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HomeMy WebLinkAbout728-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...~...~J'.8 .......... Date ................................ J[~.i1....26.., 10.60_ THIS CERTIFIES that the buildin,g located at .]~/.JB...~Gb~al]etq...~o~l .......................... Street Map No..C~pt~TM- ...... Block No....ZZ,~, ............. Lot No..:Y,~ ......... G~P,e~]pozf;.t......N,.~Z, ............ conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................... ,,T~L~qP,. ....... 2.0 ............. , 19~.~....., pursuant to which Building Permit No...,~..~28 ............ dated ..................... ~T.g.~ ....... ~ ........... 19..~'.~.., wa~ issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ................ ................... P. ~'.~ .v.a.~t~e.. one.., fe, m;i,1 ~r...d.~e;1,1 ~,~ ............................................................................. This certificate is issued to ...W.~[~,:l,a~.....]]~e ............... (.0~@~'.) ............................... ; ..................... [owner, lessee or tenant) of the aforesaid building. Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 728, z Date ....................... ~T.l~.e.. ~ ..................... lf.9 ...... Permission is hereby granted to: .......... ~.o.~.¢.~:~.....~.. ............................. ~hirley, to ~..~d A~ e~ fa~i~E d~e~li~ at premises located at .~ .~ ~ob~ ~ (Dr~y~te road) Green~r%~ pursu*nt to ~pplic~Hon d~ted ............................. J~e._..~ ................. ]~9._.., ~nd ~pproved by the Building inspector Fee $~..0g. .............. Building Inspector TO~N OF $OUTSOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUT,OLD. ,. ¥. ( ' d'ng nspector) APPLICATION FOR BUILDING PERMIT Date ............ .J..1J~f~...2.0. ,. 1.~_~ .~. .................. 19 ............ I N$'I'RUCT~ONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building I ~spector. b. Plot plan showing location of lot and of buildings on premises, relationship to adioining 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 alterations, 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) Stanley W. Suffolk Developments Ina. Bx 78.?..M.orzt. a ~k.. ~ighwm ~m.. Shl~.le~.,... E o Y, ................... (Address of applicant) State whetRer applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises...W.11'Ll~m. ZB.t~ ....................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and tit~e of corporate officer) Location of land on which proposed work will be done. Map No: ............................................ Lot No: .~. ................. Street and Number ....... ~.O.~.l..~..~.O...~....,~.~..~ ..................................... C}~.~.extp. or.~,..~...Y ........................................ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................~..~.~1"~.8. t;.~U.~t.~O~ ............................................................................. b. Intended use and occupancy ............... ..I~....e..1...]:.~..~.~ .............................................................................................. property lines. Give street and block numbers or description according to deed, whether interior or corner lot. 3. Nature of work (check which applicable): New Building...X .............. Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost......~.P~"..O~:.*....~.~2.~f).0.0.o.0.0. ............ Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling unlts.......O.~ ................... Number of dwelling units on each floor ........... .'. ............... If garage, number of cars ....... ..o..~..e. .............................................................................................................................. 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 ....... · .~....~.. ........... Depth ...~......~.. .............. ..... ~'~"~'°' u,-- ,,Number of Stories ............................, ~ ,, F Height 9. Size of lot: FrOnt ..~.~.~ ____ ~--,>-Rear ......~.~..¢.~ ............. Depth ..../. ~.~....)......j..~_..~. ,~ ,,~7 z/ .z~- ~-'~ -~ /- --~ 10. Date of Purchase ..... ~.~L~..-,4..~...~-~../...k..~....~.... ......... Name of Former Owner.~.....4~...¢-~...?.~:~...~..~.~/..~T~!...~....~ ..... t/ . ~/, re ~se are situ ted ~ d I 1. zone or use alsrr crm wn cn p m s a ............................................................................................... h 12. Does proposed constrhction violate any zoning law, ordinance or regulation? ........ ~J..~. ................................... 13. Name of Owner of premises...Z~.4~..~../...~..~ ........... Address ............................................ Phone NO ..................... of Architect..~ ......... ..~...~...~/~. .............. Address ..