HomeMy WebLinkAbout936-zFORI~ N,O. 4
'tOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD. N. Y.
C~-RTIFICATE OF OCCUPANCY
No .....~ 870 .... Date .. ~O~.~lr 7. ...... 19
THIS CERTIFIES that the building located al Peq'll~sh ~k~'~,,.,...Ctli;ChOg~t~... Streef
_Map No. .**~ Block No. .**~ Lot No...
conforms substantially to the Application for Buildhlg Permit heretofore filed in this office
dated .......... ~)ec~e.]~K ~!.., 19 ~pursuant to which Building Permit No.
dated .............. De~.e~ .12... , 19 $9, was issued, and conforms to all of the requirements
of the apphcable provisions of the law. The occupancy for which this certificate is issued is
.................................. I~lV~ O~.I~!LY ~.~L;~]~ .................
This certificate is issued to lqr, & .P~So Chester l~o.r~.esk!~...~. ~.~.r~. .......
(owner, lessee or tenant)
of the aforesaid building.
Building Inspector
FOl~d~ XO. 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 931] Z
Dote ..................... ]~C~F. ....... ~ .... 19.~....
Permission is hereby granted to:
................ ~..t,.~.t~...e..k. ~.... ~.;~.: .............................
to ......... ~. ~...?~.. ~.z. ~... ~....?..z..~..t~. .......................................................................................
at premises located at ....P~q~ ~...tt,~.e .............................................................................................
............................................. ~t~h~gu~,....!~^Y. .............................................................................
pursuant to apphcatmn dated .........................~.~..Cl~..~.....~,. ............. 19. ~.~.., and approved by the
Duddmg Inspector
Fee $.,~1~ .............
Building Inspector /
FOItM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
~:xammeo ........................................ I Y ........
Application No.....~...~....,..~.. ..........
Approved ........................................ 19 ........ Permit No ...............................
Disapproved a/c ............ ~
.................. .................................
APPLICATION FOR BUILDING PERMIT
Oate....D..ecembar 11, ............ 19 59
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 coYered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue o Building Permit to the applicant. Such
permit shall be k~pt 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 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.
'/~/z" 4~(S.~e of applicant, or nome if a corporat~n)
.............. .......
~Add'ress'of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
General Contractor
Mr. & Mrs. Chester Kor&I~aki
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. Map No: ......~.......'./~.. .......................... Lot No:..~......~.. ........
Street and Number .....~.e...q..u:.~..8.~...A..~.~.....q.u...~9. JS~..e.~...~e. 1q...~.9.-~..~.. .................................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Ex st ng use and occupancy ...... ~..J~.....~ C~-_,J~' ~ ,~
b. ntended use and occupan ...........................................................................................................................
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 ........................ ~.....qz....~ ............................................................................
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 ......... ..-'~......~27~ ........ Depth .....?..~...~.. ...............
Height ............................ Number of Stories ..... ~ ......
9. Size of lot: Front ......../....~....0.. ........ Rear ..... L..~.....O.. ............ Depth ..../...~.....O.. ............
10. Date of Purchase ........................................................ Name of Former Ow~r ........................................................
11. Zone or use district in which premises are situated ......... ....~.."-...~.'. ........................................................
12. Does proposed construction viol~te,~l/.at/_f~/l.,any zqning_ la~v,, ordinance,~,..~,~ ~°r regulation? ........ ..~.....~. ..................................
13. Name of Owner of premises..~..~Address ...~.~..?.~.../J~...c~.....c~.....Phone NO .....................
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 O -- )
couNw oF s s.
.....................................................~.~...~ ~.....~ ~f .................. be ng du y swprn, deposes and says that he is the applicant
(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 ~st of his knowledge and belief;
and that the work will be performed in the ~nner set fo~h in the ~ca~ filed therewith.
Sworn to before me this
Nota~ P I