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HomeMy WebLinkAbout417-zFO~M ~0.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUI'ANCY No....~,..39t] .......... Date .......................... .~1{~.~....~.~. .......... , 19.~)... THIS CERTIFIES that the building located at.~.~'{~..Ro~c]..,,..~.S..03,c]..Hart~o~r..Rd ........... Street Map No...x:~:~ ............... Block No ...... ~ ............. Lot Narc ........ ~ft~/..ffl~£O]]f~....~.~.~, ..................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................. A~UB.~...2~, ...... , 19~...., pursuant to which Building Permit No..~.Y~? ................... dated ............... ,. .......... Au~.st,...,2,Z ....... , 1959...., was issued, and conforms to all of the requirements of the applicable provisions of the {aw. The occupancy for which this certificate is issued is .............. ........................ ~.~Lwt~e...~.ue..~.~,~...ft~v~3,~8 ................................................................................. This certificate is issued to ~.~f{~.....~0g~ ...........(~..O.'~.~). ................................................................. (owner, lessee or tenant) of the aforesaid building. FOI~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 417 Z Dote .~.~.....~...(.. ................... ,~.--. Permission is hereby grgoted to: _ j ~ ./.~'-I, L~.....,.~ ~...~..~.,.... ~o ...... ~~~ ..................................... .... ~ ......... ~,..~,.. ........ ~~..,.~...~ ............................................. ~...~..J~.~....~" "''~ ..................................... ~... ......... Building Inspector i.~- F~ $...~ ................... FOR~ NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, H. Y. NOTICE OF DISAPPROVAL E,e No ...Z....~..Z.7 ................................................... ~ate .......................... ~...~ .......... l~...~. To .... 1~,..~..~.,, ..~. ~,.%. ,~.~ ........................................... .... 01d..,Ha~.b,o:~..~oad .................................. .... ~ew..E~.~o~,...Ne~..~0~c ................... PLEASE TAKE NOTICE that your application dated ..................... .~...~.~.1~..S...~..,..~..~.. ........... 19~...~.... for permit to constructd~,~l:L~[;~g ........................ at the premises located at ..~./.$....0~.d.....~.,~...~..O..?....~O~,¢~ .. * ~.eW · ~ .~. ~01~ ,,f..Ne.~....~.oZ'~ ................ Street Mop ........... .?. ~..~. ..................... Block ........ ..~.?~ ............................ Lot ....??..?. ................................. is disapproved on the following grounds .,i~k...o:~..J~.~.~ ......................... .......... ~.'ow~ ....,aw..2~OA ...................................................................................................................... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. Examined ................. 19. ,, Approved ........................................ 19 ........ Permit No ............................... ........ ................. (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 su0mitted 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 l~ept on the premises available for inspection throughout the progress of the work. e. No building shah 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 issuanc,e of a Building Permit pursuant to the Building Zone Ordinance of the Town of Sou'thold, 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 applicant is owner, lessee, agar, architect, engineer, general contractor, electrician, plumber or builder. ........................................ Name of owner of prem.ses....~....(~ .......... ....~.. · ...... ~.....~..4,¢(k,~. .................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which propos,~ ~(or~- wi, Il,be done. Map No: ................................ ~ ........ Lot No: ....,.. ............... Street and Number.,J~' '~-~/) //l,/ f/ ~ ~/, P ~ //..~.....~..~....~..,...~..../~....~.~.~........~....~.....o?.f~.~.~..~._~...~..~~.~....~m7... ...... Municipality 2. State existing use and occupancy of p~emises and~intended use and occu~cy of~ proposed construction: a. ~xisting use aha occupancy ......................... ~ .......................................................................................................... b. Intended use and occupancy .......................... ~.,,~. ............................................................... 3. Nature of work (check which applicable): New Building .................... Add'tion .................... Alteration Repeir .................... Removal ...... v ........... Demolition .................... Other Work (Describe) .................... ~O -~ /.. Estimated Cost. ~x.~..~..l~ ........................................ Fee ....................................................................................... 4. (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......,~v.~'. .............. Rear ,..~..,~.. ................. Depth ..c~,',,~:..J~l,~,..~.../..~,~.~ Height ............................ Number ¢~f Stories ../.i~ ........... 9. Size of lot: Front ..~..../...~..:.....)~.....~.....~Rear ..W'...~........~...~.¢.~'.. Depth ...~...~./..'.~.~..../..~....~../~ 10. Date of Purchase ...~.~.~....../..~....~-~...~.: ............. Name of Former Owner ........................................................ 'Z4.' ] ]. 7one or use district in which premises are situated ................... ~. ............................................................ ]2. Does proposed construction v2olate any zoning Iow, ordinance ok re0ulatian? ........... ,~..,,~.,~.t .............................. ,3. Name of Owner of ...... NO ..................... Nome of Architect..t.h:...~~..~..h'"~ / ~ ................. Address ....... Phone NO ..................... Name of Contractor/~.-.:..°~...~.c~.[,..~....~',,J~'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 NE~,~. Y~I~/4,~ ~( ) S S COUNT~Y,~'~''~''''''') ............ ~..:.~~.c~.... ....................... being duly sworn, deposes and says that he is the applicant (Nome of ,ndividua' sign~n~)appli~ above named. He is the ................... ~~.../vk....r~'~'~... ........................................................................................ (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 s~ fort~,!~n the applicat~n filed therewith. ,~ , Sworn to before me this N ic, .... TOWN OF SOUTHOLD BUILDING DEPARTMEHT TOWN CLERK'S OFFICE SOUTHOLD~ N. Y. ......... Approved ........ ~......I ..............19 ........ Permit No ............................... ............................ ~ ................................... Y~' ...... ~7 ......................................... ,:~.~:5~¥:¢.................~ (Building Inspector) Application No ............... /. ............ APPLICATION FOR BUILDING PERMIT Date .............. k~¢'...~'. _~ ./ ......... ~ .............. 19.~..~) ...... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and su6mitted 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. 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 Certificat, e of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuanoe of a Building Permit pursuant to the Building Zone Ordinance of the Town of Sou'thold, 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 a corporation) (Address of ~pli~t) State wheth,er applicant is owner, lessee, agar, architec~tf engin,eer, general contractor, electrician, plumber or builder. ............................................................. .......................................................................... Name of owner of prem~ses....E.~'.' ......................... .NJ. ................... ~.~ ..................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposp,,d ~or~ wiJl~)e done. Map No: ................................ ~,,.....'.... Lot No: ....~ ............... Street and Number ..~..~ ........... ............. ~ .............................................. Municipality ~ ....... '~ ........................ ,,?"~ ........................ 2. State existing use and occupancy of premises anti, intended use and occug~Dcy or, proposed construction: a. ~x~st~ng use aha occupancy ........................................ b. Intended use and occupancy .......................... ~;;'; ~...t, ............................................................... 3. Nature of work (check which applicable): New Building ...... .../~..... ...... Addition .................... Alteration .................... Repair .................... ~,'% Removal ......:.~ .......... Demolition .................... Other Work (Describe) .................... 4. '0 --' ./....0. Estimated Cost..,-~..~j....~...). ........................................ Fee ................................................................................... (to be paid on filing this application) 5. kf 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...,.'.i ......... ~ ............ 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 .................. Reor ...x. ..~ .................. Depth ............................ Height ............................ Number ¢Stories ..~..T~ ........... ¢ / ~ ,, . -~"~ /~ I~"*1¢1~)~ >/7 5/ // ~ ~ · ~tO' ~ '~ ' ~1 ' 9, S~ze of lot: Front ............................ Rear ............................ Depth ........... ~,.,/,~ ..... ............ ........................................................ ] ]. ~ono or use district in which premlsos oro situated ................................................................................................ ]2. Does proposed construction v~l~t~ ~nv xonin~ Iow, ordinonc~or~O~l~tion?, ........... ~./.~.~ ............................. 13. ~ame ot uwner or ~s ............................ ............ ~aa s .: ......................................... , ~ ,~ ..................... Name of Architect ......................................................... Address ............................................ Phone NO ..................... Name of Contractor. X>,cz;......';.....:....:: ............ :..: ........ .~ddress ............................................ 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 ..NJ~_.¥~[~,.~. ) S S ................................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signigg~pplic~ above named. He is the ............................................................................................................................................................. (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 oil statements contained in t~is ap.,p_lication are true to the best of his knowledge, and belief; and that the work will be performed in the manne~,~t~ in the opplicatig.~filed ~herewith. U . Swan to be, fore me this ~' ~_ ~. ' ~,~f~e~ "~,.~ ~-~,~,~-'~ day of ~ [~?~:!,~ :~z~,~u,~ Yo~ (S gnature of app cant) ~ot~ Public, ..~ ......................