Loading...
HomeMy WebLinkAbout656-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the. building located at~.~¥~.~...~.....~.?'...~..e...~.O...P¢~.*..,...~.O...~...~....O..~...~. ...... Street Map No. i.~.~..~ ............... Block No ....... ~, ..........Lot No .....~.~.~ ....................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated 19..~.,'~.., pursuont to which Building Permit No ........................ dated A~ril ~0 ~ - .................................................... 19....~ WaiS msued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ................ ~rA~ O~ F~IL~ D~LLI~ Teary H~n owne~ Th~s cerHfice~e is ~ssued (o .............................. ~ ..................................................................................... (owna% lessee or tenon~) of the aforesaid building. FO]~IV[ 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) N? 656 z Date ................................... ~p~;L1.....~O .... ] 9.5~... Permission is hereby granted fo: Douglas Roger. s....A/C.... ,Terr.y. ·.. Ha.rra~ ............................... .............. E~.~. ~".ion,....~,X ,. ............................. to ....~lf.e..~,~.emM.~.~L~.~....~.~f.M..o..n...~..~..e..x...t..~.t4..~.~.?~.z.!.t.~g ............................................. at premises located at ,.~/~..,.l~&%%l,e..,.p~,~vaCe.~l ...................................................................... ........................................ .Ho~,/~on..Po.fm%~....l!~ou%hel4,.....g,.¥.... .......................................................... pursuant to application dated ........................ ,t~lo;~:L],....~O ..................... 19~.c)....., and approved by the Building Inspector Fee $..5~00 .............. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c ............... ~. ........... ~ .................... ,-~ ............................ Application No....~....~...~...~.. ............. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. 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 o detailed description of layout of property must be drawn on the diagram which is port 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 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 Deportment for the issuanoe of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk, Counfy, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or o Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable laws, ordinances and regulations. (Address of applicant) qtate wheth.er 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 ~uly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map N~.C~ ........... t .............................. Lot No: .................... Street and Number ~.~:~....~..?...~......~....~.:...~.)....~.... ........~...~......: .......................................................... Municipality 2. State existing use and occupancy of premises and intended us/e-~ond occupancy of proposed construction: a. Ex,sting use and occupancy ............. ~(...~.~;.V..¥.~.';z?:.%....~!.~.~(.~.~'~.-,...' ............................................................. b. Intended use and occupancy ....................... 'M.~...~ "~-z~ - 3. Nature of work (check which applicable): New Building .................... Addition ....~.~,......Alteration .................... Repair .................... Re,~oval .................... Demolition ................... :~t,~ber Work (Describe) .................... 4. Eshmated Cost ............... ~,c..., ......................................... Lee ........................................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ ~r .......... 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 ............. ~.i .........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 ........................................................ 'A" ,~,,,~ 7- ....................... 11, Zone or use district in which premises are situated ..................................................................... 12. Does proposed construchon~' ~a-,/vJ°l'~nY zor~ng law, ordinance~-~"~'v~'~/~'°r r~gulpt~,~ .,,...,,r',',',',',',','~?~,~. .................................... 13. Name of Owner of premises,.~....~h:..~¢.....Zf..~'.~,~.::f:~.~...Address .,~..~.~./.~T%~..~./~..~'-,~ ....... Phone NO ..................... Name of Architect ................. :~/.....(......:;,~ .................... Address ..'~...~....~.7.....~..../.' .:~..."....~,j,~Phone NO ................ ; .... Name of Contractor ....... ~.....~.m,.~. ....... Address ......~..~.....,¢~'J/~;~.~ ......... Phone NO..~....~...~..~..~.'..~.., PLOT DIAGRAM Locate cleorly 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. STA'I'E OF NEW YORK, ) S S. COUNTY OF ............. ~ .............. ) ~ .~~ ~:~ ........................... belng duly sworn, deposes and says that he is the appllcant /{~arndof individual ~gning ap l~tion) above named. He is the.....~~'i..~~. ........................................................................................................................... (Contractor, agent, coqborate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file th s app [cat on; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed Jn the manner set forth in the applJcatio~ fHed~herewJt~ Sworn to before me this x, ~"~7~ ,:~ ~,-~ ~?'~ ~Z'~/~'~ - ............ ~ day of .......... ~~..~ .... 19...~..Z... Juo,~, ? ~S~ature of app~ant) TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ..................... ./../.. .............. 19...../'./..Permit 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 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 issuanae 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. .........................~...~.....>_ !~':'~...:. ~.~...K ?.~ .~-.~ .................................... (Signa~°f~pPlic~t, or name, if a corporation) .................. (. . ,: ~-~ >. .:. ...... .¥. ."/, .~ ~. . f~:./. ~? ..................................... (Address of applicant) qtate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ ........................................ : ...................................................................................................... ' Nome of owner of premises ........... .z::~.~.W~.'.'.~..; ..................................................................................... If applicant is a corporate, signature of c~uly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ....... :...;~ .......... "-~.q.. ................ Lot No: ........~. ........... Street and Number .~..~7 ......~...K..?......~..:..%~......~,>.. v. ,.-.--:~__: ....................................................... ~ Municipality 2. State existing use and occupancy of premi~ and intended use,~p~ occupancy of proposed construction: a. Ex sting use and occupancy ....... ::~/~4~..>.~.~.~r:~c:~...~,~...~;.~:..~. ........................................................ b. Intended use and occupancy ......................... ~¢~.~-=..: ................................................................................. 3. Nature of work (check which applicable): New Building .................... Addition .....fc~..........'...Alteration .................... Repair .................... Rer~val .................... Demolition ............... ,.~.Other Work (Describe) .................... 4. Estimated Cost .................. '"~'"~'~!.....t'.: ......................... 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, f any: Front .~2...7.. .......... Rear....~...(. ................ Depth .~ ................. / Height .......~..~.=. .............. Number of Star es .... ~ ........................... · ~(,~ / *~(,; ~ ...... Dimensions of same structure with alterations or additions: Front ......... ...'~.../. .............. Rear ..:.~Z.'../.. .................... / Depth ........ f~. ................ Height ....... .~...~.i~ ........... 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 ........................................................ 11. Zone or use district in which premises are situated ................................................................................................ ' ' ' ' _ ' ' Does proposed construct,on v,ol~z~ z,~,,~jn.,n,n~ Iow, ord,nance ~,~gu~.~ ................ .~......~ ................. 13. Name of Owner of premises'""""c~"~'~'~'""~'~'"~'<~'~'?Address/,-'r~ ,,,~. r~'~ ~, ~,,';~?T~c~'"r'~'~"-~"~'"';"";'"';"Ph°ne__ _ 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 YORK, ) S S COUNTY OF ......... ~ ........ .~.~.~ .............................. ~,~...~.'~,~,, -:.~...?.~ ....................... being duly sworn, deposes and soys that he is the applicant (Name z~f indi,v, iflual signing/Sppli_~catigr~ above named. He .s the ................... ~.~,~.'.~ ..... ~ ........................................................................................................... (Contractor, agent, corlborate 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 set forth Jn the application filed therewith/--~ 19....~...~... ~0~S~gnf~t/u re ~-/ ~ ' ~ - ~ ~ ~/ Notary Pubhc, State of/~ew York / Notorv Pubh~f~--~./..:~=' ~ ........ C,~,~,;ty No. 52-0344903. Suffolk County -- ~ g¢¢~ " C. omm~ssion ~xpircs jV[ar~l! ~0,~ k~/