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Home My WebLink About4482-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Cerlificate Of Occupancy No. Z. ~.0.~.7 ..... Date ............ . .I~..1' ..... 11~ ....., 19.?.3.. THIS CERTIFIES that the building located at P. ine. ~.lael ............... Street Map No. C¢.rd:Lne~r. B~t~cZktNlo.l .......... Lot No.1.37. &1.38 ..... East .l~ar:Lan conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... 5opt' ~9 ...... , 19.t- p~suant to which Building Permit No.. dated ............... ~Sep~' ~ ~9~9' , 19~S ., 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 . ~Va~. ~n~ .f~.~F. d~O~g ....................................... The certificate is issued to . . D~ .~$~.~$~. ~PB~r ....... ~ ................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .N,R, .............................. UNDERWRITERS C~RTIFICATE No...Be~ ....................................... HOUSE NUMBER. ~6~ ....... Street.. Cadar. ~e ................................... FOB3[ NO. ~ TOWN OF $OUTHOLD 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? 452 Z Permission is hereby granted to: Cmll3J. e...gem~t~...Gm.A,/~..~a~lae~.t..Z,..Ol~eeae ...Sg.l.....amm~t..Lm ........................................ .......... · ~e.~e~...g.i~ ......... I,,T.., .......................... to ............... ~1~ ..B.. a-{~L~.t~ld~lL .gD,.. ID,. dl1~ll t;JLl:l~ ..d]llel 11 ~111, ....................................... at premises located at ................. ]dllt..t.;~4~..&l~J~....~F~L~lllt~..~..l~l.t....~e~...~. ............. ...................................... Ce4~,..T~m~e .............. ~,s~..lle~.~ ...... .l~,.~- ........................................ pursuant to application dated .......................... ~Jll~lt, ......... ~ ......... , 19.6~.., and approved by the Building Inspector. -- Building Inspector ,IHJ ILDING DEI~A,KTMENT , TOWN CLERK'S Examined .................... : ................... , 19 ........ A~ .............................. :.: ....... ,' I~....,..' P~it ~ ............................. Application No....C....'. .................. APPLICATION FOR BUILDING PEItMrT - INSTRUCTIONS a. This appl'ication must be completely filled in by t~1~ewriter oJ' in ink and submitted in duplicate to the Building inspector. . , b. Pl.ot plan sho?in.g, I,oc,ation of lot .a.nd of bu_ildir~s .on p~emises, relationship to adjoining premises or public streets areas, aha giving a ~ero~lea aescriptio~ o? layout ot p~rt~ must be drown on the diagram which is port of this applicati c. The work. covered by this application may fmc be commenced before.iss~cflce of Building Permit, , d.... Upon approval of ?s a~!~at, i ,~, .the Building InSplct~ .will Islue a Building Permit to the applicant, such permit snau De Kept on the premises available ?or tne~mctlon throughout the progress of the work. , , . e. No building sholl be occupied or used in whole or In part for any purpose whatever until a Certificate of Occupancy sholl 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 R~egulati.o. ns, for the construction of buildings, additions or alt. emtiens, or for removal or demolition, as herein described I he appllcont ogrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. Oadll:Lc Const;ructton Co (Signature of applicant, or name, if a corporation) / -~' · ..?..?..l.. Summit AYe, Jersey City N [ '< ,~._. ....... (Add~'~ appli~t) ........... ' State whether applicant is owner, lessee, ageYit,~n:hi~; qjrmes,~ general contractor, electrician, plumber or builder. Cont~c'cor i . , ' ......... Name of owner of pmmi~ ............. . ~, . .......... L...: ........................ ~ ......................................... .. If applicant is a corporate, signature of duly authorized officer. ............ J[ Ki]/~.... Ea ~1~ ..~1. 3~c Jo...E.]:e.~ ....................... (Name and title of corporate officer) I. Location of land on which proposed work will be done. Map No.: ..... ;a.p~.....~ ................ ,... Street cmd~Number C~le~../.e~e. .......................................... .~s~..~z:.t~ ........ .....: ................................ 2. State existing use am occupancy of premises and i.r~,% .m~, use andLocCupa,~ Of a(:~q:)a~l~::.., ~ .~ ....~ ~ ~;...~ j ~ I.~ ~ r*c~ ~. ..................................................... ,. ....................... : n occ :,i,b,i::i:.;H:.. ;:,,,'..:ii:. ........· ........ 3. Nature of work (check which applicable): New Bujld(ng ::~ ........ ~,., .... Addition .................. Alteration .................. Repair .................. Removal .................. : DemO~ition.:.....~.....:!;... Ofher Work (Describe) ...O.u..t:..s.~.?..e.....D...e..c.~ ........ 4. Estimated Cost ..........