HomeMy WebLinkAboutMattituck MotelSUPGRVISOR'S OFFI~'~
16 Sou~n Street
Greenperf, H. Y.
Tel. Greenpeff
BUILDING DEPARTMENT
TOWN OF $OUTHOLD
SUFFOLK COUNTY, N. Y.
TOWel CLERK'S OFFICE
Main Street
Sou~old, N.Y.
Tel. SoethoM ~-3783
BUrLDING INSPECTOR'S OFFICE
307 Fou~hSh'eet
GrelnpoH, N. Y.
Tel. Greenpo~ 70101J
CERTIFICATE OF OCCUPANCY
in the Town of Sou~old, conforms substantlelly fo the approved plans end spedficafions heretofore filed in this
office with Application for Building Permit dated /'~:P~ /'~ 19 5 ~, pursuant fo which
Building Permit No. / / ~ , dated ~ / ~
~ 19 , was issued, and conforms to all of the require-
ments of the applicable prov'sion* o~ the law. '11~, occupancy for which2is corfi~,, is
~/ (owner, lessee or tenant)
o~ the 4foresald building.
Bugdlng Inspecter
(The Cediflceto of Occupancy will bi issued only after the Building Inspector is convinced of the comp et on of the
condtu~tion in compliance with the Multiple Residence Law end with ether Jaws, ordinances .or regulations affecting
the premises, and In ¢ontormlfy with the approved plans and specifications.)
SUPGRVISOR'S OFFICE
16 South Street
Greenporf, N. Y.
Tel. Greenport 74~0
BUILDING DEPARTMENT
TOWN OF $OUTHOLD
SUFFOLK COUNTY, N. Y.
TO~N CLERK'S OFFICE
Idel. Street
Sm~t~dd, N.Y.
Tel. So~h~o/d ~-37E3
BUI'LDING INSPECTOR'S OFFICE
307 F~u~.h Street
~reenport, N; Y.
Tel. Greenpor+ 7-0101 J
CERTIFICATE OF OCCUPANCY
No.. lit D.te(./~-~. ~? ,~'7
/
THIS CERTIFIES that the building located at /.~///' .~r~x~ ~C~7
Street,
"/'m
in the Town of Southold, conforms substantially te the e-i.l~;~.ec~ plans a,,~; .~.~Jrl~o;;v,,.'i~;sr~.u;~. ;,~e~ in
~'~;;'"'~ ";;~''~'t',,~-' :' ,"..,, t~r ;.~r~j ~-.,,.;, c~ema 19 , pursuant to
Building I'ermit ~o. , d~" - ..... 19 , was issUed, end conforms of~-all of the require-
ments of the *l~~llw.~¥ {: w~~~i~u$di$ ,
(owner, lessee or tenant)
of the oformeld building.
B~ldlng Inspector
(The Certificate of Occupancy will be issued only after ~e Building Inspector is cony;need o~ the completion of the
constru~flon in compliance with the Multiple Residence Law and with other laws, ordinances.or regulations affecting
the premises, and in conformity with the approved fdens end speclficefions.)
BUILDING DEPARTMENT
TOWN OF $OUTHOLD
SUFFOLK COUNTY, N. Y.
TOV~N CLERK'S OFFICE
Main Street
Southo]d, N. Y.
Tel, Southold 5-3783
BUILDING I'NSPECTOR'S OFFICE
CERTIFICATE OF OCCUPANCY
No. 18it' Date ~T~' 2~ I~ 6~
THIS CERTIFIES that the building located o~¶~O W/lB Ba~' AVe Street,
Map No. ~ , Block No. ~ , Lot No.
in the Town of Soufhold, confo~s substenfial~ ~o the approved plans and specifications here~fore fi~d in fhls
o~ce wlfh Application ~or Building Permit dated ~O~ ~ 19~, pursuant fo which
Building Permit No. ~e~e ~8, doted ~ ~ 19 68, was issued, and conforms to all of the require-
ments of the eppllceb~ provisions of the low. ~e occupancy for which this
Multiple Residence
This certificate is issued fo
(owner, lessee or tenant)
of the aforesaid bu;Idlng.
House f 21~0h7 Ave
B~ ~l&;ng Inspector
(The Ce~ficate of Occupancy wi~l be issued only after the Building Inspector is convinced of the completion of the
construction Jn compliance w~th the Multiple Residence Law and with other lows, ordlnences.or regulations affecting
~ne premises, end in conformity with the approved fdans end specifications.)
TOWN OF SOUTHOLD
Multiple Residence Law Permit
PERMIT NO. ]~. fhrl~1~ 19q~ APPLICATION NO. 'Zl& Oet,~h~z, ~,8 19~9
LOCATION I/_1 ~a_v Avl A_~x ~OOft II--W ~a~tlev Road. II-ttltuakt II,Z,
Application having been made on
covering consh'ucfion on a ~ liAA,I~4h. ~w lB ~l~m~ i~t~2e
(flew, ilfer~, or conv~ed}
multiple residen~ bui~ing, by or in behaff ~ 3=1~= ~=m~ A/~
~*.~t..~ ~.T. , for a dwelling Iocat~ as above stated, a~ the said
applic~fion hav;~ been exam~d and recommended for approval on
is hereby issued for ~e pe~orman~ ~ the
{arch;~ct~r=l, structure, mechanical, etc.)
work descried in the above num~red application and any ~ompany;ng pleas and specifications.
If no work ;s pe~or~ wffh;n one year from the time of i~ issuance, this PER~IT ~all expire by limitation.
, 19.~J~__._, for a permit
, 194o , a PERMIT
Approved Oa'l~l~m', 2~ 19
Enforcement Officer
TOWN OF SOUTHOLD
Multiple Residence Law Permit
PERMIT NO. ~__'~ ~.,_~ ]~ 19 ~1 APPLICATION NO. _1~1~_ ~-~ 1~ 19 ~
LOCATION !./~ n.~ A~,.: Ilnt, t.~t..a~; li.Y.,
Application having been made on ss._ ~ · 19._~, for · permit
covering construction on a {.aw, alter ,
or converted )
multiple residence building, by or in behalf of _.~.~14.
application having been examined and recommended for approval on ~_~ ~J 19_~, a PERMIT
is hereby issued for the performance ~f the If.~%u~l I~
(archlfect~rel, structural, mechanical, etc.)
work described in the above numbered application and any accompanying plans and specifications.
If no work is performed within one year from the time of its issuance, this PERMIT shall expire by limitation.
