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HomeMy WebLinkAbout439-zFOI~M NO. ~ TO~N ~F $OUTHOLD BUILDING D~PARTMENT ~TOWN C~EEK'S OFF~CE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at..O~..~..~.~..~...~..~..~....~...O..~...~.}..~,~.~.~."~.~,..~.~.. ~t Map No.~...~..Q.X...~..d...O..~.....~..~ck No'......*.?...*. ............. Lot No..~...?...~.~.~Jm....~.. .......................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................... ~..~.]g~.e..~....~..~.?.....]....O. ........ , 19....~..8., pursuant to which Building Permit No ........ ~.~.,,~,~. ........... dated .................... J~,~.~O~lJ~...~,,O....., 19.~..~..., was issued, and conforms to all of the requirements of the applicable provisions of the law, The occupancy for which this certificate is issued is .............. .................................................. P!~I.VAT~...Q~F. A~/IL~.. Dg/~LL I K~ ~ ........................................... This certificate is issued to .....~..~...~.?..~.....~.?......~....~..~,?.~..~'.....~...'~,...~.?. ............................................................ (owner, lessee or tenant) of the aforesaid building. HowarO. t4. FOR~I NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 439 Z Permission is hereby granted to: Aa Re:t I 1 y "&"~Ot~'" "~/O'""$g~'$'"H'2 e~te;y .................... ......... ?:{~ f'g':[{;'{i~'~ ................................................. ...................... ~?;.~.; .................................................. ~ii'i'l ~,'' 'ff0;~7 "d~ t'.L'.1:5'~ ............................................................................................................ at premises located at ....... ~;~'["?? "I';'"~18'6~" ~';'"" '~t'~5~'dbTf' T.~'~'~ ~'~'~ .................................. ............................................. O~,~.,2..~t ........................................................................................... ......................................................... ~'~uChc/td3'"' ' '~';'T; .................................................................... pursuant to application dated ....................... ~'~'~"~'~""'ZU ......... 19.~:~.., end approved by the Building Inspector Fee $'~0'i'00 ........... Building Inspector A. REILLY & SONS, INC. -/. ~'~,~ -/- MATTITUCK~ LONG ISLAND 4 f FORM NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Iq. Y. . Jb 0 5-'t Examined ........ ..~....?.~ ...................... ] 9 ........ Approved ................... /..! .................. 19 ........ Permit No ............................... Disapproved o/c ........o ...... ..,~ .......... , ................ ......................... , .......... \" ........................ .......................... / ..... Application No ..... .~./..~... ~ ............. APPLICATION FOR BUILDING PERMIT Date ..................... ii, .................................... 19 ............ INSTRUCTIONS a. This application must be completely filled in bv 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 co~ered 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 p art 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~terations, 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) A Z T ./...4,. (Address of applicant) State whether applicant is owner, lessee, agent architect, engineer, general contractor, electrician, plumber or builder. Name of owner of prem.ses. ~~ ................... I ........... :~ ......................................................................... 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. Map No: .... :. Lot No: ./..~...~¢-x..~. Street and Number .....~.;..~...~.~.~.([ ........ ~.,: ........ ~. ........ ~~.~" ........... ....~...::~...~ ................. Municipality 2. State existing use and occupancy of premises and i~tended use and occupancy of proposed construction: a. Existing use and occupancy ........................... ~.": ~:..~'...~... ........ .q.~...¢..{...~..*-..~.'~...'>.~..&..). b. Intended use and occupancy ............................... ri,. .............................................................. 3. Nature of work (check which applicable): New 13uilding ................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated ,D'5~ o ~ O lO aa 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 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 ................................ Height ............................ Number of Stories ..... ~ ....... 9. Size of lot: Front ..... ..~,.....~.....o. .......... Rear Depth / & ~ 10. Date of Purchase ...... ~ ........... ~.....".e~... ........... Name of Former Owner ....~..--~..~ ..................... 11. Zone or use district in which premises are situated ............ ./...'~.. ...... ..~.~ ...... .~:. ............................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ................ ~ ................................