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HomeMy WebLinkAbout134-zFOI'~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, hi. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at$/~..~.~...~e~J~..]~O~ ........... t ...... : ..... Street Map No...O~o.o~...Park ..... Block No ..................................... , Lot No., ........... , ......................... the App cat on for Bu ding Permit heretafare ~ed [n this office dated conforms substantially to doted ...... 0~...~ ............................19~ .... w~s issued, ond confolms to n~l of the requirements o{ the ~pp[icoble provisions o~ the I~w. The occuponcy for which this certificate i~ issBed is town er, lessee or ~enanr) of the aforesaid building. / r ' Bud ng'-~pector ~ ' J NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF ************* ~]~D~,VF~tI~NfZA~B~GI~I~t~T,~(~, UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: Geo. W. ~mith..&..~on~.....A/C.....L~ui.s..Es~ne~ ........... He&n-.t~ead. ........................................................... ........ Se'a.t, heI..d, r .....~.,.~., .................................... to ....... Mui, ld...new.. ~wel.llmg ......................................................................................................... at premises located at 8/S...pi~e...}~eek.,.Road...&..O~kwood...Drtve ........................................... .................................................. So~ho ~6 ~.....~ ~. .......................................................................... pursuant to application dated ~ 19 and approved by the ................... Oe~'='"'3 ..................... FF'"', Building Inspector. Fee $.10, O0.....pe, id FORM NO. IL TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19 ........ PermJ~ No ................................. Disapproved a/c ............................................................................................ (Buildin0 Inspector) Application No ............................ APPLICATION FOR BUILDING PERMIT 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 adioining 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, lhe Building Inspector will issue o 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 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 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, electrican, plumber or builder. ........................ .............................................................................................. Name of owner of premises .............. '.....T: :....~...~r......~<..~-~,r~,f,~-,~,,,¢, ....................................................................... 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. ~ .................................. ~.r.~. ......... ,../...~../~... Street and Number ~2;D~z~cc...:~... 'fr.,~.~.....~../.~.~ tat ex~shn use and occu anc ofraremteses and ~ntended use an o 2. S e ' ' g p y p ' ' d ccupancy of proposed construction: a. Existing use and occupancy......%~~... ................................................................................................... 3. l~!atl.lre of work (check which applicable): New BuJld~ng ....... ~...Adclltl ....................... Alt .... i ....................... Repair ....................Remg~al .................... Demolition .................... Other Work (Describe) .................... ~7~/~--'~ ~ Fee [0~-~ 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: 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 .......... t.~.~.....~..~.~.. Rear ............................ Depth ..~..~....~.....~... ...... Height..,~rr.....'~.,..~...7~.. ........ Number of Stories ..../.. ..................... 9. Size of lot: Front ...... .~..~...Z.~. Rear .~....)zc...~'.~..: .~....~... Depth ...~..~....~....Z.~...... 10. Zone or use district in which premises are situated ....... ~ .......................................... 11. Does proposed construction violate any zoning law, ordinance or regulation? ....... '.~.~ ................................ 12. Name of Owner of premise~..~Address ~.~., ..~.~.l~..*.....Phone NO.'..:.;..~ ...... Name ' c~ CA~?:ta~.;~..:~..:~~~AA~i~...~.fCDt_..~...Phone--.~..~ ....... ,~.~ ....... Phone NO.~...c,).,.,.f.:~.,~../~..~.,~ NO'¢4 ................... Name 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. ~,,,-'7~"' ~ \ STATE OF NEV~,~ YORK, .............. ~..c¢~.,: ............................ g duly sworn, deposes and says that he is the applicant (Name of individual signing application) (Contractor, agent, corgorate 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 ali 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 fn the application filed therewith. Sworn to before me this ......... ~ ......... doy of ......... ,~,,..,~,..~ .................. 1 9.,.':~,../.., E/OIS~ ~ot~l,~ public, State of New York Residing in Suffolk County No. 52-0367800 My Commiss~o~ £xp~rcs fJ~rc:t (Singature of applicant) FO~NI NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ............................... {. ....... 19 ........ Approved ........................................ 19 ........ Permit ma .................... .~ ............ Disapproved o/c ........................................................... ~; .......... ~. ~,,~ ............... (Building Inspector) Application No..../..?....~..~ ........... 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 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 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. (Signature of applicant, or name, if a corporation) 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) Locat on of and on wh ch proposed war < w be done ~ ' . =e-k:rcrd..'f...-~... ..... ~ . Street and Number .~/,~,/~r~r.......~.....~...~~..~....,~......~...~%~..~..~...¢.....~...~...,?.....~..z ~ n o u n f--i s te 2. State existing use a d cc po cy o prem'e es and in nded use and occupancy of proposed construction: o. Existing use and occupancy .................................................................................................................................. b. Intended use and occupancy ............................................................................................... 3. Nature of work (check which applicable): New Bui'lding ....... ~,,~m....Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost .~..~f~,~....i~ ........................... Fee (to be paid on filing this application) FEES: 5. If dwelling, number of dwelling units ........... Z ............ Number of dwelling units on each floor ........................ . .... If garage, number of cars ............ ~ ....................................................................................................................... 6. If business, commerical or mixed occupancy, specify nature an~l 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 ...................... i ....... Number of Stories ................................ 8. Dimensions of entire new construction: Front ......... .~..~.....~. ~/~,... Rear ............................ Depth .~..~...~..~.T ........ Height ..~. ......... /7../.. ......... Number of Stories ...,/ ...................... 9. Size of lot: Front /..'Z Z Z..:/.-.~. Rear .~.;...%:....~.'['....,~...Z;.. Depth../...~..~... '~...'.~...... 10. Zone or use district in which premises are situated ....... ~f..L.f.n/~r..'~,..~.~¢...~.i~'.~..~.(:~.~.. ........................................... 11. Does proposed construction violate any zoning law, ordinance or regulation? ....... ..'~...~.:t2 ................................ 12. Name of Owner of premise~.d.;,,,,f,....,.%~',..L,z,w~...~.Address ./zJ.,Z~:~.'~..~.~..f~(~..,ff:',~'.':....Phone NO. ~.~ ...... // Name of Architect ............................... Y~,.~ ~xC'(,*,V"' ................... Address .................................. "7" ""~-/' ,)/~ '"'F¢"Ph°ne ~,ir~NO' L ........... ~. ~ ....... Name of Contractor~:J..A/..j,,:..~i,z,[,;.-...,.....~....,.,;,..~/;~Address ... Cf, PLOT DIAGRAM ~ocate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from prop(.rty lines. Give street and block numbers or description according to deed( and show street names and indicate whether interior or corner lot. ~'2:__~?. ~ .. Sworn to before me this ....... '~F"" ........ day of ......... ~: .................. 1 9...~....~... ELOISE BOWDEN [~Ot~y Public, State of New York Residing in Suffolk County No. 52-0367800 My Commission Expffes M~rch (Singature of applicant) STATEOF NE~YORK, -, ) COUNTY OF~..~...~SS'' ............... ~....,¢¢~'..~ .......................... being duly sworn, deposes and soys that he is the applicant (Name of individual signing application) obove homed. He is the ............................................. c~..~.....~..... ....................................................................... (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 will be performed in the manner set forth in the application filed therewith.