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HomeMy WebLinkAbout648-z~O~V~ N~O. 4 CERTiFiCATE OF OCCUP/~NCY No ......... Z...92.7 .... Date ......................... ~O.V. ~.~ ...~5....i., 19_..6..0 TH]IS CERTIFIES that the building located at ..~.~],e~..-D~.&Ve,..Yla~i~tt~k.. Street .t~ap ~x~;.~.,..,~.a.~..~o ....... .*.?..?. .......... ~ot ~'ro ....... ~.?...~...~..4.~ .......................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .................. i~t.1...2.~ ........... , 19~.9.. pursuant to which Building Permit No ........ ~....~.~.~ dated ................ ~Jr~J,.,.2O ............ , 19,.$..~.., was issued, a~d conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is .............................. ~v~l.~A~E..0hrlg ..F~II2b3~..DI~LL~[~t~ .................................................. '/'his ceCtificate is issued to ...¢,...lgoJ, llmbsl~.~.,....O~rt~:~. ................... ...... .................................. (owner, lessee or tenant) of the a~oresaid building. FOCal 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) No, 648 Z Date ............................ -A. pl~-i --..~8 ........... 19-.,~9.. Permission is hereby granted to: A. Reilly & ~on....~C""Ch~'i"C~m~r~ .................................. ............. ~a.¢.¢,i~c1~-~.....~.J.e ................................... to ..... BU.¢ .~.. a~td.. e~.l<~e., e~,. a~l.t~.~..~m .~. e~[e.%~.. ~el.~.i.~ ............................................ at premises located at .3:~.~;,.~.~.~,~.....('~.~;..~ ..... ~.~¢~....,L~'b.., .........~]~ ............................ .......................................................... ~'%uck~" ' B'~::f'~ ...................................................................... pursuant to application dated ........................... ~laz~J~ ....... ~ .............. 19~¢j...., and approved by the Building Inspector Fee $.5.~0 ............... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... .~ .................... Z...., 19..,..~.. ( ' Approved ........................................ ]9 ........ Permit No ............................... Application No. (~ c/ ~e~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. This application must be campier.ely 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 punic streets or amos, and giving o detailed description of layout of property must be drawn on the diagram which is part of this lacotlon. 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 o 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 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 Lows, 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 laws, ordinances and regulations. ....... ........................................ (Signature of applicant, or name, if o corporation) (Address of applicant) State wheth,er oppriconf is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................................ ............................................................................................................. Name of owner of prem ses ....................... '.....?.," ..,...' 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. Mop No: .f~d~....~.L:./..Z..~..~.fr.~.~.:.... Lot No: ...... ~...~:~..(..o Street and Number ....~:.~.¥.~...~....~....~.~::..~..:: ............................. ~(...~....'..~....~.x.~f::.....~...~';~/..} .............................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ........ ~,...,...,~.; ........................... p.~ ............................................................................... .. b. Intended use and occupancy ............................................ .....: ......... :!.....; ............................................................ 3. Nature of work (check which applicable): New Building .................... Addition ....... ~..~..~ ........ Alteration Repair ............. ~....Removal .................... Demolition ................. ~..Other Work (Describe) .................... ~. [:st mated 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 ................................ B. Dimensions of entire new construction: Front ....... ],...~. ............... Rear ..... (...o. .................. Depth .,/..'...b~.. .................. Height ............................ Number of Stories .....0,~ ........... 9, Size of lot: Front ............................ Rear ............................ Depth ............................ 10, Date of Purchase ........ ...t':~.~ ....... .......... Name 9,f F~rmer Owner 1 1. Zone or use dtstnct m which prom sos are sffuoted ........................................................................... 12. Does proposed construction violate any zoning iow, ordinance or regulation? ........ .,~,,..,~ ................................... 13. Nome of Owner of premises......, ........... ~¥,.~..~,~.°...,.Address ............................................ Phone NO ..................... Nome of Architect ............... i ........................................ Address .................. ~. ....................... Phone NO ..................... Nome of Contractor .~.-C~.~ ~,'~¢~...,%~<..,.Address ,...,.~J~,.,.,~ ........ ~ ............... Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oll 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 V,~RY-,~:~ ~'~ ) S S COUNTY OF~...) ' ..................................... ~.....~' .............. being duly 'bworn, deposes and says that he is the applicant above nam d. H ' ..,...~ .................................................................................................................... (Contractor, agent, coriborote officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sold work and to make and file this application that all statements contained in this application ore true to the best of his knowledge and belief; and that the work wi be performed in the manner s~t forth in the application filed therewith, Not~ Public, ~~.Z..,...~~' No G2 t',S449GS, Sufiolk County TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........ '..,/:. ......... i.....~.r../..... 19...~.../.. Approved .................................. ' ...... 19 ........ Permit No ............................... 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 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 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and 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 ....... .k~g..~,x~.~.~.m.-~.~,.~,~x:~...: .................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. kocotion of land on which proposed work wiJ' bedone. Map No:. .~.~j, ...... Lot No: ....~..~...'::,..t./.o Street and Number ....( ~-.~ ~.~....~{?..A.~.............................Municipality 2. Stoto existino use ond occuponcg of premises ond intended use ~nd occuponcy of proposed construction: ~, Existing use ~nd occupancy .................. .~ ....... ................. ~ ................................................................................ b. Intended use and occupancy ........................................... ~[...~,,x..,~,,~.,~ ........................................ 3. Nature of work (check which applicable): New Building .................... Addition ........ ~i.....Alteration ......~ ....... Repeir ................ ~...Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ....... .!. .................................................... Fee .....Z ....... ~..... ....................................................................... (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 o~ existing structures, if ~y: Front ............................ Rear ................... Depth ..... ~ ......... Height ............................ Number of Stories ............................................................................................................ Dimensions of ~me ~tructu~e with ~lterqtions or ~dditions: Front ................................ Rear ................................ Dept~ .............................. Hei~ .............................. Number of Stories ................................ lb 8. Dimensions of entire new construction: Front ............................ Rear t O Depth t ~ Height ............................ Number of Stories ............................ 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Dote of Purchase ......... :,:/:....: ..................................... ~Name 11. Zone or use district in which premises are situated .................................................... .~..~ ................................... 12. Does proposed construction violate a~ ~onjng Iow, ordinance or regulation? 13. Name of Owner of premises ........................................ Address ............................................ Phone NO ..................... Name of Architect .1 .~.....,~..~, ....... ~..~ ......... Address "~'li~ ............... Phone NO ..................... .......... ~':' ~ b ~ Name of Contractor .................................................... Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly ~ll buildings, whether existing or proposed, and indicate oil set-bock dimensions from property lines. Give stree't and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW )/xDR, I~, ,~,/~ ) S S COUNTY O F ./~,/-,~a~2~.. ) ' · ........................./- ~/-,,~~~__K~y"~ ............. being duly sworn, deposes and soys that he is the applicant (Name of individual si~l,~_lc.a~ti~/~ ~ / ~bov~'~'~'~ed. He is the ................ ~ ........................................................................................................ (Contractor agent, corporate officer, etc.) of said owner or owners, ~nd is duly authorized to perform or have performed the sa d 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 application filed therewith. · ~~ ~~;;' ~ -* N~taryPubtm, State°f New YarN Not~ Publlc~~'"¢~"~*~'''~ N0 52-0~4063, Suffolk County