~5~.4~) ...................... v...,,,...~.Fee,......~,,~O .......................................................................... · ' ' [to be paid on filing this application) 5. If dwelling, number~ of dwelling units ..... ~ ............... Number of dwelling .¥nits on eoch floor ............................ If garage, number of oors .............. ,~.....'. ........................................................................................................ 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 Storms., ................~ ......................................................... Dimensions of same structure with olteratJons or additions: Front .................................... Rear ............................ Depth ................................ Height ........... :.. ............. ..Number of Stories ................................ 8· Dimensions of entire new construction: Front ................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. D~te of Purchase ........................................................ Name of Former Owner .................. ~ .............. 11. Zone.or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation.;) ............................................................ 13. Name of Owner of premises ..... ?....o..b...e..~..'?......G~-...e..e...n..e.....Address ....b,..0....~.~..h..e..~.s....~..r..e.,e.~. Phone No..~.8..8...-..6...8.?..0... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .C..~.~.]:.~..c.~.?..o...n..s..S..~....C.?. ........... Address Phone No ..................... PLOT ~IAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from pi, opefey lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lat. Fi2. 140U5G STATE OFNEW~Y~K, t ~ ~ -- ' COUNTy ............. ZZ'' i ' · · (Nar/ie of Individual signir~l applicatj_on) j :. above named· He is the .............. ~.~.~...~x..Z-..~.~..~.....~.~.d~.. ............................................................................................ % (Contractor, agent, coq~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make aad file this application; that all statements contoined in this application.am., tru,e, to the best of..bis--/laqi::~n~ and belief; and that the work will be performed in the manner set forth in the apphcat,on fded thg~ewitJ~. / Swom to before me this ~,,, .. ~. ..... ,~.~.. ...... day o f ,.,.......~. r .~'~.,~- ~:~.~.m~.;.c,~.~.cs.eo 19 .~..~. · .. ......... ,, ~ V ~u~llified in Nas.s.a_u_.~u~?Y ~ FORM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 6150 Z Permission is hereby granted to: at premises located at ..t'tL~137..&..t.g ......... Gaz~ezJ..~B~...l~t&t~ll....ll~l~[. ............ ................................. I,A~..~u~ ......... l~t. ~ ................................................................ pursuant to application dated .................................. ~])~....~.., 19~1~..., and approved by the Building Inspector. Fee $..~. ~..e.~ ........... TOWN OF SOUTHOLD luiMin~ Dq4nment Town Cled[~ Office Southold, H. Y. 11971 APPLICATION FOR CERTIFICATE OF OC:CUPANCY Instmctiom A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the following; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage dispcsal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Cede compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: I. Accurate survey of property showing all property lines, streets, buildings and unusual natural or tepographlc features. 2. Swam statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $~.00 3. Copy of certificate of occupancy $1.00 Date ................................................ New Building .................... Old or Pre-existing Building............................/ Vacant Land ............................ Location Of Property ..~..~.....~......~...~..~....~.~..~..~. Owner Or Owners Of Property...~...~....~...~...~'.../..~ ........................ , ................. Subdivision .................. Lot N°/JZTL~.~J~ock No ............. House No ............. Permit No. Date Of Permit .~..-~..~..~.~..~ZC~plicont . ..~...~....~...~ ..................... Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ~ Fee Submitted $ ~/..~.~> ....... Construction on above described building and permit meets all applicaJ~e ~co~.¶s and regulations. Applicant ...... ~.. .~ ...................................... Swam to before me this of ..... ....................... FLOYD F. KING, Jib Notary Public ~otemy.~i~.~atG~lm4~lll~ No. 52-7267800 Suffolk Coun~ ~rm E~piros l~rch 30, 19~ (stamp or seal) 1~'0~ NO. ! TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved . p ........................................ , .......... emit No ..................................... Application No. ~...z..~...: ................... Disapproved a/c ............................................................................................ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ~ ~ o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buil~;n.cl Inspector. ~s ~,(~ b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stree or areas, and giving a detailed description of layout ofproperty 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 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, ordir~ances, building code, housing cede, and regulations. i{Jgnc~r;';~ op'l~' leant, or (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ .............................................................................................................. : ............................................... Name of owner of premises ....'..~..~.~....~~.....'~:......'.....'...~ ........................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) II n ~a No ~-~7.~- Lot 1. Location of land on whic~h proposed work wi be do 9. p .: ........... ,......: ................... ~ No. ~...r...,,..... ......... Street and Number .'~f~.."~¢~'......~...~....'......<~..~~.~.~......-~..~......~..~[~ ........... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ..~.! ............. : .............................. : ................................... i...~ ......................... .. b. Intended use and occupancy .................... ~ .......................................................................................................... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair ............ ~, Removal .................. Demolitio~ .................. Other Work (Describe) ........................................ 4. Estimated Cost ...~./....~..~....~..:...6....~. ................................ Fee .......................................................................................... (to be paid on filing this application) f 5. If dwelling, number of dwelling units ...... ./. ................... Number of dwelling units on each Ioor ............................ If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ ' " ,~,,7'~" 7. Dimensions of existing structures, if any: Front ...~'..Z...~. .............. Rear ............................... Depth ..~..~..~.~...:~... Height ! ~'/ i Number of Stories Dimensions of same structure with alterations or additions: Front ..~--~'~" Rear /'~'7'>~" Depth ..~..~.:..~...:.'. .............. Height ............................ Number of Stories ....... .J. ....................... 8. Dimensions of entire new construction: Front .../...~......~.. ..................... Rear / ~' Height ....~....~ ........... Number of Stories ..... ./. ............................................................................................ 9. Size of lot: Front ...... /...~....~..~ ......... Rear ...~...~...~....~....,~. ............ Depth / ~ ~' 10. Date of Purchase ........................................................ Nome of Former Owner 11. Zone or use district in which premises are situated ...~.: ......................... 12. Does proposed construction viqlote any zoning law, ordinance or reau aton? ~ ............. Name of Owner of premses .~.."~ ,.~.~..~.~.~ Addm~..~..~'~..~...'.~......~....~.~.~ p~2'~2 ...................... Name of Archit~:t .................................. ~ ................. Addre~ ............................................ Phone No ..................... Nome of Contractor ...~'..~.~...~ .......... Address ...~ ...................... Phone No.~..~..?...-~.....~...~T.../. 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 i~F~V_YOBK, _ ~ S S " COUNTY OF .~.~.~.?.~... ............ $ ' ~e~ ~. ............................. · "~'.~..//Z..~...../~.~...~.~.~...~. ....... i ...................... being duly sworn, deposes and says tl~t he is the applicant (Name of individual signing application) Ce ~.Z ~.~ c ~ ....... above named. He is the .......................................................................... ~ .............................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have perfqrmed the said work and to make and file this application; that all statements contained in this application aretrue 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 .... ~.~.Z~ ....... da~. of ....... Z~.~ ......................... , ~.7.~. ' ~ ,~_ ~ ~. ...... ~. /.J ~, /) ~o~ p. ~a~ ,,o.. ............. ~......,~Z....~ ................................. ~otory e'uo,,c~..~...~..:.:.:.~'.2~.CNatmy.p0~e.$f6t~CoEf~ y~ ~/ (Signature of applican-~ ~' ~' No. 52-7267800 Suffolk Coun_ty Term Expires March 30, 197~