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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