The URL can be used to link to this page

Home My WebLink About6084-zl~O~w NO. 4 TOWN OF $OUTHOLD BUH.BI~G DEPARTM~NT Town Clerk'~ Office $outhold, N. Y. Certificate Of Occupancy No. E.?~.7.0. ...... Date ...............1~..1'. ..... .1.8..., 19..7? THIS CERTIFIES that the building located at Minehaha Blvd Street Map No.. ~ ........ Block No...xx. ....... Lot No...x~. ....... .S..o~.t..hg.l.d' ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...........A~lg .. 2.8..., 19. ?3. pursuant to which Building Permit No....6.0..~.Z. dated ............A.u.g....2.8...., 19..7.2., 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 .... A~.e.e.ee .orz .bv~;L.c~L .n~..(~t.ore~e.) .w~.th. ~ .addlt~toa .............. The certificate is issued to ....J.o.s.e....P..~e..:L~o. ....... . .0~n..e.~. ......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...lq.'.R; ............................. UNDERWRITERS CERTIFICATF. No. N oRo ................... HOUSE NUMBER 1230 Street g~nehaha B~vd 8outho].d .. .............. :A ........ Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 6084 Z Permission is hereby granted to~L__ ,,. ~ --. / ...~2..~.....~... .... .....~...,r.~./../...~ ............. .... .,,,,~..~...~.../'-.,~'.~,~.~.....-...,~......~....: .......... _ ~o ........ .~.~..~.:'.......~.£.,,r,;~...-~.a,,,~.,,~.....~.,¢c,c .../...~....,,~.~.z~.../,. x.z..,,-2 ........ at premises located at ............. ............ ~./.,4~.,~..:~Z.,~/.~.~. ....... ~..~/~..~......'. ................... ........ , ........................................................... ~ .~..c .~.~...~.~......-...~....~,..~ .......................... ! Building In.~ector. Fee $..../..~....~ ctor TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Examined ........................................ , 19 ........ Approved .........~../.,~....~.... .......... , 1~.....~.. Pemit No..d.~?.....~...~..........~.. ....... Disapproved a/c ............................................................................................ ~'(Building Inspector) APPLICATION FOR BUILDING PERMIT Application ............ · ................ ~[ INSTRUCTIONS · This applieation must be eompJeteiy filled in by typewriter or in ink and submitted in triplieate to the Building Inspector, wit ~J~ _-ets of plans, accurate plot plan to scale. Fee according to schedule. b. Pict plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, ancr" ving a detailed description of layout of property must be drawn on diagram which is part of this application. 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 or~ Lhe premises available for inspection throughout 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 Zorm~ J3rdinance of the Town of Southold, Suffo[l~ County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of ~ldings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws. rdinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation} (Address of applicant. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde¢.' ........................................................................................... I.f applicant is a corporate, signature of duly authorized officer. 7~,~. ~ ~ .................... ..................... ~1. Location of-land on which proposed work will be done. Map No.: .................... Lot No ............... ~ ...................... ' Street and Number ...~...~....~r..,~.. ..................................................................................................................... Municipaliw 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....................................................................................................................... '~*onded use and occupancy ................................................................................................................... Nature of work (chec whi h a pi . New Building ....................... Ad itl ...'. Alteration......'~, ....... '"' i." ¢,_.-., - ',?, ;~..°° ~'~./'.~':~' .2: ...................................... being duly sworn, deposes and says that he is tbe applicant above nemedb r: (Name ol individual signing contract) '~ ; (Contractor, agent corporate officer, etc ) ~'~ /~ "!,wn~' and '$ duy authorized to perform or have performed the said work;'nd to maj~, '~ ~ , '~:.'!.,,:~ "' ~ .~'~ his application are true to t,~,e~ be~'~i~-k~n3~iliLOdge and belief; and til~'~''~'~ ~ ...-'" filed therewith, r~,~r! r,,:!c ¢'~*o ;f Nc,* Yo~ .~ .~- ' Other Work ...., ............................... Repair Removal ..... .................... Demolition ........................ - ~' (Description) 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 natu. re and extent of each type of use ............... .......... ;: ...... 7. Dimensions of existing structures, if any: Front ....~.....~....-...O.... Rear ...../....~.....-...~.. ....... Depth ...~.~.....~...~.. ......... Height ......... ~.; ...................................... Number of Stories Dimensions of same structure with alterations or additions: Front .