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HomeMy WebLinkAbout690-zFOI~J~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the. building located at~.~..~..O...~...~..~...~.~.:~.~,~,..(.~.~..~l~..~.,~.?.~,t...,0~'~t! Map No ......................... Block No ......................... Lot No ................................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................ ~...~ ................. , 19..~., pursu.o'nt to which Building Permit No....~...~.~ ........... doted ........................... ~,.,~, ............ 19,.~,,wo.s issued, one conforms to oil of the requirements of the applicable provisions of the law~ The occupancy for which this certificate is issued is ................ P~A~ O~ F~L~ D~LLIN~ ~ ~m~o,~ ~ ~ ,o .~:~..~.~..~S.~F.}.~...9~S.~ ......................................................... of the aforesaid building. Building Inspector HO~JaD M. FOI~FI 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? 690 Z Date ................................ ~.~,,...~.. ,0.~. ......... 19....~?.. Permission is hereby granted to: Ha~'ry G. Reckhart ...... ~ .~....r..o.~.. ~.v...e. ~...~0.~.~ ................................. ....... .0.~.l.en.t ~..Ne~..Z~.k ................................... to ...... ~..u.~.~...~.o...n....,o.,n,...~.~..n.~....~...t.~.~ .................................................................. pursuant to application dated .............................. ~.'~.......~..~. .................... 19 .~.?..., and approved by the Building Inspector F~e $.5..:..0.9. ............ TOWN OF SOUTHOLD BUILDING DEPART/vtENT Tow. CLE, .'S O.,CE SOUT.OLD. ,. ','. Examined ......... ~.¢"~.......c~....~.. 19...~ Approved ......... ./.Z~., .~..~r:7.. ,~, · 19~.¢Pe r m it No ..... ~4 .~...4~. ....... Disapproved o./c ........................ .Z......~ .................................................... ,.. ................... Application No. ~,~ 0 (Building Inspector) 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 o detailed description of layout of property must be drown 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 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 port for any purpose whatever until a Certiflcote 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, Ordincmces or Regulations, for the construction of buildings, additions or a Iterations, or for removal or demolition, as herein described. ordinances and reaulations. -- The applicant agrees to comply with oil applicable lows, ~'~7~f/ /~'~7 ~' ......... i'~i'g' a ureof~plicant, r n'ame, i a corporation) ...... · (Address of a~pli~g~')' ...................... State whether applicant i wner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ......... '.ii~...'.'.~.'.'.i'.'.i'~'i.i' i If oppiicar~t is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~',X' ~ILZ- E¢:',~ ?'7~'/',/ ]and on which proposed work will be done. Mop No: ~./..~...~....~....d~....~.~.~..~,~./..~....~..... Lo,,t No: .;~-..~...~....~.~ Location of Street and Number '.~.....~.-..~..~....~.~.....~..,.~/<.~....~.....~..~,~.~.Z~_..~.....~.../.~/I, ................. / Municipality ~ State existing use and occupancy of pr. embed use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................................................................................... b. Intended use end occuponcy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition ........ ..V:~.........Alterafion .................... Repair .................... Removal .................... 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 units on each floor ............................ If garage, number of cars ...... ?...'7::... ............................................................................................................................... 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 ....... .~...Q..I.. ............ Depth. Height ......~....:: ........ Number of Stories ..................... /. ................................ ? ....................................... , ........... 1..,/ Dimensions of same structure with alterations or additions: Front ......... ~...c~.. ............. Rear ........ ~ .................... , / ! Depth ....... ~....~.. .............. Height ........ ~..~.. ............ Number of Stories ..........! ..................... 8. Dimensions of entire new construction: Front ......... ...,~:.; .............. Rear ............................ Depth ............................ Height ........ :.....-"-:. ............. Number of Stories ......... '-q. .................. 9. Size of lot: Front ....... ~...~..~.../. .......... Rear ....... .~....Q../. .......... Depth ...... ~..~.:...~....~...~..~ /°-~ 10. Date of Purchase ........ ./.~..o'. ~ ........................... Name of Former Owner ~... ' 1L Zone or use district in which premises are situated .............. ~-~.~.=.r_._:..=.:._ ~.-:~.. 