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HomeMy WebLinkAbout470-zFOI~i~ NO. ~ TOWN OF SOUTHOLD I~U~LDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY Z 586 June 7 , ]9...G..0.. No ......................... Dote ........................................................ Map No. *** Block No ......................... Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated Sept.e~ber 22 19.,~.~., pursuant to which Building Permit No.. Z 4.70 dated ....................................... ; .............. was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupa, ncy for which this certificate is issued is ................ PRIVATE O~ F~ILY DWELLING (owns. r, lessee oF tenant) of the aforesaid building. Building Inspector FORM 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? 17o Z Dote ................ 0~¢O.~OlP.....3- .................. 1 9.~-... Permission is hereby granted to: Ail.fred ~'ott~- ........................................................................... ..... ~ug.!a,~ s.. S-t, ................................................ - ~ ........................... ~)r'ze~t~-f.'...~. ~. ¥ 4' ...................... tot~:~.'}.~. ' a.-t~ ~cl¢~.~.~..t.e~a..~.~. ,',',z~ e~c.L.~.~.n~ ¢l~t~e~.],~.~§ .......................... at premises located at ..£~.~,..~.,,J_~..,.~,.l:ltlg.~ ..... - ........................................................................... ....................................................... O~...i~. ~ ~.....,~.,,~ ............................................................................. pursuant to application dated ................. ~et~'~'"-"~'~ ............................ ]9...~,., and approved by the Building Inspector Fee $.-~,~ 04) ............. Building inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ......... ~.....L ...... 19...~...~.-- Application ~-4o ........... ( ............... APPLICATION FOR BUILDING PERMIT Date ...................... .......... ........ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. PI_at plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets orT)reas, and giving a ddfailed d~cription of layout of property mu~t be draC/n on the~diagram, which is part of this location. c. Tl~e work covered by th~s apphcat~on may hot be commenced befbre issubnce of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall De 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 appligable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herei,C~(~scribed. The applicant agrees to comply with all applicable laws, ordinances and reoulations. / / .................. ........ ............ (Signatur~gf aF~plicaht, ~ame, if a corporation) Douglass ,,~twee~,, Orient, LI, ~Y (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. (O~e=) All~e,~ ~. Y~ung, Jr. 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 ~ooosed work will be done. Map No ................................... Block .................................. on ~ ~ of Douglass ~t~ree~, being ~0 feet ~ ~om Street and Number State existing use and occupancy of premieses and intended use and occupancy of proposed construction: Dwelling a. Ex~st~ng use and occupancy L~W~lling and attaohed garage b. ~ntended use and occupancy ....................................................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition .{....Z...}......A[teration Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost .................. ..~....~..0~....:..0~.. ........................ Fee .......................................................................................... (to be paid on filing this application) FEES: 5. If dwelling, number of dwelling units ....... .'..'. ................. Number of dwelling units on each floor ........... .'..'. ............. If garage, number of cars ........... .'14~..~,'1~ ............................................................................................................... 6. If business, commerical or mixed occupancy, specify nature and extent of each type of use.....:..'. ....................... 7. Dimensions of existing structures, if any: Front....i..~.?.:,~ll ............ Rear ..... ~.?.:,~t~ ............. Depth ......4,~.,?.~. ........... Height ....3...1'.~.~.~. .............. Number of Stories ...........~ ............................ .................................................................. Dimensions of same structure with alterations or additions: Front .....~.:.~. ................. Rear .....~.:~. ................. Depth ....4~.:.~i ................. Height ....... 3-?..-.~ ............. Number of Stories ...... ~..~.. .................... 8. Dimensions of entire new construction: Front.....~]i:.~.t~ ............. Rear .....2~..-,1~ ............. Depth ....22;:~.~. ............. Height ....~..-...~i. .............. Number of Stories .......~.~ ............... 9. Size of lot: Front ...~.-.;~ ............. Rear ..... ].00.-.f~ ........... Depth .....],?.,~:,,~ll ........... 10. Zone or use district in which premises are situated ......... /]~l~:L~ett¢;i.~l~ ............................................................... 11. Does proposed construction violate any izoning law, ordinance or regulation?....~..A~..~0.~ ............................. / 12. Name of Owner of premises.~],;l~..~'~..~[/~l,~l~,..~',Address .~l~],~,~..~i~f~;IA~'~hone qO.(:~..:,~,~,.~.'r~,. Name oF Architect .............. ..-~:~. l~l~,..~.~'~Address .]l~l~;I,~..~/:li~'t~f~.'li~;~.'lphone qo.O~.2..:~.~..~. Name of Contractor.,~J~..~....8'.~...~l; Locate clearly and distinctly all bu property lines. Give street and block nu whether interior or corner lot. STATE OF NEW YORK, ) COUNTY OF ...~z.~..~..:~.. ........... ) S S.' Idings~'~ ~qbersdl,~ PLOT DIAGRAM hether existing or proposed, and indicate all set-bacJ description according to deed, and show street no~ O~ dimensions from ; .......................... · .J~....;~..