Approved Ill_. 11 1959.~ ..... t ~1~ [ ~ ~_
-- EnTo~cem~ent Offic~
~he ~mildi~ eovea, ed ~ fbi. per'att, Aa am aooemaor3r I~i1~-_-, a~ e~he~
~ erigl~al imr~e# m~a~ be app~eVed ~ ~he Beard of Appealm or' 'L'enm oL' ISm~tho].4.
I{. T.
TOWN OF $OUTHOLD
Multiple Residence Law Permit
/f,3
PERMIT NO. -, / /
LOCATION
~-2 //3 ~-?
19
Application having been made on
covering construction on a ,/~~
multiple residence building, by or in behalf of
altered, or ¢onvertedl
for a dwelling located a~ above sta+ed, and the said
application having been examined and recommended for approval on
is hereby issued for the performance of the . '..,~.~--~ ~,~'
(architectural, ~mcturat, mechanical, etc.)
, 19~, a PERMIT
work described in the above numbered application and any accompanying plans and specifications.
If no work is performed within one year from the time of its issuance, this PERMIT shall expire by limitation.
Approved
-~---~.~-- /2-
/¢_..,_._, ...¢ ,,,b --
' ~ E~f~rcement ' ' /
/
Original for Municipal Building Department ~ ~
STATEMENT' OF REGISTRY
To be filed in duplicate with the municipal building department or local enforcement agency by every
owner of a mu/t/pie dwelling, as defined in subdivision 33 of section 4 of the Multiple Residence Law.
Within 30 days after the filing of this statement, the municipal building department or enforcement agency
is required by section ~00, Multiple Residence Law, to file a duplicate copy hereof with the .State Build-
ing Code Commission, 1740 Broadway, New York 19, New York.
I. Location of multiple dwelling.'.
(a} Strent and number ~/ j(~t/C:-~/U~-? /~/:)-77~'~,/~, ,Z~ ..~'
Type of :anstructlon
Height of building, including number of stories /~Z./~, ~ ! .~ 7-~ ~ ~/
(¢} Type of heating facilities
(d} Number of apartments
(e) Number of IMng rooms
(f} Number of Idt,~henettes
(g) Number of bathroom,
(h) Number of water closets
(i)
/0
/¢
Number of occupants for which building was designed or intended to be occupied or used
3. Age of multiple dwelling:
la~ Dot. wh.n constructed ~ ~' ~'~. ~. ~ - ~ ~ - / *~',
[b) Dates of substantial additions, alterations or modificatlons of dwelling, with brief descrip-
tion thereof
(¢) If now under ¢onstructlon, state when construction commenced and anticipated date of
completion ~
Describe the principal use made, or, in the case of buildings under construction, to be made,
.of the multiple dwelling (such as apartment house., hotel, apaff..monf hotel: lodging house, board-
mg house school convalescent, old age or nursing home, private dwelhng two or more stories
in height with five or more boarders, roomers or edgers, or other c ass flcat on of mu tip ·
dwelling including those specified in section 4., subdivision 33, Multiple Residence Law}:
Filed with
STATEMENT OF FILING
.~ (B~ilding ~9~artrnent or Other Enfo ce nt~ge y)
~ ~-,~--~4~ onth. ~la~
(Name of Municipally) I ~ / ~ ~ale- of Filing)
Original for Municipal Building Department
STATEMENT OF REGISTRY
To be filed in duplicate with the municipal building department or local enforcement agency
by every owner of a multiple dwelling, as defined in subdivision 33 of section 4 of the
Multiple Residence Law.
Within 30 days after the filing of this statement, the municipal building department or en-
forcement agency is required by section 300, Multiple Residence Law, to file a duplicate
copy hereof with the State Building Code Commission, 1740 Broadway, New York 19, N. Y.
1. Location of multiple dwelling:
(a) Street and number ............ ..~'/.~....,..~.~r....A...v..e. .....................................................
(b) Municipality .................. . .M~....t..t...i..t..~..¢..~.~.......N..:..Y..: ................................................
2. Description:
(a) Type of construction ............. ,f~.,%me ...................................................................
(b) Height of building, including number of stories ............ .~.~. ............................
(c) Type of heating facilities ..... ~.Q~..,f.~i/..e..d.....s...t..e...a..m.....h..e...a..t. ..............................
(d) Number of apartments ........................................................................................
(e) Number of living rOOmS ....... .~. ..............................................................................
(f) Number of kitchenettes ....... .Qrke...t~:i.'fiC;lRflD, .....................................................
(g) Number of bathrooms ..... ~ .................................................................................
(h) Number of water closets ..... ~, ..............................................................................
(i) Number of occupants for which building was designed or intended to be occupied
or used ....... ~ ............................. · .......................................................................
3. Age of multiple dwelling:
(a) Date when constructed .......... P..i?..i..o.!'.....t...o....1..~..~..2. ...............................................
(b) Dates of substantial additions, alterations or modifications of dwelling, with
brief description thereof ........ ~1,.c~.~..3 ...................................................................
(c) If now under construction, state when construction commenced and anticipated
date of completion ..... Ja/'tLl~.~r...'l.C)fD,,%...../......a.p~.J,.]...~c~,,~ ......................
........... .t..e. .t..$..n. g ................................................
4. Use:
Describe the principal use made, or, Jn the case of buildings under construction, to
be made, of the multiple dwelling (such as apartment house, hotel, apartment hotel,
lodging house, boarding house, school, convalescent, old age or nursing home, pri-
vate dwelling two or more stories in height with five or more boarders, roomers or
lodgers, or other clossificatio~ of multiple dwelling including those specified in sec-
tion 33, Multiple Residence Law).
......... ,~.Q~....Q .%I/iq..~ ~'....-.....Q.~..~../'..a..~..Q ~. ..........................................................................
Dated at ........... ~'~,.~.~.:i.~.V~.q}~ ........ New York
..................... l~am. ch.....2.9 .............. , 1 ~.3 ......
(N~me of Owner)
(Address of Owner)
STATEMENT OF FILING
Filed with the .......................... ]~.~.~.~.~J~...Tr~.D.]~.~.~.C~Z' ....................................... of the
(Building Department or Other E~forcement A~ency)
........................ .T..o..w.n.....o.?....~..o..u....t..h...o..1...d.. on the ................ ~.a.,~..c...h. ....... .2..~ ............. 19~.~...
(Name of Municipality) / / (Date of Pllir~)~
(Signature and De~ignagion o~ Official with
whom S~at~nent of Reglst~ was ~lled)
Origina! for Municipal Building Department
STATEMENT OF REGISTRY
To be filed in duplicate with the municipal building department or local enforcement agency
by every owner of a multiple dwelling, as defined in subdivision 33 of section 4 of the
Multiple Residence Law.
