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HomeMy WebLinkAbout146-zFO~ NO, t TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. C~-RTIFICATE OF' OCCUPANCY ", THIS CERTIFIES that the building located al .~/.~ Stlo~il,~.-rl~ ~t~ ~ ~o~~ Street ~, F e~onforms s~ntially to the Application for Building Permit heretofore filed in this office~5 d~te0 O~OB~ [7 1~$7 pursuant to which Building Permit No. ~e~ .............. ~.~...~.~ ....... 1~.~.~.., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued (owner, lessee or tenant) of the aforesaid building. Building Inspector/ FOP~IV[ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMEHT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES W,I~,Q~[~,,~T,~F AP, FU,L COMPlETiON OF THE WORK AUTHORIZED) No.. Z.'~b6 .......... Date ................... O~'b.o~e~-... ~? ............ 19. ~?.. Permission is hereby granted to: ,Toseloh It. Beru~e¢.~ ....... .~-.[~,...G~..~ot~.k~tg ................. So'~hot~.~. ....... .N~.g.~ ......................................... to '...]~t~..ld...an"ac}d~&~n'"t,o'"e~.'~t~'ng" '"D~'Z']:~.ng .......................................................... at premises located at "~/S'""~e~"]:~-~tg"~O'~ ............... (..-t~essau...F~rr~.) ............................. pursuant to application dated ..................... Oet~be~ ......... '~? ............ 19.~:~,., and approved by the Building Inspector. Fee $'"~¥0(} ........... Building Inspector FORH NO. 1 TOWN OF SOUTHOLD BUILDING DEPA~.TMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19 ........ Permit No ......... Disapproved a/c ,~' ...... , ............................. ~;;* .................... i;' ................................ ........... ..................... (Building Inspector) Application ~'~o ............................ APPLICATION FOR BUILDING PERMIT Dete ................ ...... ............ 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 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 oil applicable lows, ordinances and regulations. ....... ' ' .......................... (Signature of applicant, or nome, if o corporation) (Address of applicant) State whether applicant is owner, lessee. ~aent, architect, engineer, general contractor, electrican, plumber or builder. Name of owner of premises ....... ............................................ f ............................................................................ If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) ......... Block I, Location of land on wh ch proposed war< w be done ~a~ No ,, ~ Street and Number ....... /,.: ........ ~.<:...: ............ ./ .................................................................................................... 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) .................... 4. Estimated Cost ~ '.7.. ~...~. O ~ Fee (to be paid on filing this application) FEES: If dwelling, number of dwelling umts ............................ 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 ......... ~-~....~.l ........... Rear ...... i~.~:( ............. Depth ....~..2.O.. ................. Height ............................ Number of Stories ..(_~,~TJ~.,.4~,,~.... ...................................................................................... Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... ~,,,...G. ........... Rear ....."~. ..................... Depth ............................ Height ............................ Number of Stories ..4~Z'A.m~:~ ...... 9. Size of lot: Front ........ J...C~7~ ........... Rear ....... /...9..:~. ............ Depth ..... ~.~.2~!.....O. ......... 10. Zone or use district in which premises ore s tuated ./,~.....~...~..~..."'~.. ................................................................... 11. Does proposed construction violate any zoning taw, ordinance or regulation? .......... ~...~.. ............................... /~ (:',, , .... ~ ~ , 12. Name of Owner of premises....:,.~,:L....~., ~¢~:-~:.:!'-.!o.:'A~jdress' ............................................ Phone NO Name of Architect ...................................................... Aadress~ ............................................ Phone NO ..................... Name of Contractor. ,~:~,,.,3,..c~....~.,~ ..... ...... 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. STA~E OF NE,v? ¥ORI~,,, , ~.) s ................................................................................................ being duly sworn, deposes and says that he is the applicant (Name of individual signing application) .......................................... ................................................................... (Contractor, ~enL corp~rote officer~ etc.) o{ said ownor or owners~ and is duly ~uthorized to porform or hove porformed the soid work ond to make ond filo this opplicotion~ thor oil stotem~nts contoinod in this opplicofion ore truo to the bost o{ bls knowled~o ond beHef~ ~nd thor tho work w~ll be por{ormed in tho monnor sot {orth in the opplicofion filed thorewith. Sworn to before me this ....... J...~.. ........... day of ....~?.,, ......................... 19..bQ..~{.. Notary Pub I lc,....L.4UL/xUP,~,..~/.Td)7~. ~ .......... County (Singature of applicant) FORi~ NO. 1 TOWN OF SOUTHOLD BUILDING ~)EPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. £xominecl ....... .~..~...~ ...................... i ~ ........ Approved ........................................ 19 ........ Permit ................................. Disapproved a?c .............r.:?i ..................................... -;~ ........................... ..:'.'..i.. (Building Inspector) ~ Application No / q (o APPLICATION FOR BUILDING PERMIT Date ................ ~.....!...12 ............ 1 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 punic streets or areas, and giving a detailed description of layout of pFoperty 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 am/purl~ose 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) .... ....... ................................. (Address of applicant) State whether app~architect, engineer, general contractor, electrican, plumber or builder. Name of owner prem ses ~/.'~ ~ & ~~.-$~...' ' " If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on wh.ch proposed work will. bedone.,~ M~apNo ~..~....'~. ~./.W...&.'. Block ............................. ..... Street and Number ....... ,'..~ ........ '~z:~'~.~ ..........~ ............................ x. ............. ::..:...'.,j:~ ......................................... 2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction: c~. Existing use ond occuponc¥ ......................................... .'~ ................................................................................... un ti, b. Intended use and acc pa cy ................................................................................................................................ ' 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: 5. If dwelling, number of dwelling units ....... ~ ...... Number of dwelling unlts on each floor ............................ If garage, number of cars ........................................................................................................................................ (5. If business, commericol or mixed occupancy, specify nature end extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front ........ ..~T.d ............ 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....: .~m......(ff'.. ........... Rear ~-r~ Depth ':~-°e'~ Height ............................ Number of Stories ..~ ....... 9. Size of lot: Front ~ O'~ Rear i ~ Depth .~,,~ O 10. Zone or use district in which premises are s tuated ................................................................................................ 11. Does proposed construction violate any zoning law, ordinance or regulation;~ /~'L,) 12. Name of Owner of premises... :... : .... ~dress ............................................ 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 ~ot. V I0 o oAO STATE OF NEWI YORK. ) ~ C j(~~~.OUtSTaY' ~1~-'. ~....)SS'' being duly sworn, deposes and so s that he is the o icanf .....'l~'~~~J"~'~i"':" s,gn,ng:'"': ............ opphcohon),_,:'"": .................... Y PP above named. He s the ...................... ..~.~..-~...o:~ .................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to maize 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, Sworn to before me this ....... l.~ ............ day of ...... .(~.-..~.,: ........................ 1 9...,.~ ..... Notary Public,.~~,...~ ....... ~ (Singoture of applicant)