~4J~......~..,~. ...... Phone NO. Name .................... ~'~'/0' ...~~.~.Address ..,~.~...~.(,,~ ............... Phone NO./~I~..?..~'./..*~..~~?~J Name of Contract ~y ........ PLOT DIAGRAM Locate clearly and distinctly oll buildings, whether existing or proposed, and indicate all set-.back dimensions from and show street names and indicate /00 STATE OF NEW~REW~ORI~ //~,,Y/,/~,,~ ~ ~ COUNTY OF... - ............................... ~~..~~ing duly~?n, deposes and says t~at be is the applicant (Name ~i~du~l si~ application) ,. .............. ............. .......... " ........... - (Contr~r~gent~(e officer; etc.~"'~ .............. of said owner or owners, and is duly authorized to perform or h~for~ed 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 wiJl be performed in the manner set forth i.n the application filed therewith. i Sworn to before e th s , . Late ot New ~ork ........... ~.~.... ~ ": ............... ~~' ~'"'~S~ FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... .~...~..~.. · 19..~. · .'-/ Approved ............. ..~..~:~?19~.Permit No ...... ~..?.-=~../... ...... Disapproved Application No ...... ..~...~ .~.... APPLICATION FOR BUILDING PERMIT Date ............ J~t,~e... R.0. t 195.9 ................... 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 a Building Permit to the applicant. Such permit shall be kept 99 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 alterations, 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) S~nley W. Suffolk Deve].opmen~s Y~uc. Bx 78.7.. ~ nn g~uk ..~/lghw ~.~m .. Sh l~:l e.y.,../~...Y. ..................... (Address of applicant) State wheth.er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or' builder. Name of owner of premises....~.~.~'.~..~.:~,.~. ....................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) t. Location of land on which proposed work will be done. Map No: ............................................Lot No: .~.. ................. Street and Number ~.0~.0,~ ,~.~ .......... Or.e~p.o~.~ ~.Y ............... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................~..~..~....~..O..~..~..~.~.~..~..~...~..0~ ............................................................................. b. Intended use and occupancy .............. .~?..?.~.~...~. .............................................................................................. 3. Natbre of work (check w, hich applicable): New Building...Z ............... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost.....,.~.~..,~.~..O~...:....~.~.O..9.0..:..0..O.. ............ Fee ...~../O,....r..~ ...................................................................... (to be paid on filing this application) · 5. if dwelling, number of dwelling umts ................................ Number of dwelling units on each floor ........... .'.. .............. If garage, number of cars ....... ..O..~..~. .............................................................................................................................. 6. If business, commercial ar 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~ ................................ 8. Dimensions of entire new construction: Front?..~..~ ...... Rear6~..-~.-~ ........ Depth ....~.~....? Height ~'J~t,.0..,.~.,~-~-~?.../' ..... Number of Stories ...~,-~..'>~ ................ 9.Size of lot: Front ..~....~..~..~). ............ Rear ....... ./..~.~. ........... Depth ....... '}"??"J'~ Date of Purchase ¢~..~.,/ ~.. ,~, '~-"~)' Name of Former Owne~' ~..~..'.~..'?. ,0 ...... ................................ ............. 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 premis,es.~.~',~..~...z....,~r~,~. ...... Address .......................................... Phone NO ..................... Name of Architect...,,~-~ ....... ~.~'...v~.~..~, .......... Address ~(x~'.'..~..¢..¢~:..~.r...Phone NO. Name of Contract~---~~ddress ..,~,,<~.~....~...'.~: ....... Phone NO~...~...~.~...?...~.d~ PLOT DIAGRAM Locate dearly and distinctly all buildings, whether existing or proposed, and indicate alt 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. /00 ~.....~?...'~=~F~,~ .......... being ,~uly sworn deposes and sayb t~t he is the applicant above named He is the .......................... ~ ........ ~'~""~~""'~ .............. ' (Contractor agent, c~orate of~cer, etc,) of said owner or owners, and is duly authorized to perform or have pe~ormed the sa]d work and to make and fi e this app JcatJon; that a I statements contained Jn this application are true to the best of his knowledge and belief; and that the work will be performed Jn the manner set forth n the app Jcation fJ ed therew th. Sworn to before me th s .,~,~ ~. ~0~ ,. ~ ~H~,, of .~ 1~°t*~ ~ .... ~ s~ ok c~t~re of app cant) z~ .