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Home My WebLink About1114-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...~l~,.c).O .............. Date ........................... I)eeembe=.....~.., 19.6[.. THIS CERTIFIES that the building located at ...~.al~s~4)l~..Rc~al~. ................................... Street Wassau Point Club Properties Map No ....................... Block No .......... ~ ..... Lot No..~'.~....Cl~t, ehe~-~e.t...g,..y., .................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............................. ~lll~e. ......... ~,~. ........... , 19.~Q. pursuant to which Building J~ermit No..Z.~.~.. dated ............................... ~'1l~1~- ......... .1819. ~(~ ., 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 .......... ........ Pt" lYa.~.. ~r~ ..-f~i. ty.. d-wetl.i, ng. ...................................................................................... This certificate is issued to ..~;l~l~l~!..~l~.;l~m ........................ O~ll~. .............................................. (owner, lessee or tenant) of the aforesaid building. Building inspector FOI~M 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.° 1114, z Date ..................... ~.~.....1~ ................. 19.60.. Permission is hereby granted to: Chet Or. le~.i.. · · · .~ot13 · ,~t~ha~ · · .l~.~ s ............... ................. Ou.t~h~gt~e.~ · .... t~ ¥ .~ ~ ......................... to ..... to.. t~t.td'. 'll~l~' ' orle., fmlt~ty'"l~-art llllg' .......................................................................... at premises located at ..l~l~att..la~..Ol. llrb..lal, ol~.j ........ ~t...ll~r .............. (~'~l*ffie~'l.~...Ii~D~,) .... ........................................ Yans~o~..Road'i"'~tassau'"Po~n~'"Cu~eh'og~e'i'"l~;'~; ................. pursuant to application doted ............................. ~ijjl~.....].i~ ................ 19.~(~., and approved by the Building Inspector Fee $...]~0,, O0 ......... Building Inspector FORM NO. I TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. c, Approved ........................................ 19..../...Permit No ............................... 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. Plat 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 part of this location. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval af 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, ordinances and regulations. (Signature of applica'~,, or name, if a corporation) ................ .............................. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · Name of owner of premises ......... ~J~..~ ................................................................................... If applicant is a corporate, signature of duly authorized officer. 2. State existing use and occupancy of, premises aM intended use and occupancy of proposed construction: a. Existing use and accupancy ....... ~....~.~...~...~ .............................. .~ ............................................... b. Intended use and occupancy......~.~......~......~:~.....~..~...~....~."C.....~.~.~.~..-..-- 3. Nature of work (check which applicable): New Building.....X .......... Addition .................... Alteration .................... Repair ................ 2~,.Removal .................... Demolition .................... Other Work (Describe) .................... 4. Est mated Cost ~ ~ ! ~ ............ Fee .......... /....O...:..~ ....................................................... (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 .................... J.; ..................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use... ~ ............... 7. Dimensions of existing structures, if any: Front ........ .-?7.. ................. 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 ........ 6~...~-- .......... Rear ............ ..~.. ........... Depth ......~..~ ............. Height ....~....Q ............. Number of Stories ..... ~ ............ 9. Size of lot: Front ....../..~..~..~. ...... Rear ....... ~..~ .............. Depth 10. Date of Purchase ..... .~.~...~...~..~.~ ....... Name of Former Owner ..~..~...~ .................. ] 1. Zone or use district in which premises ore situoted .................................................... ]2. Does proposed construction violote ong zon~n~ Iow, ordinance or re~ulotion? .................................................... 13. Name of Owner of premises..~..~.....Address ~..~~.~,.y..Phone-- NO Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor.~...~~'....Address ..~~z.~.Phone NO~.~z.f.~.~ 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 numbers or description according to deed, and show street names and indicate whether interior or'corner lot. ~....~.~[ ...... ~ ................. beln0 duly sworn, deposos ond s~y~ that he is the opplic*nt · ' (~m~ of individual ~ionin~ opplic~tioh) ' ' ~bove homed. Ho is the ..........~ ...................................................................... i .................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized toperform or have performed the said work and to make and file this application; that all statements contained in this application are true to the ~st of his knowledge and belief; an~ that the work will be performed iff the ~nner set fo~h in the applicatio~ filed therew~ ~ Sworn to before me this ~ / ~ ~ [~ // ,. ~ , ..... f ~ '-~ ' /19 po .. ~u0r~ianature of a cant) .............. ~.~ ...... aay O 'Z ............ ~'=~ ............ ~0ta~ Public, State ~'~Z,,Z .... PP TOWN OF SOUTHOLD I:,~PERTY RECORD CARD FORMER OWNER ~ LAND IMP. ?so :t· AGE NEW NORMAL Fa rm Ac re Tillable 3 Wo~land Swampland Brushland House Plot ~k STREET '~ ~ ~ VILLAGE LOT S VL TOTAL FARM DATE W DISTRICT SUB. ACREAGE TYPE OF BUILDING COMM. IND. CB. MISC. Est. Mkt. Value ~ · (1' . ~ ~-~ ~~ BUILDING CONDITION ABOVE FRONTAGE ON WATER B E LOW Value Per Acre V,-,lue FRONTAGE ON ROAD M. Bldg. ~.~_ )(' ~ ~- Z ~ ~. Foundation C.~ Bath Extension ~ y X ~ ~ ~ ~ ~ Z ..... Basement ~ ~// Floors _ Extension ~ y ~ ~ 3 ~, Ext. Walls j~///~. Interior .... Finish ~tensio. Z ~__~ : J' ~ ~ Fire Place 0 ~ Heat ,, - ::-r ~-~ Porch ~-{[ Rooms 1st ~l~r Breezeway ~ ~ ' Sa .... Rooms2ndFIoor Garage ~ ~m ~l~ ~ Driveway __~t T~) Dormer TOWN OF SOUTHOLD PYOPERTY RECORD CARD OWNER FORMER OWNER. N V l LLAGE W DISTRICT SUB. ACREAGE TYPE OF BUILDING ~ES..55~ SEAS. LAND IMP. VL ~ TOTAL 7-0o AGE NEW Farm rilloble 1 Filloble 2 tillable 3 Noodland ~wompland ]rushland 4ouse Plot rotol LOT 4~'~1~'~' NORMAL Acre FARM COMM. J IND. J CB. MISC. Est. Mkt. Value ABOVE Value FRONTAGE ON WATER FRONTAGE ON ROAD BULKHEAD DOCK BUILDING CONDITION BELOW Value Per Acre Bldg. I Foundation Bath :xtension Basement Floors =xtension Ext. Walls Interior Fir~ish --xtension Fire Place Heat /n ~ ~ ~ .............. ~ ~ Porch Roof Type ¥~ t ~Q~0 Pao~ ~aO Porch Roo~ 1st Flor 3reezeway Patio Rooms 2nd Floor ~arage Driveway Dormer