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HomeMy WebLinkAbout114-zNO. 4 TOWN OF SOUTHOLD BU~LDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CE~TI~:ICATE OF OCCUPANCY No. Z 592 Date Uune7 19 GO THIS CERTIFIES that the building located at ................. ' ................................................... ~reeT Map No ......................... Block No ......................... Lot No ................................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated September 23 19..:~.~., pursuant to which Building Permit No. dated ................. :f.~.~:~'~.~..~.~ ........ 19..~Z.., 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 ................ PRIVAT~ ONE F~MILY DV~]~LLZNG Joseph M. Andra~e, owner Th~s cerHfica~e is issued ~o ..................................................................................................................... of the aforesaid building. Building Inspector FOP~M NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES r~:l~f~t~?~ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ......... ~...f~t.~cl~O.l~l ~...,I,Y.,~ ..................................... at premises located at ...~.~.....~fk~,~;.....G~; ........................................................................................... ................................................... C z .&¢g,'.r~.~,.~..... ~.;.,.X, .............................................................................. pursuant to application dated ............. ~.C.J~I~.~,~L,..iU.....,:.~ .................... 19.ff~..., and approved by the Building Inspector. Fee S}.O.,.OO..... ~J,, l.o Building Inspector FO~ NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. · ~Ct~" ~3 5-' Approved ........................................ 19 ........ Perm t No ................................. Disapproved o/c jO/c- App[icotion No ......... ( ./....b.( .......... 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 Jot 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 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 Bui[ding 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, ordinaqp;es~.~__~.~.,~4.~and regulation.sj~.>. /? ........... ...... re 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. Name 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 proposed work will be done. /~ap No .......... ~ .................. Block .................................. · Street and Number 2. State existing use and occupancy of prerr/ieses and intended use and occupancy of proposed construction: a. ×,st,ng use and occupancy ......... ....................................................................... b. Intended use and occupancy ............ ~...J~...e_~. ......................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition ....................Alteration .................... Repair ....................Removal .................... ,Demolition ....................Other Work (Describe) .................... 4. Estimated Cost .......~.~..~,2~.....M~. ........................... ;.:...Fee I~,~,~ ~ (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 ....'~...~.. ................. Height ..... ./....~....~...27 ........ Number of Stories ....... .~......~m. .......... 9. Size of lot: Front ..... ...... Rear ...... /~..~-d.?..~, ....... .. Depth ....4..~..~.~ ........ ]0. Zone or use district in which premises are s' tuated ~.~..~..."....~{~....~....~....~"...~.. ................................................... 1 ]. Does proposed construction violate any zoning law, ordinance or regulation? ........ ~.~...;: ................................. 12. Name of Owner of premises...~....~.?..P../~...../~....N....~..~...~'~ddress Name of Architect ...................................................... Address ............................................ Phone NO ..................... Name of Contractor.7.{~..: .~..&~...~.~...~...-~..~..~..~ ......... Address ..,~.O..'~...~".-~./~..~..~....~.....~.......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. COUNTY 0 .~ ............................. i. .................................................................. being duly sworn, deposes and says that he is the appllcant (Name of individual~l,~i,~ 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 crud 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 flied therewith. Sworn to before me this .... ~:~.~.,~.~,... day of ...... ~..., ............... 1 9..~..~..Z.. Notary ' , ........ g ~t2,,¢,~/.~..,~ ............ y I~LOI~E BOWDEN ~,OMly P~blic, Stat~ of New York Residing in Suffolk Cou~l~ No, 52-0361800 My Commission Expires March 30, Z9 ~'~ (Singature of applicant) FORM NO. 1 TOWH OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, FI. Y. Approved ........................................ 19 ........ Permit No .............. Disapproved o/c ..... ~ -' (Building Inspector) Application No ......... !...f...~'! .......... APPLICATION FOR BUILDING PERMIT Dote.....N~"~....~ ....... ..~.;....~.. ................ ,9.-.~.~.Z.. 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. Ul~on approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kFpt 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 untir 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 all applicable rows, ordinanq~ and regulations.~ (Signatu~qe of applicant, or name, if a corporation) ........... ......................... (Address of opplicadt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. (Name and title of corporate officer) 1. Location of land on whic~.roposed work will be done. Map No ..... ~ .................... B ac ( ............................ Street and Number ..~~..: ...... ~.......~.~ ......... ,~.~..,Z~'~'....,,/~: ..~..,~.: ........... ii .... 2. State existing use and occupancy of premieres and intendRd use and ~ccupancy of proposed construction: a. Existing use and occupancy .............. ~'/~../~.~.*~r~'..Z.~...~..~.. .................................................................... b. Intended use and occupancy ................ .~..~..~... ~.. ..................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition ....................Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ..... ~..~,,.~....Z?~. .................................. 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 ...~T...~... .................. Height .../....~......~...~.' ......... Number of Stories ...... ~../~....~'. ........... ~ ~' ..... /....~..~...~. ........ Depth.....~.....'~.....~.. .......... 9. Size of lot: Front .....~..'......O.. ...........Rear 10. Zone or use district in which premises are situated ....... 4%~....~;...~....~../~.~..4(....Z~....~...~.. .................................................... I 1. Does proposed construction violate any zoning law, ordinance or regulation? ....... .~..~ ...................................... 12. Name of Owner of premise ..~...~.~..~..,~._~.~..~....~.....J'.~ddress ..~./~.f.~..~..'.~..-.....~...~.. ....... Phone NO .......... '--'-. .......... Name of Architect ...................................................... Address ............................................ Phone NO ..................... Name of Contracto /~...:,~./~}~./~'....~.,~'..A.~'.~ .......... Address .S~..~c'~l~.~..4-.x~.....~..-.,e~. ......Phone NO~°'~"~'l..~... 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 NEW YORK, , ) (Na'h~e o{ individual 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 c~re true to the best of his knowledge and belief; and that the work will be performed Jn the manner set forth in the application flied therewith. Sworn to before me this . ~ .~..'~¢,e~. · ..... day of ............. ~.: ............ 19..~../,.,.. ~otary Public,. ...... EL~ISE BOWDEN N'otary Public, State of Now YO~ Restdmg in Suffolk Coun~ No. 52-0367800 M~' Commission Expires March 30, ~.9 ,:~'(-v/ / (Singature of applicant)