HomeMy WebLinkAbout9535-zFOEM NO. 4,
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
· THIS CERTIFIES that the building located at ./~/.0',.~. ......... ? ......... reet
MapNo .... .... LotNo.. , ......
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ......... ~.~ .... , 19.77 pursuant to which Building Permit No.
dated ....... ~...~ ...... , 1~ ~., was issued, ~d conforms to ~1 of the req~e-
ments of the applicable provisions of the law. The occupancy for w~eh this certificate is
...........lSS~ea is .......... f~ ................... ~~' ~~~~ .............. f..~.~~ .........
The get,incase is lssuea ~o ............... F. ~ ......................................
(owner, lessee or ten,t)
of the aforesaid building.
Suffolk County Department of Health Approval ~ ' ~
UNDERWRITERS CERTIFICATE No .........................................
HOUSE NUMBER ~0 Street ........ ~..-.. .............
BUILDING
ToWN
SOUTItOLD, N'. Y.
(THIS PERMI;T MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETIOI~I OF THE WORK AUTHORIZED)
Ne 9535 Z
Permission is hereby granted to:
... D.~.~.%t a.v... ~ r.t ~.:;.,. .............................................
................. &..E~nc.ir~g ..on ...~e.st ...p~op~r ~-y ..1.£ne ....................................................................
at premises located at ..~R...C...Ll,..!",/.13..&';z;e,~.l~:,~aCe. t:...iict. ...............................................................
................................................ ~Ia~titu~k ..........................................................................................
pursuant to application dated ~,~ o 19....~.~., and approved by the
Building Inspector.
Approved ............................... ~../......, 19 Permit No ............. - ................... :
TOWN OF SOUTHOLD ~a_ j-F~/~/'~.~ ~ ~, K~
BUILDING DEPARTMEN~ , ~ ~ _ ~
TOWN CLERK'S OFFICE
~UTHOLD, N.Y. ~
Application No./...~ ........................... q
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building~
Inspector, with 3 sere of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o/
areas, and giving a detailed description of layout ofproperty 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 work.
e. No building shall be occupied or used in whale or in part for any purpose whatever until a Certificate of Occupancy/q
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 applic~able laws, ordinances, 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 builder.
Name of owner of premises ..... d~..U..6'../.-~.~.?......~....~.].~.../.~..~...'~. ..........................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No .....................................................
Plumber's License No .................................................
Electrician's License No ..... ,/~.~...Z:,.~'.:.,,~,, ......................
Other Trade's License No ...............................................
Location of land on which proposed work will be done. Map No.: ........................................ Lot No .........................
Street and Number..~/..~..7...~..:..~..~.?)..~....~...~...~...~...Z:.'...~....'..~. .......... ...~....~...~...~'Z..~.../~..~...~L. ................................................
Municipality
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exisifing use and occupancy ..... '..~...~..../~.....~. ...........................................................................................................
b. Intended use and occupancy .i/..~....~..~.,/~,..,.,,~,.~, ,~,,.,~,~,,T~,..~.,,.,J~,,,.~
THEREFORE IT WAS RESOLVED, Gustav Bartra, 227E Breakwater~ter°ti°n ................
Road~ Mattltuck, New York, be GRANTED permission to construct
a free-standing tower exceeding maximum height, right-of-way, (Description)~c~
east side Breakwater Road, Mattituck, New York~ subject to the
following conditions: ~pplication)
1. Ail towers in the froht yard must be removed within Ioor ............................
60 days. . ...................................
2. A 50' free-standing tower (no guy wires) may be con- use ............................
structed in the rear yard area at least 50' from any Depth ....................
property line.
3. The following transmitting and receiving antennas may{ear
be placed on the tower so constructed: no more than ..
two (2) ham radio transmission antennas and no more . Depth ........................
than three (3) television reception antennas.
4. This application shall be reviewed in October, 1978o
10. Dote of Purchase ........................................................ Name of Former Owner ...~..4~..;...D........~'.~,.,°..F.'..~-.,.'~.. .................
1 1. Zone or use district in which premises are situated ...~..F;:~..L?..~...~.!7..~..~.../).~'T.A..Cc.~..'f.'..N.~, ..................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................
13. Will lot be regraded ............................ Will excess fill be removed from premises: ( ) Yes ( ) No
14. Name of Owner of premises ...~..2....7~../~..V.._....~.../~].~..~..~. ..... Address ../~..~~.. ....... Phone No.~..?.A~..~..,~'..~..?-.-~.
Name of Architect .............................................................. Address ................................ Phone No .......................