Within 30 days after the filing of this statement, the municipal building department or en-
forcement agency is required by section 300, Multiple Residence Law, to file a duplicate
copy hereof with the State Building Code Commission, 1740 Broadway, New York !9, N. Y.
I. Location of multiple dwelling:
(a) Street and number ....~.....~...~......?....V.~. ........ ../~.....~....~..C../...~..C...../~. ...... ~:...f. ............
........ .~..~...~..E.~.~.~.¢, ....... ..~..~..~.~.:~" ...........................................
(b)
Municipality
2. Description:
(a) Type of construction E../~./~ t..~. ~. ~
(b) Height of building, including number of stor es .PI.../J...//~'....j?(~...~.S;.~'......~.../~..?.
(c) Type of heating facilities ...~..~..~..~../~.....~......H.p...?'.....~..I..~./~. .................
(d) Number of apartments ..... L.~. ................................................... i ..........................
(e) Number of living rooms ..... L..~........~.../......//~....~..~.!../~.......H/.~..?...S'...~.-. ...................
(f) Number of kitchenettes ....L.~.. ..............................................................................
(g) Number of bathrooms ..... J..7. ..............................................................................
(h) Number of water closets ..../..7. ..............................................................................
(i) Number of occupants for which building was designed or intended to be occupied
or used ..~.../:'..:..~..£ ......................... . .......................................................................
3. Age of
(a)
(b)
multiple dwelling:
Date when constructed
Dates of substantial additions, alterations or modifications of dwelling, with
brief description thereof .V.~.~.(.~...~... ..................................................
(c) If now under construction, state when construction commenced and anticipated
date of completion ............................................................................................
4. Use:
Describe the principal use made, or, in: the case of buildings under construction, to
be made, of the multiple dwelling (such as apartment house, hotel, apartment hotel,
lodging, house, boarding house, school, convalescent, old age or nursing home, pri-
vate dwelling two or more stories Jn height with five or more boarders, roomers or
lodgers, or other classification of multiple dwelling including those specified in sec-
tion 33, Multiple Residence Lgw). _
................... .............................................................
............. ..................... .....
.... ...........
(Name of Ow'ne~')
............ iX~J~';~";i"~;;)"~'~'~; ~u c ~<'
L. /.
_ , STA'r~MENT OF FILING
(Building Depar>ent or O~her F~forcement A~er~cy)
Original for Municipal Building Department
STATEMENT OF REGISTRY
To be filed in duplicate with the municipal building department or local enforcement agency
by every owner of a multiple dwelling, as defined in subdivision 33 of section 4 of the
Multiple Residence Law.
Within 30 days after the filing of this statement, the municipal building department or en-
forcement agency is required by section 300, Multiple Residence Law, to file a duplicate
copy hereof with the State Building Code Commission, 1740 Broadway, New York 19, N. Y.
h Location of multiple dwelling: ~,.. · ~
la) Street and number .............. ~.w/-mm~.....~ .................................................
lb) Municipality ..................................... ~/' ~..~..~.~,~. .............................
2. Description:
lb) Height of bud ng, nc Ld rig_ ~-number°fst°ries..._ ~.,__.~_~ ........ ,2._~-)
lc) Type of heat ng fac it es ....~ ~'_[~...~"
(d) Number of apartments ....."."~- ---'''''''' ~7/~/~.~-~.~./.~.~
(e) Number of living rooms ..... ./..~.../ ......... : .................... ; .................. '.'"
(f) Number of kitchenettes ......./.~...
(g) Number of bathrooms j....~..~.~'~ ............................................................................
(h) Number of water closet ..... ~....~. ............................
(i) Number of occ/ul:},~r~s f_0~/~h building was designed or i.ntended to be occupied
or used '- ~'
3. Age of multiple dwelling: /~
la) Date when constructed ........... ~:'.~ ...........................
lb) Dates of substantial additions,~altera~/'ons~,~ ~or~ modifications~ of dwelling, with
, ]j~rief d,~scription there9~ ..~,...'r..'c..'...~. .........................................................
-.....
lc) Ifnow under construction, state ~vhen construction commenced and anticipated
date of completion .............. ~:: ...............................,~ .......................
...... ......... ....
4. Use:
Describe the principal use made, or, in the case of buildings under construction, to
be made, of the multiple dwelling (such as apartment house, hotel, apartment hotel,
lodging house, boarding house, school, convalescent, old age or nursing home, pri-
vate dwelling two or more stories in height with five or more boarders, roomers or
lodgers, or other classification of multipre dwelling including those specified in sec-
tion 33, Multiple ~ Law).~
...................................
Dated .............. ..... , New York
......... .............................. ..................
.~ (Na~e of Owner) ~ ~, ~ ·
...... ...........
_ ~/ (Address of Owner)
· STATF.~4ENT OF FILING ~
Filed with the ~.....~.....~......~ ........... of the
~ ~r trne~t or ~;tl~r ]~forcement~'~g~cy)
7~.~ ....... on the ......... ~.~....~ ................. 1~....~
whom Statement of Registry was l~lled)
Original for Municipal Building Department
STATEMENT OF REGISTRY
To be filed in duplicate with the municipal building department or local enforcement agency
by every owner of a multiple dwelling, as defined in subdivision 33 of section 4 of the
Multiple Residence Law.
Within 30 days after the filing of this statement, the municipal building department or en-
forcement agency is required by section 300, Multiple Residence Low, to file a duplicate
copy hereof with the State Building Code Commission, 1740 Broadway, New York 19, N. Y.
1. Location of multiple dwelling: . ~/ , A
(b) Municipa,ity ............................ -- .......
U
2. Description:
(o) Type of construction .......... ~E~......~. ........................
(b) Height of building, including number of [tt~ries ..... -~.~.~.~....~......~.~.'.1~ ~
(c) Type of heating facilities 0~,~ ~-,_,_x~'l~-.~.-~,.~.. .............................. .~
(d) Number of apartments ............. L.~.. ....................................................................
(e) Number of living rooms .............. .~..~... ...................................................................
(f) Number of kitchenettes .............. ~.~ ...................................................................
(g) Number of bathrooms ............... ~..~i ..................................................................
(h) Number of water closets ............. /.~... ..................................................................
(i) Number of occupants for which building was designed or i'ntended to be occupied
or used ............................... .~.. L, ........................................................................
3. Age of
(a)
(b)
multiple dwelling:
Date when constructed ...L..?....~....~......>../...~.~....~..~......~...../...~.~...~.. ................
