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HomeMy WebLinkAbout86-zFOI~ NO. ~ TOWN O~ SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No, ,.~,,,:~15 ........... Date ............................ ~.e......1..O.. .............. ~9.5.9.... THIS CERTIFIES that the building located at..l~sSa..~.OsJ~/~D..A.v~ .......................... Stree~t Map No.~..~.~,..... Block No ......................... Lot No ....... J~:%holl~t....~J~.e ................................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................ ~+~ ....... ~/,~....., 19.~1~..., pursuant to which Building Permit No ....... ,~..~.~. ............... doted ............................... ~.~g~.~t~....2~.., 19.5.~..., 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 .............. ............... .p.~j,~.~ .~...~,~..~.~.~;~., .~.e.~.~.~ ......................................................................................... This certificate is issued to ....l~TC~,~..D.~..~t~ec~' .......... .(I~QI~'~I ........................................................ (owner, lessee or tenant) of the aforesaid building. Building Inspector FOI~I~I NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL PLEASE TAKE NOTICE that your application dated ...................... for permit to ~construct ..~..~..at the premises located at'~......~..~..~,~ Map ........................ ..~z: ............ Block .................. ~ ......................... Lot ~ is ~r~:d ~ro'~ disapproved on th%follow~ng grounds~.~..~~ / ui ding nspector ~ FOI~3/I NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Iq. Y. Exam ne . . . ~ ........................... Approved....,.~.?,~M/~.. .........~ ............ 19..~.../.,.Perm,t No,.,,~.~.:,'].~:,,~ Disapproved a/c 'z ........................................................ "~";-'"z/ ...................... (Building Inspector) Application No ~" ~' APPLICATION FOR BUILDING PERMIT ate '~' ,.L 19 INSTRUCTIONS o. 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 odioining 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 k~pt on the premises available for inspection throughout th,e 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 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. ............. ....................... (^ddr;';;";'F:;;iicont> ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electricon, plumber or bu'~r. Name of owner of premises ....... , ............................................................................................... If applicant is a corporate, signature of duly authorized of ricer. (Name and title of corporate officer) ¸, Location of land on which proposed work will be dane. Map No ................................... Block .................................. Street and Number .., .~. ......... . ........................................................ ~.~:~...,~ ....... ~,:..~.~. ................... . .......... State existing use and occupancy of premieses and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................................................................................................. b. Intended use and occupancy ~.,C~.~,.",~'~'~.~.~,.. , , 3. Nature of work (check which agplicable): New Building .................... Addition ....................Alteration .................... Repair ....................Removal .................... Demolition .................... Other' Work (Describe) .................... 4. Estimated Cost ...~/.-~.,......~.......~..?.,?.; .~.~. ................... Fee .......................................................................................... (to be paid on filing this application) FEES: If dwelling, number of dwelling units .......... l, ............... Number of dwelling units on each floor ...... ../. ................... tf 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 construction: Front ....... ..~....~h....~.~((~..~'. Rear ..... .~..~..~.~.~...~... Depth ..~.~....~.~.~.~.z~.... Height .......... /~....~..~..~...'~Number of Stories ......... ../. ................ 9. Size of Jot: Front / ............................ Rear ......... ./.'./...~....~.~..~.... Depth ...~..~..~.~....~....~....~-...~/~ 10. Zone or use district in which premises are situated...../~.....]./.~.: .................................................................... 1 1. Does proposed construction violate any zoning law, ordinance or regulation?.....~ ....................................... 12. Nome of Owner of premises~d......~.:.. Address~'.~.~?~J-/~..~.~ ' ......................... r ....... hone N O. zf~/~.~'../m..~.... Name of Architect .......................... ~... ddress ............................ · hone NO ..................... Name of Contractor ...... Address ~...~.~..~.../~......~J~.. .......... 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 NEV~ YORK, '~ ) S S .. ' f (Name of ind~(idual signing application) above named. He is the ................................................ ~~:....~..~ ................................. (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 wJJl be performed in the manner set forth in the appllcat[on flied therewith. Sworn to before me this . ..... ~....~.. .......... day of ........ ..~,. '....,-~ ................... 19,~.....~.... '/' ' Notary Public,...,~,.~....~.f.~..~x.~L,~../cZ~.,.f~,.~-.u~(Z&,~,./.....i.Caunty Approved ...... . ..~;,s.I}¥. :!,,:,...~: .......... 19.~.j.'..Permit FOBM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ............................ APPLICATION For BUILDIN( PERMIT Dote .......................... .......... 9.. :2. INSTRUCTIONS o. 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 d!e diagram which is port of this location. c. The work covered by this application may not be commenced bbfore issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue o Building Permit to the applicant. Such permit shah be kept on the premises available for inspection throughout the progress of the work. e. No building shall bb occupied or used in whole or in port for any purpose whatever until a Certificate of 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, end other applicable Lows, 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 all applicable laws, ordinances and regulations. ........ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, eJectrican, plumber or bu'~r. Name of owner of premises ...... ;../~,,~.~.~.,.¢.w~_,wr ....................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) t. Location of land on which proposed work will be done. Map No ................................... Block .................................. Street andNumber ~.~(-/~.. ,,,~:'~. ~ ..~,~.'7. .~....~.. ................. ................ 2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction: a. Existing use and OCCLpancy ~ ;; , ......... ~unecr, which opgiicoble): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition. ................... Other Work (Describe) .................... 4. Estimated Cost ~.....~,.,.,.~:f74..~-/¢..~. .............................. Fee ....!,.~.~.....:: ......................................................................... (to be paid on filing this application) FEES: 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 construction: Front,,,'~...'.~......~.~.~-.~.?. .... Rear ~.'~....../~.~,..~...~..(.~..,.,. Depth ...~. ~.......,~./.~..~....7~... Height ...... f.~....~..~..~../..'~... Number of Stories ....... /. .................. 9. Size of lot: Front ...... ../,.,~,.,0. ............ Rear ........ ./../..~....,~,,, .... Depth 10. Zone or use district in which premises ore situated ...... ~ ....... .~.{.~m...~.-.J..". ................................................................. 11. Does proposed constructic~n violate any zoning Iow, ordinance or regulation? ...... 12. Name of Owner of premises,~f-~..Z~..:~..Address .6.'.~.....~:,,~,.~../..~.~,.~,. ~.......Phone NO.~X¢.,~.....~..~.,. Name or ^rcnitect ...... ,~ ....................... ,...,,.,,.,, ........... Address ................... ~, ..................... rhone NO ..................... Name of Contractor~__ ........... Address J~..~'..~/~'...../..~,....../.~... NO." * , .......... Phone ................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-back dimensions from property lines. Give street and block numbers or description according t9 deed, and show street names and indicate whether interior or corner lot, STATE OF NEVi) YORK, , ,, ~? SS.' / (Name of in;~fv~duol signing application) [ obove homed. He is the ................................................................ m.,.-u~,....'~- ......................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duiy authorized to perform or have performed the said woH¢ 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 appiicatlon filed therewith, Sworn to before me this ...... · ~, .~, ......... day of ....... C~.~..,: ................1 9.*~,,'~.~.*. Notary PubI lc, ....~,~.../~'~¢~c,~'. ' '-~..t;~:', ........County (SIngature of applicant)