comply with all applicable laws, ordinanC~uilding code and r~3Ulations,/,/---.- ........... · . .... ... ...... ;.,,.....;... ........................................ :X~: ......... (S~gnature of apphcant, or name, if a corporation) (Address of applicant) ' ~'~ State whether applicant is owner, lessee, agent, architect, engi~neer, general contractor, electrician, plumber or builder. Name of owner of premises ~-~-/'~--~/~'~--~ >''- /~,~/._~-~/t/ ,~l, 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..Mop No.: ........................................ Lot No.: ~' /~treet and Number ..~....../~./.~.......~...../~....X'.~../~........~...g.../~...~...I ~'o r~ -/--/-,z c~, ;x 2. State existing use and occupancy of premises and intended use and occupancy o~ proposed construction: a. Existing use and occupancy ./d(.~. ~-- ~. ~ . b. Intended use and occupancy '>~/..~' /'~/~.?......zT./~Y 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ......... ..~. ...... Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ..... ....~......~....~...c~... ............................... 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 ................................ · ~--! 'Rear ....... ~..~ ........... Depth ....~.....~...~. ......... 8. Dimensions of entire new construction: Front ........... .,~. ..................... Height .L....5'....F'. ...... Number of Stories ..................... ./. ............................................................................................... 9. Size of lot: Front ....... /...~..~...! ......... Rear ....... .~.../...~.../ ................... Depth ...../....~..-~.../....'~..~....~;.. 10. Date of Purchase ....~.~./.~..~i;~...;(./... ~ -- ............ Nam~ o~ Former Ownet/...~....~..:....J~'..,~....../.~.../...~....~.....Y... 1 1. Zone or use district in wn~cn premises are situated ........ ~ ..... 1;2. Does proposed construction violate any zo~i~n~ law,'~;dinance 13. Name of Owner of premises~..~...J.:....~..'...~..'...~.....?.~.~..~..:X~ddress ./..~...~..._...~./~.'..;"~...~.Z~...E~.,... Phone No.~./.~.../...~...~...~ Name of Architect ...................................................... Address .................. ~ ..................... Phone No ................... Name of Contractor .~..,~..~....~../.~.......~...~..~....~..o..:..~. .......... Address ,,T( 0--/ - ~ /~,~-- Phone ~.~ · ~.~_.~.~.;.~.~....~,..9. . ................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all sat-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~ORK~, .. '~ ¢ ~ -~ ........ ~..~.~.....~.:..~.,....-..~z~.>.._~m ................. be~ du,~orn, depo.s and sa~s ,hot he ,s the opp,,cont (Name of indJvldual signing application) above named. He is the ....................................... ~..~-~.....~....~.~..~ ............................................................................................. (Contractor, agent, corporate officer, etc.) · "~'s, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contoined in this application are true to the best of his knowledge gs?d belief; and that the work will be performed in the manner set forth in the appli~;Zn filed there)~4~ Sworn.~....~.~..to before dayme thiSof ~...i ~'~ ('"----~ ~ ) ~' 'J~ -~' '~ ~'~ (~ / / ......... ...... ..... : ........ ......... , ,~......,. ~_~ .. ~ -- --~ :,~.,,_ ,.~ .................. ......