~.~....?.'...~.~)~..~'.~.: .............................. being duly sworn, deposes and says that he is the applicant (Name of individual signing, application) above named. He is the .............. ~1~1~ .................................................................................................................................. (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 beJi~f; and that the work will be performed in the manner set forth in the application filed therewith. ,/ ) Sworn to before me this '.~_...~.~,~ ..... r~/" ..... ~ [TM/ ................ : ....... aay o* ...::; .................................. ,~ ......... , /1 ...... / / / ~~ ~/ FOR~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam ned ......... ~..../. ........ 19.?..~.7 Approved .................... !.~. ........... 19...'.f....Permit No.....~....~......~....O.. ..... Ap~{icotion No ............................ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to l~he 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 avaibble for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any p.urpose 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 alterations, or for removal or demolition, as hereir~scribed. The applicant agrees to comply with all applicable laws, ordinances and r~gubtions. / / .................. ...... /......./ .................... (Signaturef,6f og~oli6a~6%t~9/name, if a ~rporation) ................... ?... 7% .............. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. ....................................... ........................................................................................................................................ Name of owner oF prem ses ....... ..~'....:~..eS...~?....~..°...~l..8~'...~.z'.:. ...................................................................... ~ ....................... 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 ................................... Block ................................ · n ~ side ef Douglass ~ree~, ~eiug 400 fee~ 8/~ fro,. Eing 5~Aree$, Street and Number ...................................................................................................................................................... 2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction: a. Existing use and occupancy ............................... ~ ................................................................... Dwell b. Intended use and occupancy ........................... ...i~...&l~d ~t.'~&ch~d garage ......................... 3. Nature oF work (check which applicable): New Building ....i ............... Addition ....!....~....) ....... Alterat,on Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost .................. ..~....~....(~....,...0~.. ........................ Fee .......................................................................................... (to be paid on filing this application) FEES: 5. If dwelling, number of dwelling units ....... ~.'. ................. Number of dwelling units on each floor ............ ~..', ............. If garage, number of cars ........... ~..~....~ ............................................................................................................... 6. If business, commerical or mixed occupancy, specify nature and extent of each type of use.....T.~ ....................... 7. Dimensions of existing structures, if any: Front ...... ~'/.'.~f.. ............ Rear .....~.7.?..~.~ ............. Depth ...... .4.}:~;~. ........... Height ...,]"..~,',,~,~ ............... Number of Stories ..........~ ............................................................................................... Dimensions of some structure with alterations or additions: Front ..,..,~...',,.~,. .................. Rear Depth ....~.~..~ ................. Height ....... ~..~:~J ............. Number of Stories ~ ~ 2,~-~'1; Rear 2~.-~ 8. Dimensions of entire new construction: rron~ .......................................................Depth ............................ Height ....~,,'..~.,~. .............. Number of Stories ........~..~..~. ............... 9'. Size 6f lot: Fron~t ..'.~...~...~.~ ............. Rear ..... ~.(~.~..'ll ........... Depth ..... ~..-~.~.~ ........... 10. Zone or use district in which premises are situated ......... /...~l~f~.tr~l~l, ............................................................... · ~ ~,~one ~:~:~e'~. 11. Does proposed constructic~n violate any zoning law, ordinance or regulahon ..................................................... 12. Name of Owner of prernises...~'..~..~?...~/...~. ~..~.~..'Address .~.~.9~..~9~..O~..~..~...'~hone NO.O...~:...'.~..]'.~.:..~.. Name of Architect ............... ~..~...~.! ~..~.~.."Address ..]~...~'..~.~...~.?..~..~".~..~...~hone qO..0~..~..~..~".,~,. Name of Contractor ~..~f. ~'~,.~,;i!~ .~ ............... Address ...~...~.~..~.?2..~'..~..~...~hone qO.O...~..~.~..4..~t.. ..... Locate clearly and distinctly all bt property lines· Give street and block nt whether interior or corner lot. Idings,~¥ 'nber~r k.' STATE OF NEW YORK, ) COUNTY OF ....~?..'.Z~.. .......... PLOT DIAGRAM hether existing or proposed, and indicate all set-bacl dimensions from description according to deed, and show street na~neS'-~n-'d'qnd~cat~- S'. /7 o ........................... ..~..~...~.~...~.~...~. ~....~..~..: ............................. being duly sworn, deposes and s~ys that he is the applicant (Name of individual signing 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 all statements contained in this application are true to the best of his knowledge and belief; 9nd that }~he w,.ork will be performed., in the manner seC forth in the application filed therewith. Swam to before me this ~,~~~ .,~ .~/ ~ -'"'~' ................. ....................