Loading...
HomeMy WebLinkAbout48-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. CERTIFICATE OF OCCUPANCY No...(~O ................. Date ....l.9.. ,,Ta~lle;~r. ............................ ... 19..~. THIS CERTIFIES thor the building located at .]~z,..t. va.t,e...r..t.~h.t~:.e,e....N~, ................. Street Cedar Beach Park. N~:OUthOld ~ Map No ..................................... Block No ..................................... , bo~ ..................................... conforms substantially to the Application for Building Permit heretofore flied in this office dated ........... ~17~.~..,~.~ ............................ T g..~'., pursuant to which Building Permit No '"~'"'N'8"'"r ....... , dated .~:~L~...1.~ ...................................... lC~. .....was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ............ ........... ne~...d,~ell~.ng. ..................................................................................................................... :, This certificate is issued to .~.O~..,Y,...~Selll~l ............................................................................ ; (owner, lessee or tenant) ~i:'./ of the oforesoid building. ~. Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. I~UILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No .......Z.,AO ......... Date .......................... ~'ZZly..,..~l. 5, ..........19~7... Permission is hereby granted to: ,]' O:,~.~;'~.. ,~t. ,,,,...L ~ ~3 ~,¢ ~,.,~ ~ ~.:~ .......................................... . .~& :~!'~¢;, .e... ~;.~,,~'..'.;,L..~ ;~....~¢.~,~r. .............................. ( e.c~,~.w~..b~A~.. ~,, ~) ....... ~o~t, ~..~,w ,...~ ~. ~ to .~:~:..~e~f.,(~,~e~L.]:~ ................................................................................................................ ..................................... ~ ¢.~&% .~.~t, ,,~Z%,... ~ ~Z~ %,.%¢- ~......~.,.;~,., ......................................................... pursuent to epplicetion deled .............................. ~tZ3,~...-.;].~ ............. ]gE)~..., end epp~oved by the Building inspector. Fee $. XI,O.~,0O .......... FOI~I NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×omined.....,.~......L~...... ~ ~57.. ~j ,, - ,, ,r~ ' No Approved ........................................ 1 9 ........ Permit ................................. Disapproved a/c ...... ~~~~.~.~.~,~.::: ......... ........ ................ (Buildin ~ APPUCATION ~OR BUILDING PEe*aIT Dote .......... ~....Z.~ ............................ ~g.~..;.'. .... 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 adjoining premises or public streets or areas, and giving a detailed descripHon of layout of property must be drown on the diagram which is part of this location. c. The work covered by this application may not be commenced before issuance of Building Permit. d. U~n approval of this application, the Building Inspector will issue a Building Permit to the applicanL Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply w~th all applicable laws, ordinances and regulations. .... . ~ :...~..~ ....... (~;~X.'~:~.~.. ':~.~.~ .r~:~ ............................ ~Z~,'f~;~ of ~,,c~,, o~ ~me, ,f a co~o~,o~ ............... ~.~4.~:~.:~:T~f.~::.~ ........ ~.¢~.....: ...................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrlcan, plumber or builder. .................. / . ...... .~,,?~.¢,~.2..c. ~ZZ~ ...................................................................................................... Name of owner of premises....X/~/~.~..~:....~....~:~......~~,z.~,g~4:~-~~ .................................................... If applicant is a corporate, signature of duly¢6uthorized officer. (Name and title of corporate officer) ~. Location of land on which proposed work will be done. Map No ........... ~ ...............Block Street and Number ..... /~.~.'./.~.~..'...~, .~.....,.~¢.~/. ........ e~.?.....~...~......~....~....~_...;~ ....... ~....~.....c.~.~ 2. State existing use end occupancy of p~mieses and intended use and occupancy of prOposed construction: a. Existing use and occupancy........~../.'./?~?--~: ......................................................................................................... b. Intended use and occupancy ...... ~.~.~..f.d...~C.?~v../.'.~r~4.~:~..c.£~, ............................................................. 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................. ~,.ther Work (Describe) .................... 4. Estimated Cost .... /....~'...f~:~..'?. ........... Fee./. C'~ ............. (to ~ pai~ .................. FEES: ,5. If dwelling, number of dwelling units ........ ../. ................. Number of dwelling units on each floor.....'...'~... ................. If garage, number of cars ........................................................................................................................................ 6. If business, commerical or mixed occupancy, specify notu~ and extent of each tyre. of use 7. Dimensonsof~exstngstructures fany. rF~"OontM.~ ~ Rear ~ De i'''''~ ....... Height ..... ~i..~ ......... Number of Stories ....... ~ ......................................................... Dimens}ons of same structure with alterations or additions: Front ............. ~ .................. Rear ................................ Depth .................... ~ ......... Height .............. ~ .......... Number of Stories 8. Dimensions of entire new construction: Front ~z//' ! ,~ ............................ Rear ............................ Depth ~7/'''~ i Height ........ ~.~..f...~:...~.~... Number of Stories ........ ./. ................. 9. Size of lot: Front ....... Z.¥ ............... Rear ..... ,~,,~.Q ............. Depth ............................ 10. Zor~e or use district in which premises are stuated ~.,~..~.~.).' ~-~ ~¢-e 1 1. Does proposed construction violate any zoning law, ordinance or regu at on? ............................................... ........... ~ ....... - ...................... Phone Nome of Arch tect ,~..~,'.:...~.....~..~:q~.. ..............Address .....~...c..~...~:.¢/~.,,.~.. ........... Phone NOi Nome of Contractor ~'~,~,~:~....~/..~..~...¢./,..~..~:.-~, . Address ...~,%,?.~ ~ ~'Z,~f..~/.. ............ Phone NO. SJ~.,?.....~..Z~.¥ PLOT DIAGRAM Locate clearly and distinctly all buildin~:~ ,~',':.',!~,;' ~ ~,,,:r, o~ f~:~,~,~ ,~,~ ~icate all set-back dimensions from property lines. Give street and block numbe,:: ,,, :,',: :~', ~':~ ~:~':'~u~c-. ~ [ '. ,i':-,,.~! .:->..'-~ show street homes and indicate whether interior or corner lot. : - , \ \ \ \ \ \ \ \ \ \ \ FOI~NI NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. o,.....o.., o. ...... ......................... (Building Inspector) Application No..~ ~...~... ..... APPI. ICATION FOR BUILDING PERMIT Date .......................... 19:~ 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 adjoining premises or public streets or areas, and giving o detailed description of layout of property must be drawn on the diagram which is part of this location. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval 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 Southoid, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with oll applicable laws, ordinances and regulations. ........ ~.¢'~.~.~.'.~-, ...y*.~..; ...... '~.,~...,,...:-:,...,~,.,¢....;~¢..~ ...................... ::ig~ature (¢~ applicant, or neme, if a corporation) (Address of applicant) State whether applicant' is owner, lessee, oger~t, architect, engineer, general contractor, electrican, plumber or builder. ·. ........................................ .............................................................................................................................. .................................. ~ ........... y~.'...,.,:. :..~:..,..~;....~ ................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed wo~'( w be done Map No ,,, '" Street and Number ...... ~. ......... (~ ............. ~...~ ............................................... ~ ................................. ~ ........ State existing use and occupancy of premieses and intended use and occupancy of prOposed construction: o. Existing use and occupancy.....~:,-~ ................. L.? ¢? ' .............. b. ntended use and occupancy Z~&:~;~'~ ~q~>,-< 3, Nature of work (check which applicable): New Building .................... Actdi /on .................... Alteration .................... Repeir .................... Removal .................... Demolition. ................... Other Work (Describe) .................... 4. Estimated Cost ,. ~.. ....... tee ,....~. ................................................................................... (to be paid on filing this application) FEES: 5, If dwelling, number of dwelling units ...... ..........z,............__ · Number of dwelling units on each floor ........ :..-~.. ............... if garage, number of cars ........................................................................................................................................ 6. if business, commerical or mixed occupancy, specify nature and extent of each type of use ......... ~..."~. .................. 7, Dimensions of existing structures, if any: Front ........ :..'Z~... .............. Rear ............... ~. ............ Depth ............................ Height ................... *..'~.:. Number of Stories ................ ~ ............................................................................................. Dimensions of same structure with alterations or additions: Front ~ Rear ................................ Depth .......................... '~... Height ........... ~ .............. Number of Stories ................................ 8. Dimensions of entire new construction: Front .................. Rear ............................ Depth ........................... Height ....... ~-..~. ........Number of Stories ................. 9. Size of bt: Front .......... ]~:...: ...... Rear ........ ~.~ ............. Depth ......... ' ................... ]0. Zone or use district in which premises ~re s~/uarea ........................ -..r: ............................. ~ ................................... 1 1. Does proposed constructi~ violate any zoning law, ordinance or regulation? ............ ~.~ ............................... ~.~.-Address ............................................ vno~e ..................... Name of ContractorX~¢¢;~ ....... ~.- .............. Address ..,).~.f.~ ................ PhoneNO .................. Locate clearly and distinctly all property lines. Give street and b(ock whether interior or corner lot. PLOT DIAGRAM bc ....' : ~ ,:~ ~:.>. t::- , ~, .-} ~, ~ ~.., indicate afl set-bock dimensions from nt,: ,, ,~ ~,:~'~,, . tz ..... t,,: (.~ ~. ~.~:i 3nd show street names and indicate 'x ! ! !