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HomeMy WebLinkAbout76-zl~Ol~W NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CI~ERK'S OFFICE SOUTHOLD, N, Y, CERTIFICATE OF OCCUPANCY conforms substantiaIly to the Application for Bui1Oing Permit heretofore flied in this office dated ............ .~...~. ............. , 19.~... pursuant to which Building Permit No ........ ~..~.. dated ........... ~q~,q~..~ ............... 19.~.., was issued., and conforms to all of the require- merits of ~he applicable provisions of the law, The occupancy for which this ce~ificate is This certificate is issued to (owner, lessee or tenant) of the aforesaid building. NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTM£NT TOWN CLER~('S OFFICE SOUTHOI. D, N. Y. BUfLD~NG PERMIT (THIS PERMIT MUST BE KEPT ON THE ~.9R~QV,:E~P~t~,H:$.~¢.,~MD~E~.-~4~F,¢~Cc~j~I'~ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No...,Z....Zd ......... Permission is hereby granted to: ,'r, [~'. Z-:feZ~:,;~.....~'~.....;:;n~?.k..l&~;Lc~4-),~,,~.~:~ ................ at premises located at ...~/.(~..~.~.~.~.~:~.)),..?~.~,.¢.-.q~,..[;~;?~,.*~'~., ................................................................... ........................... ~!~.~.t:..~..u. ~!~,......~.~. ~ ~:. ........................................................ pursuant to application dated ......................... ..¢?.l:~'.(f~.1..~......~F. ............... 19...~.~.., and approved by the Building Inspector. Fee $..!.~Z.9~....~~ /~r~ -~ ull lng nspector FOR~.~ NO. 1 TOWN OF SOUTHOLD SOUT.O .D, ,. E×om ned ......... Approved .................. !}. ............ '.'...,., 19,..~..~.Permit ~" '~ ~ .......... ...... ..................... (Building Inspector) Application No..Z/....~-~.. ........... APPLICATION FOR BUILDING PERMIT a e ............ : ........... d ......... "/' .................... 19 ............ I NSTRUCTI ONS 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 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 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 Occuponc'~, 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 oth~er applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or olte~'otions, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable lows, ordinances and regulations. (Address of applicant) State whether applicant is owner lessee agent, architect, engineer, general contractor, electrican, piLimber or builder If applicant is q corporate, signature of duly authorized officer. ~t'~dr~ (Name and title of corl~orate o~:ficer) 1. Location of land on which proposed work will be done. M~p No. ¢.~:~f~::~;,.~Y.~..~:.z.~.. Block ...... .......... 2. State existing use and o~cup~ncy of pr~mi~ses and intended use and occupancy of proposed ConStruction: a. Ex st ng use and occunqncv ......... ~.Z.Z . T.~. , ......... ~cnecl< 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, commericoJ 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 construction: Front ~'~ Rear "~ ~' Depth Height ............................ Number of Stories 9. Size of lot: Front ....... ../,_0,.,f.",.4.~.. Rear ...,~ ................ Depth I0. Zone or use district in which premises are situated ........ Z~......~,,,d.,.'"'~0,.., cf..~..,. 1 I. Does proposed constructio~ violate any zoning law, ordinance or regulation? ...... ~..~. ................................ 12. Flame of Owner of Address fr Phone NO Name of Architect ...........C~/~/.-/] .......................... '~ ............ Address' ' '" '~~: ~.%~. '"'*Phone~,~ NO. Name of Contractor....~-.:~;a:.~.m:~.../,.~,,ct.',?r'.,~.:.:.: .......... Address., ..~...'.¢:.~:...~.;,~.,,~/~¢::.~'r.....Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, end indicate eli 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 OE,.NEW "~DRK, --) COUNT~~...) SS.' ~....~/ , bein duly sworn, deposes and says that t~e is the applicant ' (Name of individua~'signing app ication) above named. He is tF.e (Contractor, agent, corporate officer, otc,) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and fi~e this application; that oil statements contained in this application are true to the best of his knowledge end belief; and that the work will be performed in the manner set forth in the application flied therewith, Sworn to before me this .... ./..,~,. ........... day of ..... t~k,l,. :. ................. 19..~..~.., / ~.//[Sing~ture of opplicarf~) FORB~I NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined Approved ........................................ 19...~..!..Permit No -'~ '~ ~ Disapproved a/c ........... ~..~.:~ ..~..::::;.: ....... .~.~.~..~i'i: .... ................................. ........ :..:.:.. .................. .................................. (Building Inspector) Application No.~......~~. ............. ^PPUC^T,ON FOR U LD,NG PERM,T Date .................. ( ............. ...... 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. Up,on 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 b~ 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 Departmentr 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~gnd regulations. ~' ............................................... ~: (Signature of ap.plicanJ~, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land onwhchproposedworkw Ibe done Map N~.?././..~..~ L(.~J?~..~Bac< ~ ~!:'.d-- Street and Number ~..~....~...~ ','j Z./..'' .'..~..Z '..~..'~ ' ' '~/'"~'~; ~':'~"'?:.i ~(i ...... '~"'~ ............ ................... ~ ........... : ................ L. .'~-.~...~. ......................... ::....: ....... ;.'.: ....................................... 2. State existing use and occupancy of premieses and intended use ot'~d occupancy of proposed coi~structJon: a. Existing use and occupancy .................................................................................................................................. b. Intended use and o, cu-an,,, t>~,-',."-~L ~ q','-~ ~ 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ...... f.~ .,m'. ............................................. ee * (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 ............................ De[~th ............................ 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 .......... ,~....~C... ........ Rear .................... ~ '~' ........ Depth ..... ~..~ ............... Height ............................ Number of Stories ...... .~.. .................. 9. Size of lot: Front .~.....~...~..'~it..).: ........ Rear ......... .~..'~... ........... Depth ../..~,..:.~..*...~.!..~.L I0. Zone or use district in which premises ore situated ................ ~..~...tT.:?. ....... ;.~....~.....~/~...~ ................................... · > J~ :-3 1 I. Does proposed construction violate any zoning law, ordinance or regulohon .......... ~.~.......~. .............................. 12. Name of Owner of remises ~--t~.-~ .~..~..~.~r~,ddress .~.., >$' ~'~, ~r..~..~ Phone .................... Name of Architect ....................... r~'"'"~;~.v ........... Address ............................................ Phone NO ..................... Name of C ....... :~..! ...................................... 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 NEY" YORK, ) COUNTY~~~' . ...... ) S S.' ..~.. ........ ~~' ................................................. being duly sworn, deposes and says that he is the applicant ,:/~/ (Name of individu&l signing application) above named. He is the ~ ~..:~ .......................................... i~'~'r;~r~'~¥<~;",'; ~; ~:',' '~'~;[~';~ 'e' ' ;~'~i~';'r',' ' ;;'~; :i ............................................ 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 ....... /.,~..' .......... day of ....~(,Z_~..: .................. 19..~:~..'/.. atary ........... County ~elfdng in Suffalk Comffy ~ (Singature of applic~t)