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HomeMy WebLinkAbout548-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ......... ¢~...(~.6.(~ .... Date ............................... f~jX.e..~..~. ....... , 19.....~. THIS CERTIFIES that the building located at ..~. ................................................ Map N~.~,~..~ock No ....... ~. ..........Lot No ........................... ~,~.~.~ ....................... conforms substantially to the Application for Building Permit heretofore filed in this office dated , 0 ~ 548 ........................... ~.~.~...~....., l~.~...r porsuont lo which BoHd~n9 Permit No ............................ o~ the opp~icob[e provisions o~ the Iow. T~e occoponcy ~or which th~s cerfificote is ~ssoed is ................ ............................................ .................................................... This certificate is issued to (owner, lessee or tenant) of the aforesaid, building. Building Inspector FOI~H NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S O~:F~CE SOUTHOLD, N. Y. BUILDING PERMIT (THIS P, ERMIT MUST BE KEPT ON THE PREMIS~:S UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Dote ................. ~:~eo~mbe~.....;~9. ........... 19..,58. Permission is hereby granted to: Goldsmith Bra s- ..... -A~-G ....-H~.~ a.~. · ...H~.t,®~' ..................... ...... ~ou'~ho ~ ¥"--.N.,.'~., ...................................... to ""Bu±'~'~"udd'i¢.~o~s..~n...an..eE.ie.~.i. rg~.-~wet.];In6 .......................................................... at premises located at ....LO.t,~...iO~..~.,ltI, O..F~'I~,e~:~..ES.t,.~.S .............................................. ............................................... E./S-.... Gtd...S~.~ipya-~d....~ne ............................................................ ................................................................................. ~o~ho.~].~.....~,.M., ............................................ pursuant to appJication dated ........... ~. ~e~.....,']-O ......................... 19.~J~.., and approved by the Building Inspector Fee $'"~'¥ O(} ........... ~ '~3uq]~Ji6~' Inspector ~ FO~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD; N. Y. Examined ................. Approved ........................................ 19 ........ Permit No ............................... Disapproved a/c ..~~ ............ ................... (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 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 e 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 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. .......... ~.A.~ ,~.~.~.~..Z/.~.....~....~. .............................. (Signature of applicant, or name, if a corporation) .............. .................... (Address of appli~nt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber .or builder. · Name of owner of premises ..................................................................................................... If applicant is a corporate, signature of duly authorized officer. .... ~:'~ ~'~%'"'~ ~'-'~T~"~'~'~:~:~ ............... ,mbe ...... ....... .................... Mun~ipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. [xistin~ use ond occuponcy ........... ,""2 ........ Z ................................................ b. ~t,~d~ ~, ~ o~po~w ........... .~:~..~:......~~....~.~ ....................................... 3. Nature of work (check which applicable): New Building .................... Addition ....... ~..~/.~'. ...... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... ~'~ ~ -~,~'~ F .......................................................................................... 4. Estimated Cost ................... (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. [f business, commercial or mixed occupancy, spec ify nature and extent of each type of use .............................. 7. Dimehsions of existing structures, if any: Front ......... ~./.. ............ Rear ....... ,~'~.../. .............. Depth ....~....~ ............. Height ......... ./..../K. ............. Number of Stories ....... /. ................................................................................................... Dimensions of same structure with alterations or additions: Front .......... ,~.Z~../. ............ 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 Purchase ........................................................ Name of Former Owner ........................................................ 1]. Zone or use district in which premises ore situated ................................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? 13. Name of Owner of premises .... ddress ............................................ Phone NO ..................... Name of Archffect ..................................... ~ ................. Address ............................................ Phone NO ..................... Name of Contractor....~...f~/~...~..'~.~....~.: ........ Address .~.~ *~.....~;.,/r,~,..~.E/~....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 NEV~Y~)RI~, ) S S COUNTY OF :~....) ' .......... ~-f.....~ ..~...~~..~,~.,...~'~/~'L,. .................. being duly sworn, deposes ,and says that he is the applicant ,ff, J. ame 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; and that the work will be performed in the manner %~t faSb. Jrt the application filed therewith. ~ FOR]~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOI. D, N. Y. Fxamined ....... ~,~,.,-, .~.~ ...'-.,-..~,.. :.( ......... 19...~.~ Approved ............. '. . 19 Permit No...~....'%......' ....~ ...... Disapproved a/c ....,..7~ ....... /..~ ............... ~.~x' .............. :w ................................ .............................. : :.:;:i.... . ............. J/.~t.'q~.;,".....:. ............................ ;..;~ ........ 1 .................. (Building Inspector) Application No. ^. "IC^T'ON FOR .Ul,mN Date ............. .~.?.(. ,~:, ,~...¥..~..~ ....................... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and su~omitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises~ relotionshlp to adjoining premises or public streets or areas, and giving o 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 pukpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Buildlng Department for the issuanc,e of a Building Permit pursuant to the Building Zone Ordinance of the Town of SouthoJd, Suffolk County, h~ew York, and other applicable Lows, 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 end regulations. (Signature of applicant, or name, if a corporation) ............... ................. (Address of applicant) /'" State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...... .~.~.........~/-~.fi~.....~..~ ............................................................................... If applicant is a corporate, signature of duly authorized officer. ........ ........ ............. ,/ (Name end title of corporate officer) ]. Location of land on which proposed work will be done. Mop No: .. ~.~.. x ...... Lot No: ...7.?../../...~... Municipality 2. State existing use and occupancy of pr,emlses and intended use and occupancy of proposed construction: o. Existing use and occupancy ............ .~;~ .............................................................. b. ntended and occupancy ............. 3. Nature of work (check which applicable): New Building .................... Addition ......... ....~.......Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated 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 .........../ ................... 8. Dimensions of entire new construction: Front.....~. .................. Rear ......... /...~....i ......... Depth ....~...~..~. .............. Height ......~.:. ............. Number of Stories ..Z'.. ....................... 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 1. Zone or use district in which premises are situated ................................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? /~..~......~.../~..r~.¢~'..~:¢', Name of Owner of rem ses ~' ' ~ ...... '/;/~' ~'/~Add es Ph ~"" 13. p ' ./'z'f,~f~.t,~¢~vm,z,¢ r s ............................................one NO ..................... Name of Architect .................................... .tr. .................. Address ............................................ Phone NO ..................... Name of Contractor....'~://~....~.....~..~: ...... Address ...g~Z~'.~..~...6,~.~,~...Phone NO.~..~..?.'~.~.z...9'.'~',~ PLOT DIAGRAM I.ocate 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, end show street names and indicate whether interior or corner lot. STATE OF NEV~(OJ~,/)J, ) S S COUNTY OF .......~..~..':T..~..~) , ' " ' PI) ..... (~r~ ..... ..~.L__f/..~..., ....... ~~~ ............. being duly sworn, deposes and says that he is rhea ,icant ~me 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 ail statements contained in,is application ore true to the best of his knowledge and belief; and that the work will be performed in the ~ f~b_ in the application filed tberew~,, _ Sworn to before me this ~ go~i~fi~ 8t~te'~ ~ Z ~ I ~?/ ,~ ~~ ~ ......... ,~...~.... day_ of ........................................ ~,,.~/~0~ /(Signature of apphcant) . ' ~ ' ch oO P bh , .........