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HomeMy WebLinkAbout836-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z.~33~q ...... Date ............. ~u.~'g.ry.,,, 5, 19.7~. THIS CERTIFIES that the building located at 8/8..Soun~l .¥:t~ .Ava ...... Street Map No. ~ ........ Block No.. XZ-X ..... Lot No..XXX.. $0~'¢h9~[~1.. ~I.oX ,. ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... .Sgp. t}.' .~.2..., 19 .~9.. pursuant to which Building Permit No...~.~65.. dated ......... 89P. t}.. J.~..., 19 ?.9.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .P.~.i.va.t.e. 0.n.e..i'.a.~¢~.~. y..d.-tgg.l.~.~.n.g ...................................... The certificate is issued to Sianley .k/tetazynski ..... (~mer ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .B. :V :b.e.~9r.e' .r. 99~.~.r. 9.¢l. ........... UNDERWRITERS CERTIFICATE No.B...?.: .b. 9.fP~'9. ~.e.q.u~?.qd. ..................... HOUSE NUMBER ....... 1 ~ 89©. Street .. Sou.n_~. Vlew. k~ ....................... --Building Inspector ~ FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 836' Z Date ............... 8ep%e~be~....Iud. ................. 19~9 .... Permission is hereby granted to: ~%~a.l~,y.' ~i~F~e~'i ............................................. ..7~--~7t.~% .......................................................... .... ~re~k.l.~... · ~.....lt[,.'f.,~ ...................................... to · B~i'l'~" ~e ' '0~'~"'£~'~.~yy "~¢~ ~'.'t' ~ ~ ................................................................................................ at premises located et "8'/8.'"Scxmcl..Vle~-.~e ..................................................................................... ................................................ ~ou~h~,t~.... ~ ................................................................................... pursuant to application dated ............................ ~9~b ........ ~'~ ................ 195~)...., and approved by the Building Inspector Fee $~0'*~ .............. Building Inspector 7~ - 57 Street Brooklyn~ N. Y. Feb. 3~ 1975 11220 Mr. Hindermann Building Inspector Town of Southold Southold~ N. Y. Dear Mr. H~nderm&nn~ Since your inspection of premises at 11890 Soundview Avenue~ Southold~ in January 1975~ installation of all lighting fixtures has been completed. Please issue a Certificate of Occupancy for this dwelling. Sincerely, NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N; Y. Approved ..... ............ : ...................... , 19.~..~..Permit No .............................. ~'"~ ~',~//~-~' ., / . / (Building Inspector)( FOR BU,'D,NG ERM, _ 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, relatic~nship 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 part for any purpose whatever until o 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 ~emoval or demolition, as herein described. The applicant agrees to comply with oil applicable laws, ord inances and regulations. ~'-z,-- ~ ~1 ................... ~~ ~3c.".~:.~ ~I! ?~,~ ff (Signature oI applicant, or nan~ ~/a corporation) r 7 ~.ff. ........ ~..?, ........ .~.: ...... ~...o..,,_,~:X: ( L ---~--~ ..... (Addressofapplicant,- State wh applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ::: ......... ................................... . .................................................................................... o.e of own,r .............................................................. 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: ........ ~.....~... ................. Lot No: ......~:..../. ........ Street and Num e~ i~....~..~..~ ...... ~"~"/" '/"~""~"L~" .................................. /I~! ~ / //~/L~9 ~ Municipality- 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................................................................................... b. In~ended use and occupancy ............... ~.~...~1' / 10. 11. 12. 13. Nature of work (check which applicable): New Building ......... ~)~ ....... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... Estimated Cost......,.....-¢.;~...~.....~...O. .................................. Fee .............................................................................. (to be paid on filing this application) If dwelling, number of dwelling units ........ ~ ......... Number of dwelling units on each floor ............................ If garage, number of cars .......................... ' .................................................................................................................. If business, commercial or mixed occupancy, specify nature and extent of each type of use~ ............................. Dimensions of existing structures, if any: Pront ............................ Rear ............................ Depth ............................ Height ............................ Number of Stories ............................................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ Dimensions 'of entire new construction: Front ............ ../~.....~.. ...... Rear ......... ../~...~..~.. ....... Depth .......~.....~.. .............. Height ............................ Number of Stories ..... ~ .......... Size of lot: Front ...... ~...~.../'.. ........ Rear ............................ Depth ....... ..~...~ ......... Date of Purchase .............~.~.........../.~..~....o~.. .............. Name of Former Owner ....... ~.c_.~......~.......~; ............. Zone or use district in which premises aye situated .................................. ] ......................................................... Does proposed construction violate any zoning law, ordinance or regulation? 'Name of Owner of premises ........................................ Address ............................................ Phone NO ..................... Name of Architect......~.....~..~..;;.T--T. ..................... Address ............................................ Phone NO ..................... Name of Contractor. .................. i ................................ Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oll set-back dimensions from property Jines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. S'.v, A, STATE OF NEW~YQ.RI~/, ) S S COUNTY OF ..~$r/~(~C... ........ ) ' .... ~/'/'" "~/~ ~J ~.~..' be n du sworn, deposes and says that he is the applicant ................................... /.. ~'.{~-P,~X~....: ........... ....~::s~..~: ...... g y (Name of individual signing aPplicatio~u 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. Nota. P.b,,c... , . FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ......-,~ ;.;. ;).".: .{C.. ,.../..~.... 19.,~.../, Approved ................ :.'. ......... ; ........... 19..'~.:~..Permi, No. ,.¥',...~"~,..~...?.. .......... ............................(B.i,ding' ,ns .............................. APPLICATION FOR BUILDING FERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink ond submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to odjoining 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 coYered 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 wl~ole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspect6r. APPLICATION IS HEREBY MADE to the Building Department for the issuonc~e of a Building Permit pursuant to the Building Zone Ordinance of the Town of So~thold, 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 o~applicant, or narrte~itJa corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...... ~'~1-~......~ ............................................................. If applicant is a corporate, signature of duly duthorized of icer~riz~d nfficer, v (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ......... .~......~. ................. Lot No: .....~..~, ........ Street and Numi~e~..~,-~...~..~i~~//~"~'~~'~' ~ -- ----" ................................. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy., ......... ~.~...c,.,.,,~.~.......,,~--....~. .......................................................................... 3. Nature of work (check which applicable): New Building ........ ./~. ....... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated 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 ................................ 8. Dimensions of entire new construction: Front ............ .~./...~. ....... Rear ......... ../~....~.~ ....... Depth ....~....~T.. .............. 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 s tuated .................. /~ ........ ,lr~,.t ......................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ........ ,A~..~ ................................... 13. Name of Owner of premises ........................................ Address ............................................ Phone NO ..................... Name of Arch~tect.....~....~.~......--~...' ~- ¢ ..................... Address ............................................ Phone NO ..................... Name of Contractor .................................................... Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate ali 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 NE~ Y,ORJ~i ) S S COUNTY OF ~,.~,~,~,~J~.. ......... )~ ' .............................................. '.%.::.;h.~ ................. ~..~%;*~F'-.~ .......... Demg duly sworn, deposes and says that he is the applicant (Name of individual signing application)' above named. He is the ................................... /(~F~.~:~ ............................................................................................. (Contractor, agent, corl~orate 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 aDpUc, g. tJon filed therewith. Sworn to before me this Notary Public, State of New York No 52:0344963, Suffolk nty ............... ~/.w~,. day of .: ............ ~ ............. 19.~:~.6: ..... bi~, ~it~ llar,~re of applicant) · .......