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Nome of Contractor. 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~...~YO~K~ /')/.~ ) S S CO. OE ' ......................... .~....i.....~ .................................... being duly sworn, deposes and says that he is the applicant (Name of individual signin~ application),,~ , ,,__ 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 a I statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manr~lr.~et~,L,~.,f~h in the application filed therewi, jJ, b,. , Sworn to b~e~ore me this '~-~lr~, St~.O~.O~,~ .~ ('J~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD~ N. Y. Examined ....... ~.../.....~........~...d~l 9 ........ r//~ /{ 19 Perm.t ~'~ ~ ~' Approved ................... ~ ......................... ' No ............................... Disapproved a/c ..................................................................................... // .................. ......................... (Building Inspector) Application No......./~....~.~. ............. APPLICATION FOR BUILDING PERMIT uate ........... kr .................................... ] 9 ............ 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 detolled description of layout of property must be drawn on the diagram which is part of this location. c. The work coYered 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 pui'pose 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applic.able laws, ordinances and regulations. (Signcture of cppliccnt, or nome, if ~ corporQt[on) (Address of opplic~nt) State whether app icant is owner, lessee, agent,, architect, engineer, general contractor, electrician, plumber or builder. (.~/:~'"~. "~ c < ""~n: . ........................ Name of owner of premises......% :~:.~:~ ........ : ......... ?~;: ~>'.~'~:'~ .......................................................................... 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. Mop No: ...~.....'.~J:'.~.~:Z:!.J~.'.~..~.L...¢; ....... :. Lot No: /. ................ (. Street and Number Municipality 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: o. ........................... : ...................... , ............. .......... ,....., ................ , ......... :.....). b. Intended use and occupancy .............................. }~ ~ '~-...~ ............................................................... 3. Nature of work (chej Repair .q,~ 4. Estimated 5. IF dwelling, number df~dwel applicable): New Building .................Addition .................... Alteration .................... Demolition ......... .;.:L..~oOther Work (Describe) .................... ........ Fee .......................................................................................... (to be paid on filing this application) umts ................................ Number of dwelling units on each floor ............................ If garabe, 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 ~ ~C~ ....... · ............................ Purchase ......... v .............................................. Name of Former~Owner ........................... 1 1. Zone or use district in which premises are situated ......................................... lZ) ..................................................... 12. Does proposed construction violate any_zoning law, ordinance or regulation? ........ , .......................................... · V . ......... 13. Name of Owner of premises ............... ~..: ............ ( ........ Address ............................................ Phone NO ..................... Name of Architect ....... ., .............................................. Address ............. ~ ............................. Phone NO ..................... ......... ...................... ...-::::.:......... ........................ ..................... PLOT DIAGRAM Lacate 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 carnet lot. STATF OF NEW....YOP.,K.., .{)t.. ) S S COUNTY OF ...~..-~',~.~...,YM.'{..) ' - I/J/ ~'~ . .'~ .. . ......................... .~..~.........~.C..,¢.., ...... ,..r..l. ................................... be,rig duty sworn, deposes and says that he is the applicant (Name of individual signJn~ application) ~bow n~med. H~ is .,,e ................................................................. ' ............. - ......................................................................... (Contractor, ~gent, corporate officer, etc.) of s~id owner or owners, ~nd is duly ~utNori~ed to perform or h~ve performed the s~id work ~nd to m~ke ~nd file this ~ppIic~tion; that ~11 statements contained in this ~p~lic~tion ~re true to the best of his knowledge and belief; and that the work will beperformed in the manne~etet ~_rth in the app ication filed therewith.~ Sworn to before me this '~.~? ~ ~-).~ ~ [.,...~ ~ ~.~-,~' ~ of _ ~'~ -'~ I~oe,,.~°or,,· t~gnature or appuc Notary PuN,c, .....~.~.~ ........... ~y o..