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HomeMy WebLinkAbout705-zFO~M NO. 4 TOWN O!~ $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located Map No ........?..?.?. .......... Block No. *** ' ........................ LOT No. conforms substantially to the Application for Buildin!;) Permit heretofore filed in this office doted ................... ~r.~....~. .... , 19.~.~..., pursuant to which Building Permit No ........... .~....?...0.,~.. ..... dated .......................... ~'~e....~l'. ............. , 19....~[~, was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy forwhich this certificate is issued is .............. ................................................ ............................................... This certificate is issued to .~...~.~.~.1~......~..0.~.]-..0...~..~..t....~...t~....~..~.. ........................................................ (owner, lessee or tenant) of the aforesaid building. Building Inspector HOW 21D M, FO~,M 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.° 705 Z Date ........................... ~T,~I~ ..... ~/ .............. 19~j~... Permission is hereby granted to: ............ I~.t,t~.t~k.r-...,~..~ ...................................... to j~.~d., m~. ~dd.i.%i~. ~. a~. ~ sti~lj. ~ ~.;_.~ .......................................................................... t at premises located a ...lt/j.~l/oo6..]~d.(...ll~/J~.jtl~.~l~.Jl~ll..Jl~l~!~ ............................................... ........................................................... l~eaon~.e, ..... .Z.o .......................................................................... pursuant to application dated ................................... ~....~ ............... 19~9....., and approved by the Building Inspector Fee $..~01~ ............. Building Inspector~ FOR1V[ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ............ :T/. '--- ~' .......... 19 ........ Approved ........... : ........ ~ ................... 19...?....Permit No. ~ '~/-2 Z~ (Building Inspector) /' Application No. '~/ 0 .~-~-~ APPLICATION FOR BUILDING PERMIT V I NSTRUCTI ON S a. This application must be completely filleal,in by typewriter or in ink and submitted in duplicate to the Build'ing Inspector. b. Plot plan showing location 'of lot and o~ 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 cover~.d 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 onthe 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 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'~orporatibn) State whether applic~,~gt is owner, lessee, agbnt, architect, engineer, general contractor, electrician, plumber or builder. ............. ........ .............................................................................................. Name of owner of premises.....~:~.~ ........... '~.~..~ ............................................................ If~,~pp/plicant is a corporate, sign,.~ o! duly author~ed officer. ..... ~(amean~ofcorporateofficer) ~~ '~;'~ (/,~ff0v~cx~.~f~-'~'~) 1. Location of land on which proposed work will be done. Map No: ....~L..~.: .............................. Lot No: .................... Street and Number ,~...~..~...~.......:.~.~. ~./.:.....~......~....~..~...~ ........................ 2. State existing use and occupancy of.p~r, emis, es,,~nd intended use and occupancy of proposed (onstrucffion: o. Existing use and occupancy ...... ~~ .......................................................................................... b. Intended use and occupancy....,~~ ....................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... (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 ...~...,~...~...0. ........... Depth ............................ Helght /~-~ '.'-...'~... ......... Number of Stories ........... ~ ............................................................ Dimensions of same structure with alterations or additions: Front ......'~...~..:.~....~. ............. Rear ...~.~....~.~.. ............ Depth .....~..~.?....~...~ .... Height .../....~'...;.T.....-m:. ........... Number of Stories ...~f~. ................... 8. Dimensions of entire new construction: Front /~f'- .~.'~ Rear ........... :...?.. ......... Depth ............................ Height .~..:~..../..~..:. .......... Number of Stories ..... ~ ............. 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ..................... Name of Former Ow, gar ........................................................ 11. Zone or use district in which premises are situated ............................................................. ' .............................. 12, Does proposed construction violate any zoning law~ ordinance or regulation? ......... ...~..¢~.. ................................. 13. Name of Owner of premises ........................................ Address ............................................ Phone NO ..................... Name of Architect..~ ...................................................... Address ............................................ Phone NO ..................... Locate clearly and distinctly oil 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 shc~/~s~tI ~names and indicate whether interior or corner lot. STATE OF NEWr¥-ORJ~ .~,c_) S S COUN~Y~~-7/-~Z.- ~ ~ ,,,,~OF .... ~./..'zd...'~...~:....) · ' - ~~'~-~.r.'..~~ ............................ being duly sworn, deposes and. says that h~ is the applicant (N~me of ~vidual signin~.l~i~)~ ~ . . 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 thb application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work wil~ be performed in the manner set forth in the application filed therewith. Sworn to before~ this ~ ~., ~. ~ ~ , ~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Approved ........................................ 19 ........ Permit No..~...( ................... Application No .......4...\C. r:~ ........... APPLICATION FOP, BUILDING PERMIT Date ................................ ~:C.C.:.. :..[. ...... 19..~,.,. ~ .... 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 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 port for any purpose whatever until a Certiflcgte of 0ccu~ar~c~ 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, os herein described. The applicant agrees to comply with oil applicable laws, ordinances and regulations. (Signature of applicant, or name, if o corporation) ~ ~ (Address of opplicont) / /~/ State wheth.er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises.....,~,~:~ ............ ~. ............................................................. If applicant is a corporate, signature of dul~ authorized officer. 1. Location of ~and on which proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number :~2~'~(~ ,Z~,~,...~./~,Z ~,~.......':~.~/~./?~,~v.....~,.~.:..~~....~..,.~...~(. .............. ; ........ 2. State existing use and occupancy of p~emises~nd intended ~se and occupancy of proposed Cbnstru~ion: ,. ....... ........................................................................................... ....... ......................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition ....z ............... Alteration .................... Repair .................... Removal .................... Demolitlon .................... Other Work (Describe) 4. Estimated Cost....n~.f?L.~. ...................................... Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units....---------,~¢~:.¢¢~ ........ Number of dwelIin§ 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: Frant..,;.',"F.??.;.'L!~. ............. Rear .~..~.~..;.:~'~ ............ Depth .~..~...~' .~'~ Height ..../_C~.....-'...'~...'""' ""~" ......... Number of Stories ......... ..~..~ ..................... :'i: ........... ' ........................ ~':~'"' .................... Dimensions of same ,,Structure with alte~tions 9~r additions: Front ...C~..~...~.~... ................ Rear ...~...~...~.~... ............. Depth ......"~.,.."% ......... '. ......... Height ..C....c".........."-: .......... ;. Number of Star es ........C~ .cf. ..... 8. Dimensio~ of entire new construction: Front...~... ....... ./.. ............ Rear ...~?:..,~..~. ........... Depth Height ............................ Number of Stories ............................ 9. .¢~ize of lot: Front ............................ Rear ............................ Depth ............................ 10. [)ate of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ................................. ./~.J...~ ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ....... i~,//.~.). ................. '. ................. 13. Name of Owner of premises ........................................ Address ............................................ Phone NO ..................... Nome of Architect ........................................................ Address ............................................ Phone N~ ..................... Name of Contract~..~'.~.../~-.-.~/(~... .................. Addre~.~/...y/.:~,~..: ........ Phone .z~.....~......¢~.~..~...~ PLOT D~AGRAM ' , / Locate clearly and distinctly all buildings, whether existing or. proposed, and indTcate oil set-back dimensions from ' ' property lines. Give street and block numbers or description acco?ding to deed, and sh~s.~.tr~f names ahd indicate whether interior or corner lot. - ~ .................... ~ ' \ STATE OF NEW .~,ORI~, fl / ) S S COLINTY~ OF ..... ,'~¢¢;(~ zz;; .¢¢(. b,-. ) .... ~. (No~e of in,dual signing op~lic~tion)~ ~/ 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 set forth in the application filed therewith· Sworn to before m this ,,---~ _,.~ 1. ~g~ ~, I _ -, x .,