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HomeMy WebLinkAbout514-zTOWN OF $OUTHOLD BUILDING DEPAP,~TMENT TOWN CLERK'S OFFICE SOUTHOLD~, N. Y. CERTIFICATE OF OCCUPANCY No ........ ~-..~5.~ ...... Date ..................... J~,,t,~'.. 2 3 ........... , 19.62.. THIS CERTIFIES that the building located at .M~l~n~..~Bl~'.C'[,.,...~Uf.~l~o[~ ..... Street Map No.~.a...~.~.~...~ocel~lo, ....~..~..*.. ............ Lot No ................... .e..~...~. ........................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. ~¢)_¥~1~f~.~'...~1 ............................ , 19..~.~.. pursuant to which Building Permit No. ~...~J~-.~ .... dated ..~.O...~'.~,..l~....e.~....3. ......................... i 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 .......... ............. ~ ~.&'~...0~.. ~'~;~'.. ~.~.. ~.~ 7.~ ................................................................. This certificate is issued to ........ ~tJ,~a~,.~.~e~e~;~..&..G~a~a..~)P,~ta~:~,,,.~tte'l:te~! .............. (owner, lessee or tenant) of the a.foresaid building. ~3uilding Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWH CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: 66 Helen Ptainvi~w~ Build new dwelling at prenaises located ot Latching Waters pursuant to application dated ..................... }:~OX~7339~]: ;~ ...... 19..?~., and approved by the Building Inspector 10,OO Fee $ ........................ Building Inspector 'J TOWN OF SOUTHOLD BUILDING DEPART/~AENT TOWN CLERK'S OFFICE SOUTHOLD~ N. Y. - Examined ........................................ 19...~.... ' ....... Approved ........................................ Ic) ........ Perm t No ....................... Disapproved a/c ............................................................................................. (Building IJnspector) Application No.....~'..../..~.~. ............... APPLICATION FOR Bt/ILDING PERMIT Date...:: ~ .~.~../~..~....~'..~..........-m.:'2). ............... 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 a detailed description of layout of property must be drawn on the diagram which is port of this location. c. The work cov. ered by this application may not be comme'nced 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 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 Bbilding 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 al~ applicable laws, ordinances and regulations. ........ . . :.:. :. .............................. (Signature of applicant, dr name, if a corporation) .................................. ~w.: ....................... ~g.-.-.....~..~..v.~.~ ........ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of ............ -.,.,. .......................... 7- ................................................................................... If applicant is a corporate, signature of duly authbrized officer. (Name and title of corporate officer) Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... / Street and ....... ...... .............. , ............ ................. Munici~lity , State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: a. ' ' ~ ~~ V ~ ~ ~ ' .. Ex,st,ng use and occupancy .............. ./L..,Z. .........,....fL~. ........... y.....::~ ......... /,~ ........ ~......:; ........... ....~ ....... .~ ......... Intended use occupancy.....~.~",,..~.~-,,/."?..:,-....'~.,- ........ '.., .................... .~. .......... --"' ......... / 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Fstimated Cost. ~-cO~) (--) Fee O ~ (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, Jf any: Front......~ ................. Rear ............ ~'Z ........... Depth ....... ~ ........ ~ ......... Height ......... XZ ............... Number of Stories ............................................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth ............... ~.~ ............ Height ........ .~Z ................. Number of Stories 8. Dimensions of entire new construction: Front..~.~Z.~ .............. Rear ............. ~ .............. Depth ............................ Height ............................ Number of Stories ....~.~.~ ........... /O~,~'~ ~. ~ ~ b~ ~ ...LL~..L.~ ....... ~ .... ~l.J~..~ ....... ~m ..~.~.~,.m,~ ........ 10. Date of Purchase ..~..~.~,..Z.~.Z.~.g.~ ................... Name of ~ormer Owner .~(~:....~.~.Z%C~.ff%~.ffrZ .... 11. Zone or use district in which premises are situated....~.~.~.~.~Z~.....~.~..~...' ................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ...~.~.~ ............................... 13. Name of Owner of Name of Architect ............ ~.~¢.X.] ................................ Address ..... ....................... Phone NO. Nome o¢ Contractor......~ ................................. 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 ~ccording fo deed, and shaw street names and indicate whether interior or corner lot. 11¢,1~ t STAT[ OF ~[~Y~,~ ) S S. COUNTY OF ~~......) ................................................................................................. boinfl duly sworn, deposes ~nd soys that he is tho (~omo of indivld~l si~nin~ ~pplicotion) ~bove n~med. Ho is the......' ........................ ~~ ................................................................................................. (Controctor, ooent, corporato officer, otc.) of s~kt owner or ewners, on~ is duly outhor[zed to perform or h~ve performod the soid work ond to moko ~nd file this opplicodon; that *11 stotements contoined in this opplic~tion ~ro truo to the best o{ bls knowlodoo *nd ond that the work will be pofformed in the mon~se~t~h~in the opplicotion filed therowith. Sworn to b~ore me this Rgi~bi'¢ Sta~EN NoraW Public, ~..J~~..~..~nty ¢~~ ~ FOI~i~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... ~.~....t~...... ~..... 19.....~...~j:~ Approved ........................................ 19 ........ Perm t No ............................... Disapproved a/c .........~ ............................... ::: ...................... >.. ..................... ......... ........................ 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 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 pu?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 issuance of a Building Permit pursuant to the Building Zone Ordinance of the Zowo of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construct on of buildings, additions or o Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all opp~licab e laws, ord r~ances and regulations, ............ ....... ............ ................ ($~g,r~?ture of applicant, or name, if a c~orporation) .... ....... (Address of applicant) t~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or b0ilder.~ - ' .d....'" Nome of owner of premises ..... ./..~...~...~......~.....~.&.?../. ......... r......, . ./.~.../....~.. 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: ............................................ Lot No: .................... Street and Number ....fi.:.(../../'J .P./..C./L~...~...c[.....~...~...~..,~..:......t.~.~...~...67.~..~./...O-~L..~!d~?~ ....... :'~d¢~?'~'"/?'~'/'/"~" ............ Municipality ~ / State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Ex,st,ng' ' use and occupancy ....... z~ fi'{,,:.. ...... '~.._.~..9~ ................. Z ~'* ./Z......:,.~' ...... .:.: .......... 7'; ........ : ...... : ........................ z~ ........... b. Intended use and occupancy 'D~/:~r..~../f:./2 / 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ........ ~...~...~......~,..,,~,'. .................................. Fee ..1,.0....~.?... ........................................................................... (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 ....... :Z:;Z ................ 7. Dimensions of exisfin; structures, if any: Front ........ :~ .............. Rear ......... ~ .............. Depth ...... ~ .................... Height ....... ;~ ................ Number of Stories ............ ~ ................................................................................................ Dimensions of same structure with alterations or additions: Front .......... :.~ ................ Rear ..... z~ ...................... Depth ................. ~ .......... Height .......... .~ ................ Number of Stories 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ ~, 9. Size of lot: Front ..... ~.~¢~.~ ....... Rear ...~.~.~.t.~ ........ Depth ...(.~.I..~.~ ........ 10. Date of Purchase J~.~,.Y.~/..l.~.~..~ of Former Owner ..................... Name~ ~ . ...................................................... 11. Zone or use district in which premises are situated ..................... ~(~ ............... ~J~ ............................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ...~O~ 13. Name of Owner of premises ......................................................................................................... Name of Architect .........~r ...................................... Address ....~..~r~.~. ......................... Phone NO Name of Contractor....¥~:~.;/'/ ................................... Address ...¢,~K~C~.~ ......................... 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, sTAT S S cou NTY OF ...~t~.,.) ' ................................................................................................. b~bg duly sworn, deposes nnd ~ys that ~ is the ~pplic~nt .............................................................................................................. (Contractor, ooent, corporate officer, etc.) of soid owner or owners, *nd is duly outho6zed to perform or have performed tho soid work ond to m~ke ond file Ibis opplicot[on; that oll stotemonts cont~inod in this ~ppIic~tion aro true to lbo best of his knowlodoo ~nd belief; ond lhot the work will be porformed in tho m,n~(t~he opplication filed thorewith. Sworn to before me this Re~i~itl~'?~ ?~]~ Ot N*~ W~ ~A~,.~. of ...,......~.~..q.~.~~ C°g]~is~Z,°~6Z80o' "''[y q c~. (Sianoture of o licant)