Dates of substantial additions, alterations or modifications of dwelling, with
brief description thereof '
(c) If now under construction, state when construction commenced and anticipated
date of completion ............................................................................................
4. Use:
Describe the principal use made, or, in; the case of buildings under construction, to
be made, of the multiple dwelling (such as apartment house, hotel, apartment hotel,
lodging house, boarding house, school, convalescent, old age or nursing home, pri-
vate dwelling two or more stories Jn height with five or more boarders, roomers or
lodgers, or other classification of multiple dwelling including those specified in sec-
tion 33, Multiple Residence .Law).
........................................... ............................................ ::::
Dated at ..*~'~/~...., New York
............ ~.~.... ~..~. ............ , 19i~.Z...
(/'t u AI S 'FF' T T )
q (Nanle of Owne~)
...... ....... .........
STATEMENT OF FII. ING
(Signature and Designation o~ Official with
whom Statement of R~istry was l~lled)
Original for Municipal Building Department
STATEMENT OF REGISTRY
To be filed in duplicate with the municipal building department or local enforcement agency
by every owner of a multiple dwelling, as deft.ned in subdivision 33 of section 4 of the
Multiple Residence Law.
Within 30 days after the filing of this statement, the municipal building department or en-
forcement agency is required by section 300, Multiple Residence Law, to file a duplicate
copy hereof with the State Building Code Commission, 1740 Broadway, New York 19, N. Y.
1. Location of multiple dwelling:
(a) Street and number ......~./~_.~.~...~.~
2. Description:
(a) Type of construction ...... ~....~...~....~...~: ................................
(b) Height of building, nc td ng number of stories ..../..~..r.~ - .~ ...............
(c) Type of heoting facilities ..........~ ................................
(d) Number of apartments
(e) Number of living rooms ...... ~ ............................................................................
(f) Number of kitchenettes ...... ~ ...........................................................................
(g) Number of bathrooms ........ ~ ........................................................................
(h) Number of water closets
(i) Number of occupants for which building was designed or intended to be occupied
or used ................... ~ ..........., .......................... , .............................................
3. Age of
(a)
(b)
multiple dwelling:
Date when constructed ./.. ? 'fi' 7
Dates of substantial additions, alterations or modifications of dwelling, with
brief description thereof ....................................................................................
(c) If now under construction, state when construction commenced and anticipated
date of comp et on C~...~ ..~.. ~......../...?.....~'....~. .................................
4. Use:
Describe the principa. I use made, or, in the case of buildings under construction, to
be made, of the multiple dwelling (such as apartment house, hotel, apartment hotel,
lodging house, boarding house, school, convalescent, old age or nursing home, pri-
vate dwelling two or more stories in height with five or more boarders, roomers or
lodgers, or other classification of multiple dwelling including those specified in sec-
tion 33, Multiple Residence Law). ~
(Name of Owner)
(Addres~ of Owner)
STATEMENT OF FILING
( ' ding Departn~ent or Ot~er En~rcerner~A~ency)
..~~....~.~..~.~.. on the .......... ~......'~... /~ .... ]95.Z.
cCM/L ~ /-/.qUN~ 7-E 7-1-ER
Nay 2~ 1068
Ma~then Wi].liamson & Eisenstadt
170 Old Country Road
Hicksville~ N.Y.
Attorneys
Attns John Williamson
Dear Sir~
In re~ly to your letter of May 1st BEs Nattituck Notel~
Bay Ave.~ Eattituck~ N.Y.t Please be advised~-
This motel was built prior to the adoption of the To~n
Zoning ordinance and has been carried on our records as a "non-conforming"
use since that time (April 1957),
The small building in the South-east cornerof the propertyt
(near the road) was approved and built as an accessory building -
recreation room only - after the zoning ordinance adoption.
The last registered owner was Emilie Haunstetter.
The premises have not been inspected for several yearst
and will need to be inspected before registering to a new owner,
Trusting the above will be helpful to you.
Yours truly
Building Inspector
Original for Municipal Building Department
STATEMENT OF REGISTRY
To be filed in duplicate with the municipal building department or local enforcement agency
by every owner of a multiple dwelling, as defined in subdivision 33 of section 4 of the
Multiple Residence Law.
Within 30 days after the filing of this statement, the municipal building department or en-
forcement agency is required by section 300, Multiple Residence Law, to file a duplicate
copy hereof with the State Building Code Commission, 1740 Broadway, New York 79, N. Y.
1. Location of multiple dwelling: //j /,~
(a) Street and number ~.~/.~..,v~ .~.~.~ ,
2. Description:
(a) Type of cons~truction ........ ~~ ......~.....~....~......~..~ ...............
(b) Height of building, including nu_gnber of stories
(c) Type of heating facilities ....~..~...~....~....~... ...........................
(d) Number of a~artments ..... /'.~. ............................. ;: ........................................
(e) Number ;[ li~'ng r°;~eS ..... ./. ;~/. ......... .................... : ...........................................
(f) Number o k'tchene es .......~ ..............................................................................
(g) Number of bathrooms ..... ~..~ ............................................................................
(h) Number of water closets ....~.../ ..........................................................................
(i) Number of occunan/s for wh~h building was designed or intended to be occupied
or used .......~......."-..~......~.. ........ . .......................................................................
3. Age of multiple dwelling: 17
(a) Date when constructed ........... ~.~~. ............................
(b) Dates of substantial additions, altera~ons or modifications of dwelling, with
, ]~rlef dsscnpt,on t ereoJ, ..~...~~~ ......................................
//~./.~.. ? -- $/t~/~', - /~/~../.~...~
'r ~ ........................ ;Z;7';;","- r ;~ ....... . .............. '7'""-"7" ...... ' .............
.......... ................................................
(c) If now un~er construction, state when construction commenced and anticipated
date of completion .............. ~tt ............................... ~ ......... , ...............
...... ......... ....
4. Use:
Describe the principal use made, or, in the case of buildings under construction, to
be made, of the multiple dwelling (such as apartment house, hotel, apartment hotel,
lodging house, boarding house, school, convalescent, old age or nursing home, pri-
vate dwelling two or more stories in height with five or more boarders, roomers or
lodgers, or other classification of multiple dwelling including those specified in sec-
tion 33, Multiple R_esi/ci_e_~ Law). ~
.............................................................. ...................................
Dated at .~~ New York
............................. "*'¢ .................. ........
.r~ (~ o~ Ow~e~-> ..-) -7-/-'7'----
............