Nome of Contractor ............................................................ Address ................................ Phone No .......................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from
prop~;rty lines. Give street and block number or description according to deed, and show street names and indicate
whether interior or corner lot. I,, ~
I
STATE OF NEW YORK, I c ¢
COUN'r¥ OF ................................ ~' "'~
.................. ...~....~..~.?]....~..?........~.....~....,~...~27..~...~, ........................ being duly sworn, deposes and soys that he is the applicanl
(Name of individual signing contrac¢)
above 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 to make and file
this application; that all statements contained in this application are true to the best of his knowledge and belief; and
tha~ the work will be performed in the manner set fo~h in the application filed therewith.
Sworn to be(ore me this ~ ~
.... ........... ,
Noto~ P~ ic, ,.., .......... ~ .................................... Coun~ .............. ~~.,,~:,~ ..............................
-"~7 7~' ~ ]_, ~ (Sig~ture of applicant)
[ ~ARY E. DAWgON
~OTAR~PUBUG, State of New York
No, 52-4~4372], Suffolk County
Term Expires M~rch 30, 19~
BUILDING DEPARTMEN~~ , '-).~.~c,~._ ,~ _ v,/'
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined .............. ./.. ............. : .........
r~ -~ 19Z~.~. Permit No .............. ~ .................
Approved .............................. ~........, ~'~ ~ ~- ~
Disapproved a/c .......................................................... ..-
~ - 30' ~ ~,~ ~ APPLICATION FOR BUILDING PERMIT
~ate ................/....Y...i..: .................. , 19
~ ~,~ INSTRUCTIONS
a. This application must be completely filled in by typewriter oe n nk and submitted in triplicate to the Bu Id
Inspector, with 3 sete of plans, accurate plot plan to scale. Fee according to schedule.
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 ofproperty must be drawn on the diagram which is par~ 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 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, 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)
K -
.......... (Add,ss of applicant) ( ( ~ ~ ~
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electric:lan, plumber or builder.
·
If applicant is a comorate, signature of duly authorlz~ officer.
(Name and title of corporate officer)
Builder's License No .....................................................
Plumber's License No .................................................
Electrician's License No ................. -. ..........................
Other Trade's License No ...............................................
1. Location of land on which proposed wore will be done. Map No.: ........................................ Lot No .........................
Street and Number..~:'...~..7....~..: .~.~.....~....~....~.../~...7.....~......~......~?..
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
b. Intended use and occupancy /.~.~./4/~/~ ~'~/~"'" '"""
B,~~- ~-~ ~-- ~c~- ¢3 ,'t~7
THER~FOP. E IT WAS RESOLVED, Gustav Bartra, 227E Breakwater&~terati°n ................
,.~ Mattituck, New York, be GRANTED permission to construct
a'free-standing tower exceeding maximum height, right-of-way,
east side Breakwater Road, Mattituck, New York, subject to the
following conditions:
1. All towers in the froht yard must be removed within
60 days.
(Descriptlon)~
~pplication)
1oar ............................
2. A 50' free-standing tower (n__o guy wires) may be con- u~ ............................
structed in the rear yard area at least 50' from any Depth ....................
property line.
3.The following transmitting and receiving antennas may{ear ............................
be placed on the tower so constructed: no more than
two (2) ham radio transmission antennas and no more . Depth ........................
than three (3) television reception antennas.
4. This application shall 'reviewed in Ooto er, ieee.
10. Date of Purchase .......................... ~..~i .............. ~i ....... ~JName of Former Owner ..?,.~U.,./...~........~....o...~...~,.,~.. .................
~ 1. ZOne or use district in which premises are situated ..~.~...!..~..~..~.J.~./..~. ~...~¢~..~.'..~...~..~.~.,...,~:~LY~ ..................................
]2. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................
13. Will lot be regraded . ........................... Will excess fill be removed from premises: ( ) Yes ( ) No
Name of Architect .............................................................. Address ................................ Phone No .......................
Name af Contractor ............................................................ Address ................................ 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 YORK, ~ ¢ c
COUNTY OF ................................
................... ....~...~..%.?.....~..~.....~...-~...~:..'~/ZT~.,~ ........................ being duly sworn, deposes and soys that he is the applicon,
(Name of individual signing contractO
above named.
He is the ......... ..~_...l~...../~.....~-~...~ ...........................................................................................................................................
(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
thor the work will be performed Jn the manner set forth in the application filed therewith.
Sworn to before me this
Notary ~//olic, .¥ .......... ,~ .................................... Count/ .............. ~...,~,..~..~.c. .................................
~//., / ~- ~, I // (Signature of applicant)
( ~'ARY E. DAWSON
INOTARYwPUBLIC, State of New York
No. 52-4643721, Suffolk County
Term Exi~ires March 30.