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HomeMy WebLinkAbout398-zFOP~[ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFIC~.TE OF OCCUPANCY No..Z..201 ........... Dote .............. Sep. tembm~.....3.0..!'. ......... 19.~.~... THIS CERTIFIES that the building located at ..](/.~.....W~s.~-..-V.J,e.~..I~.~.V.I~....~ ........... Street Map No. W. es.t,'s/~bo.x,z ................ Block No ......... ~ ......................... , conforms substantially to the Application for Building Permi't heretofore filed in this ?ffice dated ............... ,~.U3~ ....... ~ ................... 19..~0.., pursuant to whicK,Building Permit No .....Z.i',.~ ........... , dated ................. .~.B~.g'......~ ................... 19.~.., was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy 'For whic~ this certificate is issued is ..~. ........ Pr/IVATE DWELLING This certificate is issued to ...['~o,~...Bgggtor~ ....... (...oI~¢,~..) ........ '!f ................................................... (owner, lessee or tenant) of the aforesaid building. \ Buildin Inspector FOI~I NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 398 Z Date ........................... i~.~ZZ.....~. ........... 19~.~... Permission is hereby granted to: ................ ~li.~.c~z:.he.a~.....~.,.1% ............................ to -.~&c!--.~e.~.-~e~ ~.~g. .............................................................................................................. at premises located at ....~f. es.t..~,~r~T..d~e. .................................................................................... pursuant to application doted ............................. J~Z3,~ ....... ~8 .............. 19....~8, and approved by the Building Inspector Fee H ........ i ................ i~ ................................ z ........ : ......... uilding Inspector TOWN OF SOUTHOLD BUILDING D[PARTMENT TOWN CLERK'S OFFIC[ SOUTHOLD, N. Y. BUILDING PERMIT (THIS DERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 373 Z Dote .......................................................... 1~ ........ Permission is hereby granted to: at premises located at ............................................................................................................................. pursuant to application doted ................................................................ 19 ........ , and approved by the Building Inspector Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ..... ./.. ..................... APPLICATION FOR BUILDING PERMIT Dote .................... .7..$. ....................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 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable laws, ordinances and regulations. (Signature of applicant, or nar~, if a corporation) ............ :~',.~,('..,*,::.':2',;k. ...... ?:.-~=:...:..: ................... (Address of applicant) State whether applicant is owner,)gssee, ag,~nt, architect, engineer, general contractor, electrician, plumber or builder. L,4~ ~ ~, _..~7:..~::...:.~,~[?Z...~..~..: ........................................... Name of owner of premises .............. ;......j~ ..................... -;...;.,..~r...~..~.:: ............................................................................... If applicant is a corporate, signature of duly authorized officer. 1. Location of land on which~proposed .work will be done. Mal) No: .. ~.'i :.~.~::~.'..~.Z ........... Lot No: ...~.TT.' ............ t,, > , ,, .. ,>., z . --4 .......... ,~ ........................... .............................. ......... ....................... ,. ......... Municipality 2. State existing use and occupancy of p~e~ and intende~ use and occupancy of proposed construction: a. Existing use and occupancy ................................ ~. ............................................................................................... b. Intended use and occupancy ........................~.~:~::~¥~z4..:~ ..................................................................... 3. Nature of work (check which applicable): New Building...~' ....... Addition .................... Alteration .................... P, epair ........... ~,)......Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost...~..~.l_ ....... :.~..:; ..................................... Fee ............. Z.: ................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... ~ ........ Number of dwelling units on each floor ............................ If garage, number of cars ..................... ~: ........ ~...;~;'~ ................................................................................. 6. if business, commercial 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 ............................ Number of Stories ...... ~ ....... 9. Size of lot: Front .......... I...I..~ ........ Rear .......... ~... Depth ................ 10. Date of Purchase .............~..]..Z.~. ........................... Nome of Former Owner ....................................................... 11. Zone or use district in which premises are situated ............. ~....~..: ............................