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HomeMy WebLinkAbout73-zTOWH OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY N o....~......~ ......... Da te ......................... Apri],_.~L~. ~ ........... 19~.f~ .... THIS CERTIFIES that the building located at ~/.~....~,~.~.~(t,..~.],...V.~ ...................... Street Map No Lall~.h.:Lt2§...1~/~t.t,e~.s. Block No ............. JBeO..~. ............ , Lot No .... .l~...~Oll.t~o3~i..~.. cgnforms substantially to the Application for Building Permit heretofore filed Jn this office dated ............................. ~.U.~.I~.¢..~......]-...~....19~.'~..., pursuant to which Building Permit No ...... .~...~.] ............. , dated ....................... ~.e;g.~f~.~.~..~,~....19,.~.~.., was issued, and conforms to all pf the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ............ .................................................. .P.'[~T,~f~,'~',..DI~F..L[,.t. Nf~ ....................................................................... This certificate is issued to .]~l~gH~,~C]...CJ.~].]~t~8,fl .......... (...Ot~;'~,e~..) .................................................. (owner, lessee or tenant) of the aforesaid building. Building Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CL[RK'S OFFICE SOUTHOLD, N. Y. BUIlDiNG PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES ULL COMP, LETIO OF THE WORK AUTHORIZED) No ........ ~.....7.~ ...... Permission is hereby granted to: Date .................... ~ .................... ~).(... ..... ~.~t .~.~t ~.~ c~;, ·... · ~f~ ,.~. · ..................................... to ....D~ ~ ~d...ne~z.. d~.~.l ].~.n~ ............................................................................................................ pursuant to application dated ............................... ~l~ll~-¢,......~.~t ....... 19..~.., and approved by the Building Inspector. Fee FO~M NO. 3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTIC~= OF DISAPPROVAL 3.2 South Mo=utaXn Avenue l.I.o.~,¢~.~.~..N,Z, ...................................... PLEASE TAKE NOTICE that your application dated .............. .A..~.~..~...~..~.....~..~.. .................. for permit to construct ...f]:..~.,.~..]r..~..~.~..~. ..................... at the premises located at ........ 1~..0...~. ~..h .0. ~ .C1:. ~...~ t .~. ?. ...................................... Street Mal~. ,~..~..~...~.~-~....~-I~. ~ .~..~...~... ~ .~oc ~ ......... ~.~..~ ............................ Lot ....~..~. ................................... is r .._ .;?,',',',',','~disapproved on the following grounds ...A..~...~.~....~.~.~.~...~.~...~.~....~..9.~....~. .......... ........ l~...w~th..las~ ...~han .. lO0...f.~ ~.. fr.on~¢.., .................................................................. Building Inspector FO~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERICS OFFICE SOUTHOLD, N. Y. Examined ..................... ~ 9 ........ Approved ....... ~.~.:..,... .......... r ....... 19 ........ Perm,t No -- D sapp ved o/c ........ .................................. ...... ....... ...................... (Building Inspector) APPLICATION 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 a detailed description of layout of property must be drawn on the diagram which is part of this location. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval 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 o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. ........................ ....................................................................................................................... Nome of owner of promises ......... ~.~....~<(~..f'....~'.~.....-~.......~.i.~..¥~.~....,~ ............ ~s-/.z:, .................. : ............ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................................................................................................. 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ~ ~ ........... Fee (to be paid on filing this application) 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 nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth ............................ Height ............................ Number of Stories .............................................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ / 8. Dimensions of entire new constrbction: Front ....... ~..?. ............... Rear ........ .'~...~ ............. Depth ...'?...~ .................. Height .......... ]...~.. ........... Number of Stories ............................ 9. Size of lot: Front ........ .~.~.. .............. Rear ....... ..~...O.. .............. Depth ........ ./..~ .~.. ......... 10. Zone or use district in which premises are situated .......... ..~...~...~.~.~. .................................................................. 1 1. Does proposed construction violate any zoning law, ordinance or regulation? ........ ~..,'. .................................. 12. Name of Owner of premises' ......... J"' ~' '~'~' ~'".~ .......... Address ............................................ Phone NO ..................... Name of Architect ...................................................... Address ............................................ Phone NO .................... Name of Contractor...Z~..~../~..~...C.~......~..~..~.~.C~..~./...~'...~.Address ~ .... '/Z ....... /, ............................ Phone ~,..~, ....... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW~Y?R.K, · ) COUNTY OF.~r~C~t,Z~. ....... ) S S.' .................................................................. / ............................. De ng duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ......... ..~...O.....z~..~/.?....~....Cr.~....0.../.~. .......................................................................................................... (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 Jn the manner set forth Jn the application filed therewith. Sworn to before me this ............. oyof ............ ............. (Singature of alzf~licant) FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SGUTHOLD, N. Y. · / 3 S 7 ................................. Approved.....~ .................. 19 ........ Permit No ,2 7 Disapproved a/c .(~J,r~,,,..c,~...,,~,.,,~ ; ............... .................... ............................ 7'"'". ......... ....... (Building Inspector) Application No.....~..,7..~. ............ APPLICATION 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 a detailed description 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. Upon approval of this application, the Building Inspector will issue o 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 port for any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or nome, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. ................................. ..................................................................................................................................... Nome of owner of premises ........... ~.:<::L/.:: ..... ~..':., ....4~,~<*.~,,:,~,~,'~,(.¢ .... : .....(.,/4.,:.,~ ....................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) · L: /? ~i r~', , . . 1. Locotion of lond on which proposed work w l bedone MopNo'.~-c..~.'.'.'r.l~.¥:~-{I.,/~.h[.~, ~j~r~_kd,9.~..tf/~7' ~/~ ., · . -- /~ _, .', _ ~. ~j ,' ......... ,~, ............................... 2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction: a, Existing use and occupancy .......................... ~.:..;~*, h2-,12:72T.i::;T..T:D,~-.L-.::..: ................................................ b. Intended use and occupancy ~./k. 4,.~, ¢ -, , / 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ...............~...~..O....o..o. ........................... Fee .~....0....~.'~.:'~ .......................................................................... (to be paid on filing this application) 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 nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth ............................ Height ............................ Number of Stories .............................................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ 8. D mens~ons of entire new construchon: Front ....... ~.~ ................ Rear ....~. ...................... Depth ~O ......... Height ........ l.~.. .............. Number of Stor es ..]. ........................ 9. Size of lot: Front ....... ..~..~. ................ Rear ....¢..0. .................... Depth .....J.~..~. ................ 10. Zone ar use district in which premises are situated.......'x.;.~...~ ............... .~ ................................................................... 1 1. Does proposed construction violate any zoning law, ordinance or regulohon ..................................................... 12. Nome of Owner of premises ~ . .~.~...~..~...Address ............................................ Phone NO ..................... Nome of Architect ...................................................... Address ............................................ Phone NO ..................... Name of Controetor.~./~.~!.~.tn. 7.~.~...~..0...~.~.~.-~'...G. .......... 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 numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEWj~2YO~R~K, ,,/] ) COUNTY OF.~.....) S S.' ....................... ~ ................... ~.. ............ /. ............................. bmng duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ........ .(~.J)../~/..~T'..4'?./:~..~.0...).~. ................................................................................................... (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. Sworn to before me this da of ~.~' 19''~7 (Singature of ~pplicant)