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HomeMy WebLinkAbout645-zFOKM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY ~ July. 7 ,19 5.9 No. Z...].$.5 ............. Date ................................................................. THIS CERTIFIES that the building located at..J~.~.f~$.~...~O~,~.~.,...~.0..~..~.~.Q~.~,...~[*~rtvee, t Map No ......................... Block No ......................... Lot No ..................................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................... ..~D~..$~....~.~ ...... , 19~.~....., pursuant to which Building Permit No ..... ~....~...#..~. ............ dated ........................... A~[1..~.l ........ , 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 .............. ................................................. .............................................. This certificate is issued to ...~r~f~-...J~.~-.,....~,~ff!. ...................................................................... (owner, lessee or tenant) of the aforesaid building. HOWARD L~ TERRY FOI~M NO. 2 TOWN OF $OUTHOLD 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°. 645 z Permission is hereby granted to: George W. ~7'~"E~¥;~,t"d"B~'d ............................................ ~..~..t.?...e.~. ..................................................... .s.o.~.t. ~.o..Z..~.,...~...~?.~.k.. .................................... to build an addison on exlstir~ d~.llirg tParadise Point~ ~outholdt Ne~¢ York at premises located a ............................................................................................................................. pursuant to application dated Ap~ii 1~ 19 ~'~ and approved by the Building Inspector Noward M. Terry FOI~M NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD, N. Y. Examined ............ ~..~../..... · 1 9.~.7~.. Approved .............. ~....o~..~... 1 9 k~..~77.. Per m it No ...... ~ .~....-~.. ........ Disapproved a/c ..~.. ............. Z~>~..~.~,*.~]~ ................... Application No ..... ......... (Building~~/(-~lnspector) 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 thrdughout the progress of the work., e. No building shah be occupied or used in whole or in part for any purpose whatever until ~ Certificate of Ocdupancy shall hove been granted by the Building InspectoK APPLICATION IS HEREBY MADE.to the Building Department for the is~uanc,e 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 applicable lows, ordinances and regulations. __ _ .w.., ..... (Address of applicant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. 1. Location of bnd on which proposed work will be done. Map No: ................. ~' ............... ~ ..... Lot No: .................... Street and Number ........ ~../~...~..~...~.~...~...~..:...~~...~'"~"~'~':"~' '~"~'"'~'"~'"" ..................... Municipality 2. State existing use and occupancy of'~ ~L., ~,~premises and intended use and occupancy of~proposed construction; a. Existing use and occupancy ............ ~_~~'~-~~~'"'"i ..............................................................................' b. Intended use and occupancy ......... 3. Nature of work (check which applicable): New Building .................... Addition ...4i~, ........... 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 ...... .~..m~. ............... 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 ....... .w~.,~.. ............ Rear .....~....~.. ................ Depth ..../....~.'. .................. Height ~....~,~. ....... Number of Stories ....... 9. Size of lot:~Front ...... ./...Z.~..~ ............ Rear ..../...~.'.',4. ............. Depth ..../_,~,.~..~ .............. 10. Date of Purchase ...,~:~.'~'.....'./....~>.ff...~.. ................ Name of Former Owner ..~..?.~...~"~....~.~ ......... 11. Zone or use distric~in' ' ~wh~ich premises ore situated ........ ..~.~.:/.~..~.~'.~.fi.ff..'~..-- ...................................................... 12. Does proposed construction violate any zoning law, ordinance o,r regulation:) ~7~, 13. Name of Owner of premises..~....'.....~'~.~' ......... Address .,~~.~... .............. Phone NO ..................... Name of Architect ................................... ~ ................... 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. COUNTY OF . ..~/~-~"~ ,7 ' ' ~.?~/~'~.~'~ZZ~....~~ ...................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) ~ above named. He is the.....~.'~.~....C-r]J./.....~.....-~ .'~r:~.~.~.~7 .......................................................................... //- /x (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly ou~orized to perform or hove 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 set forth in the applic~t, ion filed therewith~ Sworn to befor~ me this //' J--z~ ~-x'~ ¢~... day of ............. .. ,~.. ]9.,?~... ~ d~~~f opp,cant) .................... -- TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHO{.D, tq. Y. Exomined...~.,.f~..~.,.... 19....~... Approved ...... ~.....,c~....~. 19..~.~ Permit~ No .......... . .~...~......~,~, · .~. Disapproved (Building Inspector) ~/~:z Application No ...... ..~...~.~. ...... APPLICATION FOR BUiLDiNG PERMIT Dote....~...~..~....~..../..i.z. ........... ../..~.]. ............ 1 ..~../.~..' .... 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 purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MAD£ 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, y ~, ..~r~. ~.., .'.~. ':..~.. ......................... ~ ............ .~ .......................... (Sign~ure of applicant, or r~me, 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....~--~...~-'. ........ ~r~ ................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which pro~osed work w~ill be done. Map No: ................ ./~ ................ .>, ...... Lot No: .................... Street and Number ...... ~Z"~~.~?..,.~....~....~~....~..:...~.,~ -- ........ Municipality 2. State existing use and occupancy of pr,emises and ~tended use and occupancy of proposed construction: a. Existing use and occupancy .................~ ................ ~ ............................................... ............................................. b. Intended use and occupancy .......... ~~~ ................................................................................ 3. Nature of work (check which applicable): New Building .................... Addldon ....~ ............ Alteration .................... Repair ................ ~Remova[ .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ....... ~..~.¢..O ....................................... Fee .......................................................................................... (to be paid on filing this application) 5. IF dwelling, number of dwelling units ......... ~ ........... Number of dwelling anits 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 .......... ~..~.4.,~......Number of Stories ............................................................................................................. Dimensions of same structure with alterations or additions: Front ........ ...'~..~... .............. Rear ....~.~.~... ................... Depth .....~ .................. Height .............................. Number of Stories ...... /.,~.,~....4~(..~,~. /" ?¢'*'~/~ 8. Dimensions of entire new construction: Front ......... ~,~..~ ........... Rear ....~..~.. ............... Depth ............................ Height .;~¢.¢,,,~%/ ....... Number of Stories ........ ~ .......... 9. S~ze of lot: Front '¢"'"":/'~O'; ........ Rear ....../'.~..,¢ ............ Depth ....¢~...~..¢. ............. ]0. Date of Purchase ...... .,.~2~, ,.,.,/~i~,~"~ ................ Name ~f Form,er Owner .....,~..~....~...~ ....... 11. Zone or use district~h'/wh'~ premises are situated .......... ~ .................................................... 12. Does proposed construction wolate any ~,bning law, ordinance or regulahon? ........ ..~...."~...: ................................... 13. Name of Owner of premises....~{2~...../~.~., ....... Address,,...~ .......... ...Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor.. ./,~',.,~~essI ......... 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 ~lock numbers or description according to,,deed, and show street names and indicate whether interior or corner lot. ' ('~ ,at_. STATE OF NEW~'~).~..K, .., ,¢ ) S ~' ~).',;,,/'?- (Nome or inowiaua~ sioning opplieationj above named. Ho is the ...... ~,,~......~.~......~~'. .......................................................................... - ~ / -(Contractor, agent, corporate officer, etc.) of said owner or owners, and'is duly auCrl'~rlzed 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 wile be performed in the manner set forth in the application filed therewith,o Sworn to be~,~ me this , .~~~ ........... o,.. ..........