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ............ ~.~*~ .............................. 13. Name of Owner of premises.. :3....~c¢'~-r~,: ..Address ............................................ Phone NO Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Controctor..~..~.~,~....~,~..~.~" --" ........... Address-~-~- L Phone ..... - ,' ..... .r~.. ............................. NO ..................... PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-back dimensions from property iines. G~e street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE~AZ YQP, J(, ,~/ ) S S COUNTY OF ..~.,~.'~.~.~......) 2.~. ............................. ~......... ................. .tZZZ.~fiT~.l.~,,being duly sworn, deposes ~nd says that he is the applicant (Name of individual signing app~ti~)~__~. above named. He is the ............................ ~z.~z...~:.<:~ ................................................ ~ ................................... (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 ali statements contained )n th2~ application~re true to the b~ of his 'kno~dge ~d belief; and that the work will be performed in the md~r;~.~forth in Sworn to be,fore me this ~'-~ ., Notary Public, ~0~ NO. TOWN OF SOUTHOLD BUILblNG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exomined ......~......~.....~..... 19..~.~..~- Approved ...... :/ .......... ,~ ........ ~.~. ...... 19....~..Permit No.....~......?..?..~. ...... Disapproved a/c .................. ........ l ....... ................... (Building Inspector) Application No .......~...?......~.... ...... APPLICATION FOR BUILDING PERMIT Date .................. : ....... 19 ..... INSTRUCTIONS a. Tills 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 ad]olning 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. Sul:h 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 ~oart 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of_applicant, or narj~, if a corporation) ........... ................... (Address of applicant) State whether applicant is owner,~J~ssee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ......__"~'~: ........... .~....~..~.;. ........................................................................ if applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Street and Number ..~.~......Z~....~ ............ ~..~C.~..~.'2~ .~.'.. ..... Municipality 2. State existing use and occupancy of pre_mi~,~ and i ntende~ us~e and occupancy of proposed construction: V ~.-c.~ ~,,~'/,~ .... . a. Existing use and occupancy ............... .~. .......... ~..........~ ................................................................. b. Intended use and occupancy ........................~,~.~...=.z....~ ................... ~ ................................................ 3. Nature of work (check which applicable): New Building...~ ....... Addition .................... Alteration .................... Repair ........... ~ ...... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Eshmated Cost.~.L.~;/...G...~ ...................................... Fee ./..0.....~-.......~...~.. .................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units .........~ ........ Number of dwelling units on each floor ............................ If garage, number of cars ..................... ~ ....... ..~...~ .................................................................................. 6. If business, commercial 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 ....... ~.~,~.. ;O_.. ...'.'. ..... Rear ..... M...~.....O. .......... Depth ~' ~ Height ............................ Number of Stories ...... ~ ....... 9. Size of lot: Front .......... L.t...O.. ........ Rear .......... ..~..~...... Depth ....,~.~/.~...~.r. ¥ ]0. Date of Purchase ............ ,/..~...~'.....o~... ........................... Name of Former Owner ...~........~....~ .............. 11. Zone or use district in which premises are situated .............. /~....~...: ............................................................ 12. Does proposed construction vi~ate any zoning law, ordinance or regulation? ........... ..~.....O.. ....... Owner of' premises..z.'c~:~....~.~~..Address ............................................ Phone NO ..................... 13. Name of Nome 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~YO~, I/ ) S S COUNTY Of ..~...) ' -~-.~ /~ I/ .............................. Y. ........................... ~~being duly sworn, deposes and soys that he is the applicant (Name of individual signing ap~n)~~~_~ above named. He is the ............................. ~.~.z~..~..~...~ .................................................................................... (Contractor, agent, co~orate officer, etc.) of said owner or owners, and is duly authorized to ~rform or have pe~ormed the said work and to make and file this application; that all statements contained in this application are t~e to the ~st of his knowledge and belief; and that the work will be performed in theist fodh ~e application fil~ therewith. _ Sworn to befgre me this ~ _ ~,~,~~,~ ~.~ ~ ,~ ~ of ~ · ~ o i n r ...... ~ .......... day ......... ~i....,~,s~~ (S'g atu eel applicant) . ,,