STATrr~AENT OF FILING ~
Filed with the ~~.....~.....~.....~ ........... of the
(BulldOg Dep~rtment or Other Enforcement~.cy)
.~..~..~ ....... on the ......... ~.~....~ ................. 1~....~
~ fame of Municipality) (Date of 1~lli~
whom ~t4~t~nent of l~eglstry was Filed)
FORM NO. 5
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Al:fidavit: of Final Cos : ot: Const:ruct:ion
STATE OF NEW YORK '~ ss.:
COUNTY Of ....$....'~,..~.O....]~.. ............................
.................................................................................................... , being duly sworn, deposes and says:
(applicant or agent)
that he (she) is the applicant (or agent of the applicant) named in the Application for Building
Permit dated ...................... NO~'.......~ ......... 19..6~ .....relating to construction or other work to be
performed on, or in connection with, the premises located at ..1~/~q.....,~a~...~'.D ..............................
.J~.....t,.~..~'~..~.g~.~...JJ,~.. ; that the estimated cost stated in said application, of the construction
or other work described therein was .......... .e.~.[.J)..~...~..~o.~&rtd .................
Dollars ($....8.$.QC}.0. n.O.Q .......... ); that the actual finc~l cost of such construction or other work was
~..~...~.~.f:~4,~.,,.~-~4~..~?. ...... ~ ........... Dollars ($ ........................ ,. ...... ) and that the
said construction or other work was performed in accordance with the applicable provisions of law.
(applicant or agent)
Sworn to before me
I Residin tn S of New York
No. 52-7031050
~311~mlssion Expires March 3g~ ~970
Filed Cost $. J~ t O. CIO.,~ ............
Permit Fee Paid $...26.~.00 ............
Final Cost $....../...6q.~../.~.~...~. ......
Additional FeeS ...... . .~..~....~.~-.'~.'. ..........
(Costs for the work described in the Application for Building Permit include the cost of all ~f the
construction and other work done in connection therewith, exclusive of the cost of the land. If the
iinal cost is less than the estimated cost stated in the Application /or Building Permit, no portion of
the fee paid upon the filing of the application will be refunded.)
TOWN OF SOUTHOLD
BUILDING DEPARTMEHT..?L~
, TOWN CLERK'S
SOUTHOLD, N.
~.omin~ ......... ~ ....... I. ........ . l~ ..........
..........
.......................... ....~ ....................
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to th~ Building
Inspector.
b. Plot plan showing location of lot and of buildings on premises, relationship to ad oining premises or public streets or
areas, and giving a detailed descriptianof layout of property must be drawn on the 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 on the premises available for inspection througl~out 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 !S HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of 5outhold, Suffolk County, New York, and other applicable Laws, Ordirmnces 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, buildin, g~,code, housing code, an~,regulations.
(Signature 0'f applic~, o_r name, if a corporation)
(Address of opplicQ~)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
................ ~.~ ......................................................................................................................................................
Nomeof ow.er of pre m,ses .~.~..~ ..m.~..~,,~.~,,,x'......~ ........... ~...~......,d..~.~ .........................
If ~licant is a co~orate, signature of duly authorized officer.
(Name and title of corporate officer)
1. Location of land on which proposed work will be done. Map No.: ..................................... ;.. Lot No.: . .......................
Street and Ndmber ................................................................. ~.~.~,.,....~..Z~..~...~..~ ......... .~.~..~.././.~ .......
Municipality "' /
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
~..~/~..
a. Existing use and occupancy .............................................
· u ~
b. Intended use and occ panty ................ ~.~'~,~. .................................................................................................
3. Nature of work (check which applicable): New Building .................. Addition .................. Alteret~ion
Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........... ~ ............................
4. Estimated Cost ...~./L.~...6.-.'~.. ~ Fee
(to be paid on filing this application.)
5. If dwelling, number of dweIling units ............................ Number 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 / /
7. Dimensions of existing structures, if any: Front ..........~...~'... .......... Rear ..... .~'..Z..../. ............... Depth .....~ .........
Height ..... Number of Star es ../...
............................... .................................... ........
Dimens ons of same structure w th a terat ons or add tons: Front .......... 4~. ...................... 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. Date of Purchase ........................................................ Name of Former Owner ........................................................
1 1. Zone or use district in which premises are situated .....................................................................................................
12. Does proposed construction violate an.z zoning law,,cor¢inance or regul~ion;~ ....
Name of Owner of rem,ses'~?..7'' 7'///'..~.,~Z-4~ ~/'~'~ '~9' /~ .........................................................
13.
p ......,~.~.. im;¢~/,,¢4 ........... Address . ./..~/./~..~...'./~././..~.'~ ....... Phone No .....................
Name of Architect ....~.:?.~. ............... i...~ ........ ,-. ........ Address ......................... Phone No .....................
Name o~ 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 co 6er lot.
STATE OF NEW YORK,
COUNTY OF ................................ ~ ....
..... ~~..~..~ ....... ~....~..~ .................. being duly sworn, deposes and says that he is the applicant
(Name of individual signing ~cation)
above named He s 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
that the work will be performed in the manner set forth in the application filed therewith.
.S..~.:.~..t.:~b.~.r.: d;;tho: ...~.¢.&~:~..: 19..~.~~......:...~~ ...................
Notaw Pu~~....~.,....~ ....... County /(Signatu~f applicant)
NOTARY PUBLIC, State of New York
No. 52-3233~20 Su ~olk County
Term [xp res March 30, 19~
Duplicate for New York State Building Code Commission
STATEMENT OF REGISTRY
To be filed in duplicate with the municipal building department or local enforcement agency
by every owner of a multiple dwelling, as defined in subdivision 33 of section 4 of the
Multiple Residence Law.
Within 30 days after the filing of this statement, the municipal building department or en-
forcement agency is required by section 300, Multiple Residence Low, to file a duplicate
copy hereof with the State Building Code Commission, 1740 Broadway, New York !9, N. V.
1. Location of multiple dwelling:
(a) Street and number ........................................................................................... :.
(b) Municipality ....~.?.../~..~..e~./..~......~..".~..~...~...?./ .......................................................
2. Description:
(a) Type of construction ft~q..~. E .~..,~_J~
(b) Height of building, including number of stories .~...//Z.~....~..o..U..~.~,.,-.., .7".~....~.....~..~.~/~$ ¥ I ~'"~
(c) Type of heating facilities ...~.~..~..~.....~4~..~.......'.~...LJ~.......~.../...~. ........................
(d) Number of apartments ......... ./..~.. .........................................................................
(e) Number of living rooms ......... /....~... ........................................................................
(f) Number of kitchenettes !
(g) Number of bathrooms ........ /..7. ...........................................................................
(h) Number of water closets ....... ./.2 ..........................................................................