~ ........................ Rear ........................ , ............. Depth ............................................. Height ...... ; .................................. Number of Stones ...................... ,~ ............. 8. Dimensions of entire new construction: Front ....,~...~....-..~.... Rear .~..~..~/.....-....~. ....... Depth .....~...~.;.;.,.~..,:.....?:~ Height ..... ~ ......... - ' ..................... v ........... Number of Stories ........................... ; ...................... ................ "".; ......... 9. S.ze of lot. Front ....... l~.~,.......,w.. .............. Rear ...... t....,~,... ........................... Depth ............... ~ ....... Height .................................................... Number of Stories ...; ................. ~-],~; .................................................... ~ ~.f/_ ................ Name of Form,er O,wner ./.~..~.~..' ...... 10. Date of Pa rchase ...~..~....~....~.. ..~...2 .....~..../....~ .~.~..~_ 11. Zone or use-district in which premises are situated ....... ,C..-/ ................ ; ......................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... /,w~....~... ...................... .,'"~, ..... 13. Will lot be regraded '-~..~...' ..... ;~. )~/ilL,excess fil.I b_b_.~e.e removed.~rom~m,,,.premises: [ ] Yes [ J ~14. Name Of Owner of Cremises .~l~....~.....,~...i..~.~...'/'~'?.~. ...... ~.o...~.~.....,~....~..../~.... ...... .~....~-...~i..~..:, (Address) (Phone No.) Name of Architect ............................................................................................................................................... (Address) (Phone No.) ~ Name of Contractor ............................................................................................................................................... , (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set,back dimenSiOns Property lines. Give street and block number or description according to deed, and show street names and indicate er interior o~ corner lot. 3. Nature of work (check which applicable): New Building ....................... Additio~./'..4..~....~....;. Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work .;~.,..I ............................. (Description) (to be paid on filing this application) 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 natu, re and extent of each type of use ................ , ........ ~; .......... 7. Dimensions of existing structures, if any: Front .../...,..~?...-....O.... Rear ....... Depth ...(~'...~....~....~,. ......... b fSt i He ........................................................... Num er o or es ............................................................................. Dimensions of same structure with alterations or additions: Front .~ ........................ Rear ........................ Depth ............................................. Height ...... ; .................................. Number of Stories ...................... 8. Dimensions of entire new construction: Front ..../...~....-..~.... Rear ..../..~......--..~ ....... Depth .....~...~.....~.~....~ ....... Height ..... , .............................. v ........... Number of Stories ....................................................................................... Size of lot: ~'Front Height .................................................... Number of Stories ..................... : ...................................................... Zone or use,district in which premises are situated ....... vf~/...- .......................................................................... 12. Does proposed construction violate any zoning law, ordinance or re§ulation: ..... ~.. ...................................... 13. Will lot be regraded ~--~...~ ........... :;. ~JJJ~excess fil be removesL~rom premises: [ ] Yes [~1 (Address) (Phone No.) Name of Arch tact .................................................. (Address (JJ[n'~'~"l~l'~.) Name of Contractor ' tAddress Phone No. (,x' PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-back dimensions property lines· Give street and block number or description according to deed, and show street names and indicate whea~ 10. 11. er interior or corner lot. STATE OF NEW YOR~,,__~, ,, v,///'/' ~ ) "~!,,·.~.~....~.~.........~..~",~.·.~-'...~'/'~...,4/~...','~ ~---- ..................................... being duly sworn, deposes and says that he is the applicant above named. · (Name of individual signing contract) s the ................................................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) ~1 owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all r~ ,~t$ contained in this application are true to ~he best o~ tlis kno~lge and behef; and that the work wdl be ~erformed ~n the mann~Jr ~ .~ the apphcat~on hied therew.th, ri - ' , lic, ~ ~~ea~.~y~ ................... :....~... ..~.- :: ............ '- ........ ~ , ;/, ~ ....... ~, - ~ ~ (Signature ofapplicant}~