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HomeMy WebLinkAbout422-zFOI~ N~O. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CEI~TIFIC~TE OF OCCUPANCY No. ~. 992 Date Januarl~ 19 ~9.~. Niap No ......~.~ ........... Block No ........~.~ ......... Lot No, conforms substantially to the Application for Building Permit heretofore filed in this office dated .................. ~.~...~.~ ......... 19.~.~.. pursuant to which Building Permit No. .................... ~ 4~ dated A~St 25 19..~.~ was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is ....... ~A~ O~ P~Y This certificate is issued to ...~.~J.~....gW~ ......................................................... (owner, lessee or tenant) of the aforesaid building. FOR~I NO. 2 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) N.o 422 z Date ................... Xtli~l,~it.t.....~.~. .............. 19~.~ .... Permission is hereby granted to: ~u2~..G~+.a~Ja~. ......................................................... ........... 9.~-.~',-.....~LL~ ~ .......................................... ................... Ozon~...Pa~....-#,.~.,...~6~- to .;ilu~ ..~r., ..~,~..~.~.~m....~.~...~..~..x.~..~..t.....~z.....d..~...~!...~.~ ........................................................ at premlises located at~,~...,.~o...Ll~/,/.23...~,¥~ ................................................................................... .................................................................. I~at.~,~u~k ~..... Ii, ~, ........................................................ pursuortt to application dated ........................... A~.~i~i~;.t,....~. ............ 19.~.~..., and approved by the Building Inspector Fee $..~00 ............ TOWN OF SOUTHOLD BUILDII~G DEPARTMENT TOWN CLERK'S OFFICE: SOUTHOLD, Ft. Y. xammea ............... ~. ...................... lY ........ Approved ........................................ 17 ........ Permit No ............................... (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 pi.an 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'eommenced 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 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 issuanoe 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. Auk ~u.l- ~\ .......................... :. ............. A..J ......... ..................... (Signature of applicant, or name, if a corporation) '~ (Address of ap,plle~nt) ! State wheth,er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (Name and tltle of corporate officer) 1. Location of land on which proposed work will I~ done. MaD No: ............................................ Lot t~lp:.~: ......... [J Municipality 2. State existing use and occupancy of premises~_gnd intended use~qnd occupancy of proposed construction: o. Exls..g.se 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. Est.mated Cost.......l...'~' ................................................. Fee .................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............ ~': ...... Number of dwelling units on each floor ............................ 1F 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 ......-~...O...~ ..... 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 ............................ Hei§ht ............................ Number of Stories ...~ ...... 9. S~ze of lot: Front ...... (.~.....C¢.. ............. Rear .............. ..~'....~. ..... Depth 10. Date of Purchase ........................................................ Name of Farrier Owner ........................................................ 11. Zone or use district in which premises are situated ......... -~.....~..(,-,¢-~ ........... ~.'~....':¢~... ....................................... ~=~ ~ 12. Does proposed construction vb;~late an zoning law, ordinance or regulation~ ,/~V' O 13. Name ofOwnerofpremises.V.~...~ ............ ~.~ Address~'~.'.~.J......~..!~..~... 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 lot. I STATE OF NE'v~/"-YOJ/,J~,/~ ) S q~, COUNTY Of .~Y'~..)¥/'/~--~/... ~ / ~. ~,, ,~- .......................... ~~~..~~....being duly sworn, deposes .and says that he is the applicant (Name &~n2Nidual signing applic~) above named He ~s the ................................................ ~: ..................................................................................... (Contractor, agent, corporate officer, etc.) of said owner ~[ owners and is duly authorized to perform or have performed the said work and to make and file this application, that all statements contained i~s~,~J.ic.ation are true to the best of his knowledge and belief; and that the work will be performed n the manne~;~?.{oF~,~c~)~e application filed therewith. ~. ......~~.~.~/:~5~ (Signature of applicant) P.b c, FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD~ N. Y. Approved ........................................ 1c) ........ Permit No. Disapproved a/c .......................................................................... -' ......... ~""'"'~'"'c':"~"'~ '~'"'"~(Bui]ding Ins~' ...................... 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 l~ept 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 issuanae 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) ............ r ....... %/ ...... '''z- .................. State wheth,er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .............................................. .............................................................................................. Name of owner of premlses..~,.,~..~¢.;~ ......... L......~....; ......... ¢.~..~. ................................................................................................ If applicant is a corporate, signature of duly authorized 8fficer. (Name and title of corporate officer) 1. Location of land on which proposed work will be~ done. Map No: ............................................ Lot No: ~ .......... Street and Number .d~..:..~:. ............ .~..~.:..:.....~.~-~/t:...~..-~:~.:~-~ ........... .~.~?....~... ................................................... (~/ Municipality 2. State existing use and occupancy of p~emises~and intended user,nd occupancy of proposed construction: · ._,, . . o. Existlngpse and occupancy ..................................... ; ......... ' ...................... t;;.;'; .......... ...~. .......................................... b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition....................~ Alteration .................... Repair ............... ,~..Removal .................... Demolition ................. ?.Qther Work (Describe) .................... 4. Estimated Cost........ff..~..?......T'.'.. ..................................... Fee .....~...~ ......................................................................... (to be paid on filing this application) 5. if dwelling, number of dwelling umts ................................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify naturf.~ and extent of each type of use ........ ~ ....... 7. Dimensions of existing structures, if any: Front ............. ..'~...~..'..~..' Rear ............................ Depth ....~..O....'~]~. .... 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 ....~T....."Y:.~ ..... 9. Size of lot: Front ......~,~..¢:2. ............. Rear ............... ..~...~ ..... Depth .......... 10. Date of Purchase ........................................................ Name--~/]',~J.°f Farter Owner~ ................ j ....................................... 11. Zone or use district in which premises ore situated ......... X~....~/.~.,4fr....~ .......... ~,':t~....~.'..~...? ........................................ 12. Does proposed construction/-~vi°Jate any zoning law, ordinance or regulation?m ~?~t ................................................... 13. Name of Owner of premises~:'~...~?~,,~..Address 9.~....~./....~../...~...~.~.m.~.:..~..~..Ph~e'l~'6 ..................... 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 lot. STATE OF NEW('¥OR~/'~..~ ) S S CO NT OF72 ..............................''" ~'--- ~ ~ ~'~-~/~:~:::~.~_..~;:~'.~C.C~....being du~y sworn, deposes and says that he is the applicant (Name o~ in~vidual signing applicator) above ,named. ~e 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 all statements contained ~i~plication are true to the best of hi~"knowIedge and belief; and that the work will be performed in the ~ann~'..~t,.,f~E~.,.in the application filed thffrewith. Sworn to before me this Notaw Pub ic, .~...~......~y