(i) Number of occupants for which building was designed or intended to be occupied
or used .~ ~' :~.~.. ........................................... ~ .....
3. Age of
(a)
(b)
multiple dwelling:
Date when constructed ~...~.../~'.~..~.?/.,/)/. .................................................................
Dates of substantial additions, alter~)ons or modifications of dwelling, with
brief description thereoft/...~..l~..~...~...'~. ....................................................................
(c) If now under construction, state when construction commenced and anticipated
date of completion ............................................................................................
4. Use:
Describe the principal use made, or, i n the case of buildings under construction, to
be made, of the multiple dwelling (such as apartment house, hotel, apartment hotel,
lodging house, boarding house, school, convalescent, old age or nursing home, pri-
vate dwelling two or more stqrJes in height with five or more boarders, roomers or
lodgers, or other classification of multiple dwelling including those specified in sec-
tion 33, Multiple Residence Law).
...................... ; ......... .........................................
Doted ot .~.~....~... ........... i New York
................. ~....tj~ ................ , 19~. ~. .....
(Name of Owner)
....................
STATEMEN~T OF FILING
................ ~...'~./~/~/on the ................. ~..~ ........ 19~....~
(Name of ~ctpa~y) ~ / ~te of ~)
............... ....
(Slg~e ~d ~t~ation ~ Off~cl~ with
whom Sta~t of ~t~ was ~)
Duplicate for New York State Building Code Commission
STATEMENT OF REGISTRY
To be filed in duplicate with the municipal building department or local enforcement agency
by every owner of a multiple dwelling, as defined in subdivision 33 of section 4 of the
Multiple Residence Law.
Within 30 days after the filing of this statement, the municipal building department or en-
forcement agency is required by section 300, Multiple Residence Law, to file a duplicate
copy hereof with the State Building Code Commission, 1740 Broadway, New York 19, N. Y.
1. Location of multiple dwelling: _ v//
(a) Street and number ......... .~r./.~¢~.. .......... ~,¢¢~r/~......~ ....
Mun cipo, ........................ '-' ..................
2. Description:
Type o{ construction .................. ~ ................
Height of building, including n~mber of stearins . ./.O..~--~_~.. .......
Type of heating facilities ........ ~..-~.......~ ............................
(a)
(b)
(c)
(d) Number of apartments ............. /..7. ......................................................................
(e) Number of living rooms ........... ./../7... .....................................................................
(f) Number of kitchenettes ........... ./.~. .....................................................................
(g) Number of bathrooms ............ /..~.. ....................................................................
(h) Number of water closets ......... /...~... .....................................................................
(i) Number of occupants for which building was designed or intended to be occupied
3. Age of
(a)
(b)
multiple dwelling:
/.
Date when constructed ........ '~"'~7' ....... /'~"Y/"')'"/"'~' '''~'':''''/''''y''''f''' '~" ........
Dates of substantial additions, alterations or modifications of dwelling, with
brief description thereof ....................................................................................
(c) If now under construction, state when construction commenced and anticipated
date of completion ............................................................................................
4. Use:
Describe the principal use made, or, in the case of buildings under construction, to
be made, of the multiple dwelling (such as apartment house, hotel, apartment hotel,
lodging house, boarding house, school, convalescent, old age or nursing home, pri-
vate dwelling two or more stories in height with five or more boarders, roomers or
lodgers, or other classification of multiple dwelling including those specified in sec-
tion 33, Multiple R,~4idence Law).
................ i..i....i.....i .................. (...z4(. .........................................................
Dated
at ........ New York
....... ...... .......
~ ~ (Add~,es~ c~ ~r)
7,
STATEMENT OF FILING
Filed with the .~~.~..~~6..~~,~,,,. ,, -- ~ ...... of the
~ ~(Bulld~¢ ~partment or ~er ~o~ment
(S~mature and Designation ~f Official with
whom Statement of Registry was Filed)
FORM No. 5
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
ORDER TO REMEDY VIOLATION
Date ..../'~...~..J ..........~....-~. ............ 19 ........
(owner or authorized agenf ~f owner)
(addr~ of owner or authorized agent of owner) f
PLEASE TAKE NOTICE there exists a violation of:
Zoning Ordinance ~ 7 '"~'6~:"7~'~? ..................
Other Applicable Laws, Ordinances or Regulations.'],~ ....... ,~.~.....,0 ....... ,~ ........
at ~,emises hereinafter descr'bed 'n that...~..~~..~..~..~.~.~
(state charactfr of violation)
·
............................ .................
in violation of.~~....~,~.~...~......~~.O.I ..........................
(state secRon or paragraph of applicable law, ordinance or regulation)
YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the
conditions above mentioned forthwith in or before the .......... ~..~ ..................................
day of ............ ~~ ......... 1 ~..1.....
The premises to which this ORDER TO REM EDY VIOLATION refers are situated
~r~/.~t¢~¢.., ...... ~.~~.... County of Suffolk, New York.
Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law
may constitute an offense punishable by fine or imprisonment or both.
FORM NO. 5
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Affidavit of Final Cost ot: Construction
STATE OF NEW YORK
................................................ ~......~7:......., being duly sworn, deposes ond says:
(applicant or agent)
that he (she) is the applicant (or agent of the applicant) named in the Applicatior~ for Building
Permit dated ........... ~.../....~.. .... 19..~....7..... relating to construction or other work to be
performed on, or in connection with, the premises located at .......~r./~.~......./...~....%....~
/..~ .~I,<~,~,,~.....~..C.~.~, ..~...-.~that the estimated cost stated i~n said application, of the construction
Dollars ($...~..J....~.......~....); that the actual final cost of such construction or other work was
...... ?~...~....~..~...~..__..-~........Dollars ($..~.)...~TtO. ......... ) and that the
said construction or other work was performed in acc,q~anc~e with the aj~plicable p/c~visions of law.
(applicant or agent)
Sworn to be(ore me
th is..~....~.....~...day of.....~ ....... 19...~..~.~.
Filed Cost $..(~..o...~..o..! ..........
Permit Fee Paid $....~.....L..O....~. ...........
Final Cost $,.(~.~ ........
Additional Fee $...~.
(Cost~ for the work described in the Application for Building Permit include the cost of all o~f the
construction ~ad other work done in connection therewith, exclusive o~ the cost of the land. If the
final cost is less than the estimated cost stated in the Application {or Building Permit, no portion of
the fee paid upon the filing of the application will be refunded.)