1:2. Does proposed construction violate any zoning law, ordinance or regulation? ................................... ~. ............ z 13. "~ Name of Owner of premises..~.~'.~ ..~..' ............. Addres~...~..~..L~..:.~one NO ..... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor .................................................... Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly afl 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. Thtr STATE OF NEW, YORK. ) S S. COUNTY OF :~,~'.~,...~.. ....... ) (Name of individual signing application) above named. He is the ...................... ~........~....~.. .................................................................................................................. (G: .......... ' '-~,, 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 ali 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 me this ............ ~.,,~. .... do~ of ........... ~ ~:.. ........ 19..~...~.. d~/,Sign~ture o~p'~?? / / ~ ............... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .............. ~.~.... 19..~..~... Approved ............. ..'~...f~..... 19..~....?.. Permit No .......~..~...~-. .......... Disapproved a/c ~ -- -...~............ ........................ ____:::.:..r. zz./... ......... Ctor) Application No....~</.../.... .............. APPLICATION FOR BUILDING PERMIT ~NSTRUCTIONS 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 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 ofc;~f~plicant, or nam/_.~f o corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................................ ............................................................................................................... Name of owner of premises ......... ~..../~....~....~....~......~...:...../..~. '~....1~./~'....'~......~'....~........~...r. .................................................. If applicant is a corporate, signature of duly authorized officer. .................... ................... 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: Street and Number ~.~..T.7....~.~..C~...[~(.~.~.~.~.2..~.~.~~.~...~.~.~. .... Munic'pal'ty ~ ........ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... ~~ .................................................................................................... b. Intended use and occupancy ....... ~.~ ..................................................................................................... Nature of work (check which applicable): New Building ....................Addition ........ Alteration .~.~ .... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... ~ t .~.,,..~...o O~ p. 0 .......... ~.~..o. ................................................ 4. Estimated cos ....................................................... Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... ~ ....... ..~Z ......... 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 ....... ~ ................................................................................................... '2- / ......... .q....~ ............. Dimensions of same structure with alterations or additions: Front ............. ~ ............... Rear Depth ....L~.....~...I. ............ Height ..~..~ .............. Number of Stories ........ ~ ...................... 8. Dimensions of entire new construction: Front .......... ~ ................ Rear ............................ Depth ............................ Height .......... -~:.:: ............... Number of Storie~...~ ........................ 9. Size of lot: Front ....... .f;/m~.~. ........... Rear ........... ~..0.~. ..... Depth ....~'../~!....~'...O...../O~/ l Ir. ..... ......................... ........../) 10. Date of Purchase .......... /...0...>..~..~..SZ...~ .............. Name of Former Owner ,'-Z/~%Z/¢~..~..__ 11. Zone or use district in which premises are situated..../.~.~.../'~.!...C'..~.7'..4/.~to.~.U.L-....'f".../("~.....4...~.../.~..~./*'J'..'/..L.~...~ .... 12. Does proposed construction violate any zoning law, ordinance or regulation? .... .../~..~. ......................... . ............... 13. Name of Owner of premises'"~':'"~'ff"C"~'"/~' '~'"~'"'?"Address/~"~'"'~"/~'~cC~"~'"'/~'~'/'~'"~h°ne N~'~'~~ 4Z ..x/~.l '3'-' Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor .................................................... Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly alt 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. (~ , r Pr4't~o ~- /¢ l~'~c t~ o~ - StOol STATE OF NEW.,~,. ) S S COUNTY OF ..~t~.~ .......... ) ' .... ~.~..~_...~.C.~..Z.~:.~..~...C. ............. being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ....................... O...~.L~.~ ........................................................................................................ (Cv,,I,~u,, ~g~,~t, ~o,~.~[~ =fficcr, etc.). of said owner or owne~, and is duly authorized to perform or have pe~ormed 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 application filed therewith.