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HomeMy WebLinkAbout397-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...~.....3...~..8..4.. ............ Date .......... AUgUaLt..22., ...................... , 19.68... THIS CERTIFIES that the building located at ...Zn].e.t,..~ll~:LlZe. ........................................ Street Map No. ~.~.~..~.~.~...... Block No ....................... Lot No. 97fl~ .......................................................... K:l. dd conform~ substantially to the Application for Building Permit heretofore filed in this office dated ........................... .~.~.~....2...8.~ ................... , 19..~..8... pursuant to which Building Permit No.~....399. ..... dated ................. .~,..~.~.....2..8..e .................. , 19....5..8.., 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 ........ ..... ......................................................................................... The certificate is issued to ..... .~....c~...~.~...cl,...~...e.~...~..e..~..o.....(.l:~.l~.~.:[c..) ........................................................... (owner, lessee or tenant) of the aforesaid buiJding. TOWN OF $OUTHOLD BUILDING DEPAgTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 397, Z pore .................... ,Z.u%:~..~ ..................... ~9~..8.... Permission is hereby granted to: Irwt~ T~ t hi i i.... ~..~...F,~.w~...~e.r.t..e.~.~ ................................ ....... Y~a ~.t i.~uek ~.....;~{,.~. .................................... to .. make., an...~ lte~.a.tf on...-.... ~udd& ~&o ~...~a.. mn...exi s& i Pg.. dw..e..~ ~.'.x.D~ .......................... at premises located at ..~-'~...~x~.i.v~ ................................................................................................ ................................................ Ca.p.t,....K.i~.~..~.Ca.te$ ...................................................................... .............................................................. t4a-tt ~-%uek.~.,...-N~ .~. ~.. ........................................................... pursuant to application dated ................................. ,~-t~2~. .. 2_8 .............. l C~...., and approved by the Building Inspector Fee $.-..~:~,. O0 ........... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. A proved s/ ~t ' 19 ~ Permit No. ~-~ 3 ~ 7 Disapproved (Building Inspector) / APPLICATION FOR BUILDING PERMIT Dote .......... ~.;,¢.............~, ............................... 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 o detailed description of layout of property must be drown on the diagram whlch is port of this location. c. The work covered by this epplicotion 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 pukpose 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 name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................................ ~:..~.X .~d; ;.:.;::5~ ....................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ,. Location of land on which proposed work will be done. Map No: ..~.t./..~...~.C:!C....../..~..:'~...~..,. Lot No: .................... Street and Number ..0~:*..~."~..~..~.':: ........ :~..~'.~...~..~..~/..~,.~.~ ...................................................................................... Municipality 2. State existing use and occupancy of premise~ond intended use and occupancy of proposed construction: -~- o, Existing use and occupancy ...................................................... : .............................................................................. b. Intended use and occupancy ........................ ,~t,,a,~,;.::.,: ........... ~ ........................................................................... 3. Nature of work (check which applicable): New Building .................... Addition ..... ~....Alteration ../,,~.. ............ Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 5-0 4. Estimated Cost ...... ~ .................................................... Fee .~.. ..................................................................................... (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 n~ture 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 .....L..'~... ............... Height ............................ Number of Stories ~ 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ........................................................ Name of FormerFD\wner ........................................................ tl. Zone or use district in which premises are situated .............. /~..:.....~..~.!.~--- ....................................................... 12. Does proposed construction violate any Z:oni/gg_law, ordinance or regulation? ........... ~..~....~ ............................... 13. Name of Owner of premises...~.~ ......................... Address ............................................ Phone NO ..................... Name of Architect .......~. ........... ;~.......~:..;.,..i....Address, tA. ~,.), ............................................ Phone NO ..................... Name of Contractor...~ ................................. Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate dearly 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~..~. ) S S COUNTY OF ......... ?~r.<,[x. ........... ) .~..., ./....~...,-------~ i ,~..~.....~:,.~, be ng du y sworn, deposes and says that he s the app cant (Name of indiwUual signing appliF, Rtion) above named. He is the .................................~ v v-----~-- · ....~'"~ '~'"~',~'~'~' ........... i .......................... : ........................................ (Contractor, agen ,TT-corporote officer, etc.1 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 tortbe best of his knowledge and belief; and that the work will be performed in the manner set forth in the application[lied therewith. . Sworn to before me this ~ - of ..... ............. ~ , k/ ~ Notdry Pub[ c, .~...(.~...Z~..Cddnty TOWN OF SOUTHOLD BUILDING DEPARTI, AENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...... ...~...... 19.?..~. Approved...../.. ................................. 17 ........ Permit No ................... Disapproved a/c ...I......./~ ................ ~.'..~ ............... ,,,~ .............. ~:~ ................ .............................. .......... ...... .......... (Building Inspector) Application No. ~ ¢ ? APPLICATION FOR BUILDING PERMIT Date .......... .,(..~ ...........~.~. ............................... 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and su~omitted 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 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 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 Buil~ling 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 name, if o corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 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. Ma[~ No: ..... ?..~:.¢. .. Lot No: ~.'.~.~.?..~,. .... Street and Number ..r~.¢:.....'...; ............... ..~:.....,.-.......-"~'~"¢~. ...................................................................................... Municipality 2. State existing use and occupancy of p~emise~nd i. ntended use and occupancy of proposed construction: o. Existing use and occupancy ..................................................................................................................................... b. Intended use and occupancy ........................ ~'...~;. .................. ~, ........................................................................... 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ..,.~C'... ............. Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost......f~...-~......~.......'~.. ................................... Fee ..~. ....................................................................................... (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 ............................ Rear ............................ Depth ............................ 10. Date of Purchase ........................................................ Name of Former~wner ........................................................ 11. Zone or use district in which premises are situated .............. /...~. .............................................................................. ..... p /kJ~' 12. Does proposed construct.on wolate any zoning law, ordinance or regular.on ........... ¢..~... ................................... ame ner of ~emfses ~'~ ~ Address 13. N of Ow p' ,.,' . ................................................................................ Phone NO ..................... ....... Address ............................................ Phone NO ..................... Name of Architect .......~.. ......... ~_.~i~.~.~.] 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. S AT,: O. N,W R i_ ) s s ................................... ~..'~....¢~.:::~:..~........~::,~,,,,beln~ duly swarn~ deposes ,and says that he is the applicant (Name of indiv~rual signing applic~ion?~__ above named. He is the ......................................................................... · ........................................................................ (Contractor, age,t, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and ~o make and file this application; that all statements contained in this application are true t~he best of his knowledge and belief; and that t~e work will be performed in the manner ~. forth in the appllcatib~ filed ~herewifh, ~ Sworn to before me this ~ ~ ~ ~ ~W~ ~ ~ ~ ~Z~ / ..... ........ Nota~ Pubhc, ~.1.~ ............... Cou~t~ ,.,,:, ~, ,~ ,~ ~