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HomeMy WebLinkAbout88-zFORI~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY ZHIS CER'FIFI£S that the building located at ..~/.S.....~.,~y...~ve ................................ Street Map No....G.,....]~....~U.t~t.'l.]:.'l.. Block No ..................... .~,~.~......, Lot No.?8.~...~&.t.~.~.t~ue~.~.....l~,~'o conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................... J~U~.....~,C) ................ 19..[~.., pursuant to which Building Permit No .......... ~...~ ......... , dated ............... ~e.~ ..........~.~ .............. 19..,~.., was issued, and conforms to all of the requirements af the appticable provisions of the Iow. The occupancy for which this certificate is issued is ............ .................................................... ~.~.V-A.~F,..D~.F,.4r~LZ;~4G ...................................................................... 'Fhis certificate is issued to ...~].~.e.~...~e~.l~,e.~. ....... (...~eZ?.)-.....: ................................................. (owner, lessee or tenant) of the aforesaid building. Building ~nspector ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES ¥~;~1¢~N.~,,~{~;~C~,~.~, APPROVE .~ S Zl FULL COMP,LETION OF THE WORK AUTHORIZED) No ..... ~..-.8~ ....... Permission is hereby granted to: ............ ;~ ~:¥..¢% 1.t~.*ek.~...** .~'I~,~ * ............................. to .....~,te~.$~e. * .8,?~,..~t ~?e.,/~, .~on...t e... e~t~.t &,-~,~O'' ¢,~'~e3,]* ~zr~i .......................................................... at premises located at ¥~.~S..~;t*~c?Z...~¥g~. .............................................................................................. ................................................. "~t ¢,'&.~ t.~ e~ r ....... *~.,* ........................................................................... pursuant to application dated ................. ~,~,F-~¢:8~..-.2'~ ....................... 19~.~....., and approved by the Building Inspector. Fee Building Inspector FOP~M NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL .... £~?..,...r.: m? ........ ;. ~:..~m:..'/'m~..~..:: ...................... ~ ........ ~.. ~ L ~..:~ <':~,. rf& ~ :-,,~....'~ .............. : ...... : ....... PLEASE TAKE NOTICE that your applicotion dated ~ ~ ~ for p~t *o ~o.~.~t .~~.~ ........ ~ ~ p~i~ ,o¢~t~a ~t .~..Z ...................... .... :~..~-,:.,~.....~~. ........... ~,~ returned herewith and disapproved on tke ~ollowing grounds ......~~v · '- ............... ...~::~:~:.~ ...... :~,~...~: ........ :.~:~,.....~ ....... ~:::-(? ...~....::..~:,?~,....::....~. ~....,:..e.: ~...zA:.~.:....:~ ............ ..~.~-z...::~,.~..~.~.~,..~.,~ ......... . .............................................................................. '. ............ Building Inspector FORI~I NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×om ned ...... ........... ...... Approved ........................................ 19 ........ ermit No ................................. Disapproved a/c . ......_..~...... ........ .¢M-~. ...... Application No...~.. t'~.',....~,... .... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 Dremises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any Ip.urpose 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 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, electricon, plumber or builder. Nome of owner of premises..~.~..~...~ ......... /..~...~'~ ................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which B,roposed workwill be done. Map No..~..L[.L./..--..~..~.~.....-~4~k~ Street and Number ...'..~..~ ........~"¢/'7' ....... ~7 ...... Stat ex~stm use and occu anc of rem~ese and ~ntende ' e an 2. e ' ' g p y p ~ ' d us d occupancy of proposed construction: b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Bufldi¼g .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... g. Estimated Cost ..~.. .... 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 ......... .~. ............... 2- ~, '~- ~ 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 ! ~, 5' Rear /3, ~ ~ Depth '7 ~' fO <~ Height ............................ Number of Stories ..~ ..... 10. Zone or use district in which premises are situated ...... ./~......./~.~~ ................................... 1 1. Does proposed constructior~ violate any zoning law, ordinance or regulation?_......~. ............................... 12. Name of Owner of premises..~.(~....~..~Address .~...~ Phone NO Name of ' ~ .................... Archnect ...................... ! ............................... Address ............................................ Phone NO. Name of 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 numbers or description according to deed, and show street names and indicate whether interior or corner lot. ~LD~ L~~ (Name of indiwdual sj~ing application) above named. He is the .................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly ~uthorized to perform or have performed the said work and to make and file this application; that ail statements contained Jn 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 ....... ~,.: ............... 1~ Notary Public,~.. J~.~.,....County ,-/ FOI~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exo mined......C.~.~.~. ...... ~'...~./ ...... Approved .................... '.' ................... 19 ........ Permit No..~....~..'....~..... ......... Disapproveda/c ~/~'~ /~'f ~z <., ~ ~)-q ' ~ ...... '~ ..... ,,"~ ~ .......................... .~ ....... .~ .......... ~........ ........... (y ................... (Building Inspector) APPLICATION FOR BUILDING PERMIT are ...................... .~ .......... I ...................... 19 ............ INSTRUCTIONS a. This application must be comp[ete(¥ filled in by typewriter or in ink a~d 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 p.urpose 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 with oil 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, ele~trican, plumber or builder. ................................................. Name of owner of premises....~,r~....~:~:%...~...<d ......... /..~...~.~.~...~.~.~ .................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 2. State exlsting use end occupenc¥ of premises and intended use and occupancy of proposed conStruct[on: a. Ex~st~nguse and occupancy b. Intended use and occupancy Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost (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: ~ront Height ............................ Number of Stories ..... ~ ..................................................................................... Dimensions of some structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ · ,~" ,, ,fi- ' 7 ' fO' 8. Dimensions of entire new construction: Front ........ ./..~.f ............. Rear Depth ............................ Height ............................ Number of Stories 9. Size of lot: Front ............................ Rear ~"' 10. Zone or use district in which premises are stuated 11. Does proposed construction violate any zoning law, ordinance or regulation? ........ ./~...'~.. ............................... 12. Name - , ~. .................. · .............. ~ ........ ,~aaress ..:.~r....'../ .............................. mane mu ..................... Name of Architect ...................................................... Address ............................................ Phone NO ..................... Name of 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 end block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEV~ YORK, ) COUNTY, ,.,~ I/'~/OF~t") SS.' (Nome of indivf'dua[ si~ing application) above named He s 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 aBd~, belief; and that the work will be performed in the manner set forth in the application fi/ed therewith. . ' Sworn to before me this ....... .~....~.. ........ day of ..... ~.,: ................... 1 9...~..'~..~.... Notary Public,....~.~.~.. ............ oun y My Corem:ss!on £×plrms M~rch .~0, (Singoture of oppli~qt)