Loading...
HomeMy WebLinkAbout860-zFO,BM ~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF' OCCUPANCY z3o? No..Z....~ ....... rate ............................. *..~ ........ a~', ~9....~.o THIS CERTIFIES that the building located al ....W./.~i ...~..O._%l.~.h......H..a..~. ,I!.Q.~...~,II~. ........... Street -~ap No....~ ......... Block ~o ...... ~ ....... Lot ~'o ...... ~..: .......... S.~.l..t...hg.~.....J'!,.!,. ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... :.$...e...p.t...e.~.b...e_r...... ~.~. ..... 19..~..~.. pursuant to which Building Permit No ...... ~..~6.0 ...... dated ........ : ....... .~..~.t...e.~b.~....~..~., 19.,~.~, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is Private one fa.m...i...1.y...d.~.l~.~. ..................................................................................... This certificale is issued to ...... ,C...h.~.s.TM Berry. ~ ( .o.~.9r.}. (owner, lessee or tenant) of the aforesaid building. FOI~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? 860 Z Permission is hereby granted to: ....~?~.e.~..~:~ .................................................. Ca~'o].]. A~enue ..... t'~, ,.. ~..~.~'~k ......................................... at premises located at ...~...u.~.h.....l~..~..~.....~?..u...~..h..O..~..d..~ ..~...~...~..~..~: .................... pursuant to opplicotion dated ............................... ~,~t~i~....~. ......... 1~.. ...... , and approved by the Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c .............................................................................................. Application No. ~' O (Building nspector) APPLICATION FOR BUILDING PERMIT IN'STRUCTIONS 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 alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, o~fne, if a corporation) ..... (Ad'dress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................. .~......~.... ~..,'f. ............................................................................................................................................................ Name of owner of premi.~..~........, ........ i ............................ ; ......... , ....... ; ......... ;..:... =;. .... ;.~. ............................................. 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. Map No: ............................................Lot No: .................... S,r,e, .................................................. ......... Municipality 2. State existing use and occupancy of ~mises and intended use and occupancy of proposed canstruction: a. Existing use and occupancy b. Intended use and occuponcy .................................................................................................................. 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 e~ch 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 cons~rumion: 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 situa~ed....~ ......... (..~,~..?....~...' ......................................... 12, Does proposed construction violate any zoning law, ordinance__or regulation? ...t;)..¢ .......................................... 13. Name of Owner of premises,,~x/.C¢r,~/,.;-'.r.~,C¢.z/,.Address .......... Phone Name of Architect..~,.~[.].l..~~ ................ Address~Z¢~.C~l~.~.....Phone NO.~.¢.~..~¢Y .~, hone PkOT DIAGRAM ~ocote cleorly ~nd distinctly oll buildin~s~ whether exist[no or proposed~ ond indicate oll set-bock ~imensions from property lines. Give street *nd block numbers or description ~ccord[no to deed, ond show slreet homes ~nd indicote whether interior or corner lot. t STATE OF NEW ~OR~ ,, ~) S S COUNT,~( OF ..~...¢g~,Ff.z,~C-,~,) ' ~Jl~..,~..~,,~~.... ............. being duly sworn, deposes and says that he is the applican~t (Name of individual sigrri~Z,,5 ~//'/, ,---/~-~ z'z ,~,~.apphcat~°n) "2_ ~ above named He is the .............. J~(,~g~":T~..~rr......~......t~..'~?-M¢;..,~....g'~...~...~....% .............................................................................. (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 Jn 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 befor~,rne this -- Nato Pub C a Public State al New FORM NO.! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOW. C,ER,'S Of,CE SOUT.OLD, .. ¥. Exom i n ed ~~~... ~-9..~.~... App rove,~.~...°~.,.~.~.. 19....~.. Pe rmit No ........ .?...~.~...~.. ..... Disapproved a/c ......................................................................................... (Building Inspector) 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 issuanoe 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 Ibws, ordinances and regulations. (Signature of applicant, ,6~,~qame, if o corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ ~-~ ~. ~ ...~.. ................. Name of owner of ............................................ , ....... /-- ...................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work will be done. Map No: ................. '.]i]~i ...................... Lot No: ....Z~E'. .......... Street and Number ~.`..%..`~.~.~.~..~:/;~.//.~£~.~.~..~.~¢.~.~>.~.~..~.~¢~Z~ .................................................. -- Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy....(-.~/~.x///}.~..£ 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....~... ........... 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.......-z:: ................................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...... .?~..:T .................. 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 ............................ Height .../..~.../. ................ Number of Stories ..... ../. .................... J 12. Does proposed construction violate any zoning law, ordinance or regulation? ..../:..}..~. .......................................... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions from and show street names and indicate STATE OF NEW '~O~>,. ~ ~'_ ) S S COUNTY OF ~._L~- ' ~~~ .................................... being duly sworn, deposes and says that he is the applicant "' .... (Nam~~i~g applica~n) (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 ore true to the best of his knowledge and belief; and that the work will be performed in the manner set forth Jn the aD~tion filed therewith. 'JU~IT~ T. 'B~ Sworn to before this ~ - ...... ~,u~lc State 0 New Y0d, ~ ~r~r~2 034~'963 Suffolk Cou t , .......... ~....: day of ..~ 19~b:ss;o~ ~x0,,',s ~'~9~'~at~re of appli~ , ,.