M~, ¥%lltau¥tokham, Attorney
HainRoad
Nattttuek~
In answer to 7o~r~ telephone ~qut~y tod~Y p~eaae be ad. ced
that t~ ~tuek ~tel, W~ ~ AVe. 0 ~l~k, ts a ~egt~to~
~tlple resld~o aa ~q~ ~er the N~ ~k ~tate ~lttp~o Ro~tdeneo
lavo f~ tr~lent ~e~ ~de~s, toe,ate, ~tel ~t8 oM.)
At the last inspection of the premises there were n~ v~olatlons
outstandinf, The ~eudses il a ~eo~~e~e~e %~
~ati~, ~ing tn ~ ~Au district, ~e ~e sever~ dlr~t~o~l
a~e~tiling ol~s ~oh ~o ~ ~e pr~ses ~ ~e ~bJ~t ~ the
~xoloned &re statement of re~tst~y£o~met v~llyoukindlyhave tho
no~ owner complete them and fol~ they hire and ~een eopy to mot and
keep the pink oopy for h~o records,
T~ust~ng the above w~ be ouff~e~ent for your needs.
Zours tru~
Bu~ld~nf lnspeetor (
TOWN O;' E}O'UTHOLD
SL,I~...~ C.CIUN'T'Y, N~'W YORK
OFF'II~E ~' BUILDING INSPECTOR
TO: ............................................. '2" ...................
...........................
Please take notice that them exists a violation of the Multiple Residence Law and/or
premises above mentioned as follows-
Sectim:
Section:
.Se~pn: t37~
Section:
Section:
Section:
YOU ARE HEREBY DIRECTED AND ORDERED to comply with .the law and rmnedi/ the core~
Failure to remedy the r..~xtdittom aforesaid and coi~Ply with ~he applicable provisions of law eq~
comtltute on affe~e punilhoble by fine or imp~ a~ both.
TOWN OF SOUTHOLD
APPLICATION FOR BUILDING PERMIT PURSUANT
· TO MULTIPLE RESIDENCE LAW
New Multiple Residence Building
APPLICATION NO.
LOCATION
// ~ ,9 ~'-7
-
um Street
Height: /O / ~'~'¢~~ Area:
Distance from Nearest ~orner
(I) Type of Occupancy
(Permanent or Translenf)
1 (Fireproof or Non-fireproof)
[3) Estimated Cost of Construction ~
(4) State what disposition will be made of waste and sewage
(Public sewer, private sewer, cesspool, etc.)
($) Occupancy (in detail) as follows:
Stow
~nclude
ellar & Persons fo be
Basement1 Apartments Rooms Accommodated
Cot B
First ~ ~.~.~ ~ ~ ~
Second
Third
Fourth
F~ffh
Sixth
Seventh
TOTAL ,.~ /..f g .~/,~,,,~ ~
DIAGRAM.
The said lend and premises are situated es folio
The norfh point
of the diagram
MUST agree wlfh
f~ee arrow
Page I
STATE OF NEW YORK
COUN OF SUF O,K
being duly sworn, deposes and says: That he
(Typewrite Name)
in the City of ./~TT~' '?-~/C,/c. in the State of ~ L~ ~ FB/~-t~.. : +ha+ he is making this
application for +he approvalof ~ ~ T~CTu~ ~ ~ ~T~c~ ~
(Architectural, structural, mechanical, etc.)
plans and s~cific~+ions herewffh submiffed end made part hereof, and that fo +he best of his knowledge and belief,
the work or construction will be carried out in compliance with such plans and specifications, and that it will conform
to ell applicable provisions of +he laws 9ove~ning multiple residence construction.
(SI~N MERE) / ~'-~ ~~ ,Owner
Sworn to before me, +his
day of. , 19
Notary Public or Commissioner of Deeds
If application is to be execuhed by someone other than owner, acting in h~s beheff, the following additional inform-
ation should be supplied:
Owner's Name Address.
(If a corporation, give f~ll name and address of at least two officers)
(SIGN HEREJ , Applicant
Sworn to before me, this ~D~.(S/ ~:~ 4ay of ~ , 19 ~?
Notary Public ' · ILGI~ II~/DEN
~ State ef
Examined and Recommende~
for approval on ~
Approved
FOR OFFICE USE ONLY
/ ,9 -7
Super;ntendent,
Work commenced on ~ /' ~ I~afe Completed 19
I HEREBY CERTIFY that the above report is true in every respect and that the work indicated has been done
in the manner required by law and Rules and Regulations of this Department.
Signed
Inspector.
Page 2
TOWN OF SOUTHOLD
APPLICATION FOR BUILDING PERMIT PURSUANT
TO MULTIPLE RESIDENCE LAW
New Multiple Residence Building
LOCATION "~/j~/c.~-~'/''''' I~
House Number
Street Distance from Nearest ~orner
(I) Type of Occupancy (Permanent or T~..s;enfJ"
J4) State what disposition will be made of waste and sewage ~ ~o~-~ T-~ ~
(Public sewer, prNafe sewer, cesspool, etc.) ~ ~ ~ ~ ./~ & ~-~ /~ ~ ~ ~ ~ I
Occupancy (in detail) as follows:
Story
include
ellar & Persons fo be
BasementJ Apartments Rooms Accommodated
CorB
First ~
Second
Third
Fourth
Fifth
Sixth
Seventh
TOTAL
DIAGRAM.
The said land and premises are
N
slfuafed ~
The north point
of the diagram
MUST with
theagrea
STATE OF NEW YORK
COUNTY OF SUFFOLK
being duly sworn, deposes end says: That he resides et
in the City of a~,~ ~ ~C~ in the State of
(Typewrite Name)
: that he is making thls
application for the approval of
(Architectural. structural, mechanical, etc.)
plans and specifications herewffh submlfted and made part hereof, and that +o the best of his knowledge and belief,
the work or construction will be carried out in compliance with such plans and specifications, and that if will conform
to all applicable provisions ~of the lews~.~governlng multiple residence construction.
~y Pubfic ~r Commis~oner of Deeds ' '~r' Pu~fic, State of ~ew Y0~
~f application is fo be executed by someone other than owner, acfin9 Jn his behalf, the following additional inform-
at;on should be suppl;ed:
.Address
(If a corporation, glve full name and address of at least two officers)
(SIGN HERE)
Sworn to before me, this
day of.
Applicant
19
Notary Publlc or Commissioner of Deeds
FOR OFFICE USE ONLY
Examined and Recommended
for approval on ~'~/~,,~
Approved on
Examiner.'
19
Superlntendent.
Work commenced on
I HEREBY CERTIFY that the above repod' is true in every respect and thef the work indicated has been done
in the manner required by law and Rules and Regulations of this Deperl'ment.
