HomeMy WebLinkAbout9435-zTOWN OF SOUTHOLD
BUILDING DEPAHTMENT
Town Clerk's Office
$outhold, N. Y.
Certificate Of Occup; ncy
No. Z-~869 ...... Date .............. Sept .... 2 ...., lg.??.
THIS CERTIFIES that the building located at . %~/~ .Aid.tick Lane ........ Street
Map No...xx ........ Block No.. ;~x ...... Lot No... ~x~ ·.. Laurel. · .N,~~.. · .........
conforms substantially to the Application for Building Permit heretofore filed~~ce
dated 9/2/.7.7 & Dec 6 , 19 7.6 pursuant to which Building Permit ~i
...................... ·
dated . 9/2/77. & .Dec. 6 .... , 19.76., 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 ?.r.i..va.t.e.. one.. ~a.~y..dwoll.f~ng .4. a.c. ges~.qry, b.uildLug ..............
The certificate is issued to .C.~r.~...B.o. sqh.e.~t~. ....... .0~. ir~ar ..........................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval pe~uding ...........................
UNDERWRITERS CERTIFICATE No..N~2~. ~.0. ..... /~D~...ll..~.9.7.7 ...............
HOUSE NUMBER ....... 27.~.5... Street .... ~A~-Ch .~v,e ....... ~aur.~l ..........
Building Inspector
lrO~ NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N., Y,
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 9 35 Z
Date ....................... ~J~t ......... 2 ........... , 19..7.7..
Permission is hereby granted to:
.... .g.:,zL..~.o..~.a.~LL ~ ..........................................
.............. A~d.r.~h..ha~ .......... I~u~et .............
~o J~LL..r,-m:...aac ~ ~%.&t o~ ~c .. ~u&l~ ~ ~g ......................................................................
at premises located at ...... ~.~/.,...~.ic~L.L~ ...............................................................................
........................................................... ..L~.u..r..e.1 ..................................... i ................................................
pursuant to application dated ..................... *~e~(; ....... '~ ............... , 19..9::)., and approved by the
Building Inspector.
Fee $...l~.e,~. .........
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
T~OWN CLERK'S OFFICE
SOUTHOLD, N. Y.
........................................ , 19.. Permit No ...... 2~.i .....
............................... .........................
APPLICATION FOR BUILDING PERMIT
Date Sept 2 19..~. .....
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building
Inspector, with 3 sets 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 a;Jjoining premises or public streets or
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 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 ather 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.
......... F ........
Aldrich Lane Laurel
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
o%~zte r
Nome of owner of premises ....~R~.],..~P.,~.~.]g,~.t,.t~.. ...............................................................................................................
if applicant is a corporate, signature of duly authorized officer.
(Nome and title of corporate officer)
Builder's License No. owner
Plumber's License No .................................................
Electrician's License No .............................................
Other Trade's License No ...............................................
I. Location of land on which proposed work will be done. Map No.: ......... ~ ........................... Lot No..,~. ................
Street and Number ....W/.J~..~,~L~,.g.~....~Zke. ......... La~.~.el.....J(,.~r., ................................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exisiting use and occupancy ....~..~.~...~..1...~_~.~. .........................................................................................................
b. Intended use and occupancy ...... !! ............... w:Lth..ac~easo~.3r...s.tar~ge...b~i3_d±zag ...............................
3. Nature of work (check which applicable): New Building' ....~,X. ........ Addition .................. Alteration ...............
Repair .................. Removal .................. Demo~itia~ .................... Other Work ....................................................
(Description)
4. Estimated Cost ............................................................ Fee ....$0.,~0~ ..........................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units .......... .o..~..~. ........... Numbcr 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 ...8 ...................... Depth ....... ~ ..............
Height .................... Number of Stories ........ .0.i'1~ .......................................................................................................
9. Size of 1at: Front ........................................................ Rear .......................................... Depth ................................
10. Date of Purchase ........................................................ Name of Former Owner ........................................................
11. Zone or use district in which premises are situated ..... !~..A..!!....~..i..s...t. .............................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ..... ~A~ .............................................
13. Will lot be regraded . ......_riO. ............... Will excess fill be removed from premises: ( ) Yes ( ) No
1 4. Narne of Owner of premises .C~a~.l...]~s¢l, te.t,i;$ ................. Address ......L~&I~.e;L ........... Phone No .......................
Name of Architect .............................................................. Address ................................ Phone No .......................
Name of Contractor ................ o~next ................................ Address ................................ Phone No .......................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oll set-back dimensions frorn
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 Y. ORK. I c ¢
COUNTY OF ..... ~.¥1~'.~. f~],~¢ .......... f~'~
..................... (~:q.lr:.'l ..~$~},,e.t,~;J, ......................................... being duly sworn, deposes and says that he is the applicom
(Name of individual signing .co~tracf)
above named.
He is the ...................................... .O. Wll~l'.-..10tlJ, l.d.~lq. ...........................................................................................................
(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 ail 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 forth in the application filed therewith.
Sworn to before me this
..e. ..... dw of ................... ............... ,
Notary Public, ~u~.foll¢ County ...~. ................ ~ .....................................................
................................................... (Signature of applicant)
flow
v*~'~ Richord .4. Miller
or formerly
~f,/e.~°1~' ~67.
Areo .. 1.941
nOW
or
0 ominic -J' -Cotolono
formerly r .
tVO r~ :
WATER ~RVICE-' ~tvArE WEt~ ' ~
REVISIONS
YOUNG & YO
, 400 OSTRANDER AVENUE, RIV
ALDEN W, YOUNG
SURVEY FOI~:
C~IRL BOSCHETTI
AT
L A I. IREL
TO'~v N OF SOUTHOLO'
· SUFFOLK CO., N.Y.
SCALE:
GUARANTEED
' I
I -- lO0' DATE:NOV. 19,1~76 J .