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HomeMy WebLinkAbout126-zNO. 4 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .S~.S.....I~i~/:~OW..~ ............................. Street Map No..X~L~,~. ........................ Block No ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................ ~t'""30 ............ 19...~, pursuant to which Building Permit No .. ~f..~,:~6... , dated ........................ ~]~p~,......~O .......... 19.~.~...., 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~ .~.V.A~'~ .. ~!,~/EL~ ~T. NG ............................................................... '. !. ..................... This certificate is issued to ..~o~.t~ho.~i...DO~/e~l~.~.....~oz'.D ............................ ~ ...................... (owner, lessee or tenant) /' of the aforesaid building. Building Inspector FORi~I NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES ~.~$~ W~P~V~,B~,a~~,4~,UNT~L FULt_ COMPLETION OF THE WORK AUTHORIZED) No ..... Z, .326 ........ Date ................. 8e~teml~,~. ,....30 .........19..~[~.... Permission is hereby granted to: Oeo ~m~th &..Sons...A/O..Se~thotd...~evetopmen.t..¢orp~ ........ ~tn...Road.,.Sou.t~hold~......N., .~',, ............ to ......... /~ve.-exes %in~-.-. dwetti.~g...to..-thi~.., toeatio~ .................................................. at premises located at .~/.~..l~...~$e~..Bo/td .................................................................................. ............................................... ~ou. thol~r....//..~.. ............................................................................. pursuant to application dated ................... Sept, eml~.......30 .............. 19..r~7.., and approved by the Building Inspector. Fee Buildin9 [nspector FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUT.OLD, N. '". Approved ........................................ ~9 ........ ~armit m~ ................................. Disapproved a/c Application No,.../.,?i.9 ............. APPLICATION FOR BUILDING PERMIT Dot e,. · -- .~. ·..~'- ·. -~'-..'(, ..i · ,,....~?, ..~· ...................... 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 ereos, and giving o detailed description of layout of property must be drown on the diagram which is port 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 ovoilobI~ for inspection throughout the progress of the work. e. No building shc~ll be occupied or u'sed in whole or in port for any purpose whatever until o Certificate of Occupancy shall hove 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, ordinance.s, and regulations..~ ............ .... (Address of applicant) f State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electricon, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Location of land on which proposed work will be done. Mop No ................................... Block .................................. and Number .~....~...~...~....~,~" '"'~ .................................................................. Street 2. 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 ......... ~.~ .................................................................................................. A terat'on l 3. Nature of work (check which applicable): New Building .................... Addition ........................................ Repair .................... Remov I.~..~ ................. ~_..DemolitJon . ................... Other Work (Describe~ ~'4~v-~,4~ 4. Estimated Cost ./.,...,,._~....,~. oo. ............................. Fee J. ' , .......................................... (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 ......... ,~....~,-rr~.... ..... Rear ....... ~...~ ......... Depth ............................ Height ..~...~..Z../'.. ............ Number of Stories ....... ~ ........................................................................................ Dimensions of some structure with alterations or additions: Front ........ 3..~b, ............ Rear ....,Z~...~ .............. Depth .............................. Height ...//.~-----------------~'.~... ....... Number of Stories ....~ ............. 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ....~...~..~.... ........ Rear ...~...~....~. ............. Depth .,,~...~ ' 10. Zone or use district in which premises are situated..../(..~....~.-.......................~........ ............................................ 11. Does proposed construction violate an,/ zoning /aw, ordinance or regubtion?.~f,...~.:~ ~J2-""~'/~/f")"~J~~"~-- ~ ~'/~"'~ Phone k~n ~., ~, ~;~ 12. Name of Owner of prernises..~.~c-~.~'^'dcWess .............. ,.~,~,~,..-~;.=~. ........................... 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 and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ) i)' ..... ~ ' ...... ' COUNTY OF " ' "~ . SS' ............ ~~..~.~ ................................. beln~ duly sworn, depose~ ond soys thor he is the oppllcont (~omo of*individual si~nin0 opplicotion) , . .... obove n~med. He is the ............................................................................................................................................. {Contractor, o~ent, corporote o~icor, of s~id owner or owners, and is dul~ outhorized to perform or h~vo performed the soid work ~nd to m~ke ond file this oppHcotion; that oll stotements contoined in this ~pplic~tion are truo to tho best of his knowled~o ~nd ond that the work will be pofformod in tho monnor sot forth in the o~plic~fion filod thorew~th. ~ Sworn to before me this ............ ......... ........... ~ (Sin~oture of opplicont) ~otorV Public~...~.~~ ........ County ELOISE BOWDEN ~ Public, State of New York Residing m Suffolk County No. 52-0367800 My Con]mission] Expires March ~0, zg~ ~ FOI~V~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examinea.....~r..r:. {).:'. ........... ~ ..................... A roved " . pp ........................................ 19 ........ Permit ma ................................. Disapproved a/c ~ -' ~ ....... z .............. ...... ................................. (Building Inspector) Application mo ............................ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submi(ted in duplicate to the Building Inspector. b. Plot plan showlng 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. (Sig,~'ature of applicant, or name, if a corporation) % ,(Address of opp~ 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, signa,Cure of duly authorized officer. ........ ..... (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No ................................... Block .................................. and Number ~~ Street ............... ...~...y ................................ ~ ........................................................................ 2. 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 .......... ~ .............................................................................................. 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair.................... Removal .................... Demolition. ................... Other Work (Describe~.~.~ .,~z"/x-~, 4. Estimated Cost ....... ~ ................................................. e .......................................................................................... (to be pald on filing this application) FEES: 5. If dwelling, number of dwelling units ...... ~ ....... Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................................................ If business, commerical or mixed occupancy, specify nature and extent of each type of use ................................ 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 ..../'..~..,~ .............. Rear ..... /... .................. Depth ..../..~ .............. 10. Zone or use district in which premises are si~.-uated ...... ~ ...................................................... 1 1. Does proposed construction violate,, any zoning law, ordinance or regul, gtion?.....~ ............................. .... 12. Name of Owner of premis~J//~~ddress .~ ............... Phone NO ..................... 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 and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF COUNTY OF~.....) S ........... ~...~ ................... being duly sworn, deposes and soys that he is the oppllcont (Name of individual signing application) above named. He is the .......................................................................................................................................................... {Contractor, ooent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and fine 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 ....~ ..0 ............. day of ....... ~..~ ............. 19..~.~..~... Notary Public ,..~......~...¢~~ ....... County ELOISE BOWDEN ~l)t~l!t Publk:, State of New York Residin~ in $~ffolk County My Oommissmn Expires March 30, 19 (Singature of applicant)