Signed
Inspector.
Page 2
TOWN OF $OUTHOLD
APPLICATION FOR BUILDING PERMIT PURSUANT
TO MULTIPLE RESIDENCE LAW
Altered or Converted Multiple ResidenCe Building
APPLICATION NO. / ~.~
LOCATION Hou~/~umber / Street
Height:
(i)
(2)
(3)
Type of Occupancy of Bu;Idlng
to be-a~fered or converted
Type of Construction
Use and Occupancy after Alteration
or Conversion
/ '(Permanent, Transient. or PrJvite~/~/~/
( ~Jreproof ~,~orl-f;reproof )
(4) A new C of O Jwill) (will not) be required
(iSn~t~uude EXISTING OCCUPANCY PROPOSED OCCUPANCY
Cellar &
Basemen+) Persons fo be
Apts. Rooms Apts. Rooms Accommodated
Cor B
Second
Fourth
Fifth
Sixth
Seventh
TOTAL
(6)
(6) Estimated Cost of Alte;at;on or Conversion
State generally~in what manner the Building will be altered~(or cony. erred .//~""~":2
,.... -L.~-~~. :~....._..£.,< / 7_ / o
(7) Is Appficat,on made fo remove violations? If yes,: State Violation Nun~ber
~Public ~wer, private sewer, ~sspool, etc.) /7
Page I
STATE OF NEW YORK
COUNTY OF SUFFOLK
(Yypewrlfe Name)
be,ng d~y swor~ depo,s ~nd says: The, ~e resldes af
,,pli,,fion for the ,pprovel of
(Arc~f~ctur~l. s~ru~tu~J, mechlnJceJ, etc.)
plens end s~cJfJcef[o~s herew~h submJffed e~d mede pert hereof, end fhet Jo the best oJ his knowledge end belief,
the work or construction will be cerrJed out in compllence with such plens end specJficefJons, end the~ Jf will conform
~o ~ll ~pplJceble provisions of the lews govemin~ multiple residenCe construction.
(SIGN HERE)~'/~ ~~ ,Owner
Sworn
If epplicefion is fo be executed by someone other then owner, e¢fin9 in bls behelf, the followin9 eddifionel inform-
is making this
ation should be supplied:
Owner's Name
;Address
(If · corporation, g;va full name and address of a+ least two officers)
(SIGN HEREJ
Sworn to before me, this
dey of
, Applicant
, 19
Notary Public or Commissioner of Deeds
FOR OFFICE USE ONLY
Examined and Recommended
for approval on
19
Approved on 19
Superintendent.
Work commenced on
19_~r/gate Completed
I HEREBY CERTIFY that the above report is true in every respect and that the work indicated has been done
in the manner required by law and Rules and Regulations of this Department.
Signed
Inspector.
Page 2
TOWN OF $OUTHOLD
Multiple Residence Law Permit
PI::RMIT NO. JJ_ll,_~_ _~_.~,~,. ~ 19..~.~APPIlCATION NO.~ 19 ~
LOCATION Jl.l~, l~ A,~,~ Jl~t.,~'l~ J'.~.
Application having been made on ll¢~Y~e I~ , 19 68
covering construction on a &'Jt. erat~'.~ori o~. l~tm.~fl~ ~I~D'Ie ~.(].elfi~
(new, altered, or converted)
, for a permit
multiple residence building, by or in behalf of IIs~t~t~tt~_lr Natal (~e~q~ B'II~ ~Op)
, for · dwelling located as above stated, and the said
application havinq been examined and recommended for approval on R~ ~r , 19.~, · PERMIT
is hereby issued for the performance of the
alteration ¥ol'k
Jerchitecturel, structuraJ, mechanical, etc.)
work described in the above numbered application and any ~ccompanylng plans and specifications.
If no work is performed w~thln one year from the time of its issuance, this PERMIT shall expire by limitation.
Approved ~ 19 19 ~L
Enforcement Officer
NO, 1
'r~N OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
APPLICATION FOR BUILDING PERMIT
Dote ...................................... , ?
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building
Inspector.
b. Plot plan showing location of lot and of buildings on premises, relationship to adioining 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 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, os herein described.
The applicant agrees to comply with oll applicable laws, ordinances, buHdioa--code, housin~,-code, o!~J)rea~dotions.
(Signature of~pp~cant, j~' na~e, if a corporation)
................/.-./Z..~..~.~.~.......x ................... (Address of"('applic~t~'''; ..........................................
State whether~c~lica~ i/s 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.
(Nome and title of corporate officer)
1. Location of land on which prgposed worl$ w)ll be done. Map No.: ....................................... . L~,.9.t No.,: .......................
Street and Number ............... /.- ................................................................................... ; ................... ./ ...... ../.....~ .......
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ................... .~ ..............................................................................................................
b. Intended use end occuponcy ..................................................................................................................
3. Nature of work (check which applicable): New Building .................. Addition ................. ?AI.f~ration
Repair .................. Removal .................. Demolition .................. Other Work (Describe) ~ .......................................
4. Estimated Cost ~.. ~ - tee ..........................................................................................
(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 nature and extent of each type of use ............... ;~ ..........
, ~x -- Depth ..../.~ .........
7. Dimensions of existing structures, if any: Front ..........~...~.. ........... Rear ......... 7. ...................
Height ........................ Number of Stories .... ~ .................................... ~,;.~..y .................................... ~i~.~ ........
Dimensions of same structure with alterations or additions: Front .......... .f2. ...................... 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. Date 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,,,3~, ~~regulati°n? ...........................................................
..... z 2'
Name of Architect '"'~'7' ...... .~.......~/~.~..Address ..~.;~.-~.~.~...... Phone No .....................
Name of Contractor .~.~....~/...~..........v~.,...x..'./....~..~..,..J v~ x~/o~-~'~-- ....... Address"../~/. 7~../.~...'...<..'2.'.'~..~'"'" Phone No .....................
PLOT DIAGRAM
Locate clearly ond distinctly all buildings, whether existing or proposed, ond indicate all set-bock dimensions from
property lines. Give street and block number or description according to deed, ond show street names ond indicate
whether interior or corner lot.
STATE OF NEW YORK, 1. c ¢
COUNTY OF ................................ .f ....
(Nome of individual signing a~ication)
above named. He ,s the ................. ~Z~.~ ..................................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke and file
this application; that all statements contained in this application are true to the best of his knowledge and belief; and
that the work will be performed in the manner set fo~h in the application filed therewith.
Sworn to before me this / J ~ ~ . 4
NO, 52-3233120 Suffolk Count~
Te~m Expires March 30, 1~ 2