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HomeMy WebLinkAbout576-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPART/~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...~....27.9 ......... Date .......................... A~...I~. ............., 19.~.~... THIS CEP, TIF~£S that the building located at...~./..S.......~.~9.~...?..o..~..d...s....~..?'...~ ....................... Street Map No..][~XX. .............. Block No .....X~:' .......... Lot No. ~X ............ ~=ie~f.,....~t.~,. ....................... conforms substantially to the Application for Building Permit heretofore flied in this office doted ........................ FabU~c.y. .......... 7......, 19.5c3..., pursuant to which Building Permit No....7~..~ ............... doted ........................... F.~1~,....7. ............ , 19~9....., was issued, and conforms to oil ofthe requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .............. ........... ~I~IW.~ ..f11~'E. ~.A[~I~..~;~.~.....-.,....(~.~..~$~. ~.~.~.~.t...~!~}. ............... This certificate is issued to ..Jo~]~:~.,l'.,..~.~t~ ........ ~t~z'. ............................................................. (owner, lessee or tenant) of the aforesaid building. Building Inspector FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS P, ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 576 z Date ............. .F.®b,,~r.y....f/~ .. 1959 ............ 19 ........ Permission is hereby granted to: .... ~?~...s.~....~.t. ............................................... ............. .z.~..-..z.~.~....s.~ ............................................. ............... ~.~.~...c..t.~:.....~:,~ ~. ............................. to Bu~*ld an ~dd:l.%:ton on ~n ext~tr~g dwelling at premises located at ............................................................... ..0r...t.e...~.t,.,....~,. ....................................................................... pursuant to application dated ..............~..~.b...u~. ,.~Z/'...~. ....... ~..~,~.~ ................. 19 ........ , and approved by the Building Inspector Fee $..~.,...0~)... ............... FOP~M NO. TOWN OF $OOTHOLO BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... ~....~ ....... .cZ..... 19....~..~ · · 7-5-7 Approved ........................................ 19 ........ Permit No ............................... Disapproved a/c .................................. _ ..... ............. (Building Inspectqr) Application No..~..~..7 ~ APPLICATION FOR BUILDING PERMIT Date ........ ~b~a~..Z%h.~Z~D9 ................ 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 on the premises available for inspection throughout the progress of the work. ~. e. No build ng sha ~ be occupied or used in whole or in p art f~or any purpose whatever until..~ 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 SouChold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of b~ additions or a Iterations, or for removal or demolition, as herein described. ..The applicant agrees to comply with ail applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) Joseph J. Slawski °t ll~-lSth Street sGarden Cz y,N.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 ~Z~s.¢.l~h, Jr. ~..1.~.~..s...k~.i~.~..~...~r~T~.~.~,...~l~.'~.~.~.~i. · . If applicant is a corporate, signature of duly authorized officer. No Cor~. 4/ ~ · ..... 1, Location of land on which proposed work will be done, Map No: ............................................ Lot No: .................... Street and Number ~.~.9~.~..e~9~,n~p..e.~..~.~8~2.~p~r~.~.~.~.~ri~eni.~N~L~ ..................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy..~.~?.....?....~.P.~....0.f~;)?~..~'.e.a~..~.~},a~..o~£z~fl .............~ ................................... b. Intended use and occupancy... ~..~.~.$.?,.z...o~. ~..Le./~;~,~.e~0.C~.,1,..~.o.~.e.~ .................. ............................. 3.Nature of work (check which applicable): New Building .................... Addition .~.....~...o..~.~......Alteration .................... Repair .................... Removal .]~...9~.b.P'..]:.e..Demolition..~.¥.e.~,.b..u.~.(Dther Work (Describe) .................... 4. Estimated Cost....(.,~...7...¥..'..~..~.. ................................. Fe~.:..0.9. ................................................................................... (to be paid on filing this application) · One ne 5. If dwelling, number of dwelling un,ts ................................ Number of dwelling units on each floor.../~. ....................... ~..If garage, number of cars ............................................................................................................................. : .............. 6. If business commercial or mixed occupancy spec,fy nature an~textent,of~each tyl?e, of us~J~.~7~..~a:~nasz ...... Roome 9'x x 8~ used £or bueimeee bal~of~,used ~ud to oe u~rt tar reszaence. 7. D,mens,ons of ex,st,ng structures, f any Front ............................ Rear., ......................... Depth ............................ ,~Height ............................ Number of Stories ..]4.~ ....................................................................................................... Dimensions of same structure with alterations or additions: Front ...~]~ ......................... Rear .~. ............................ Depth .~.J~ ........................ Height .............................. Number of Stories ....]:.'~? ......................... )imensions of entire new construction: Front....%~ .................... Rear ......... ~,9 ............... Depth .],~ ........................ Height ............................ Number of Stories ..~ ................... ~i Size of lot: Front ...~..~?~..fl. ............... Rear ...... ~..O..,..d..7..~ ........ Depth 182 ft olus tw]O. Date of Purchase ..... .1..c).~.7..~ ........................................ Nome of Former Owner ....... ..N..'A:....L..u:~.e. .............................. ~,,~] ].~. Zone or use district in which premise~ are situated ............... l!..A.i.'....d..i..s..t:?..f.?.~ .......................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? .,~9..%r..v ...................................... o sep J St ici . , N o.Pi o.-..~.-..~.4..~..7.. -- .... ~Ot~e--O~rDe ]~' S eehe~o]te s ~JJres None Name of/~rcnlYecT ....................................................... racial S ............................................ Phone NO ..................... Name of Contracto~...°...b~.....B.~.q.e.~ ................................ Address ~1 Main Bt. Greenpor~bhnn PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from :roperty lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. Inerior Lot STATE OF NEW YORK, ) COUNTY OF ..~.t~;~.o,~k ........... ) SS. .......... ~.o...~.gjg..~...sT.....j~]~.~:~ ...................... ~ ............................. being duly sworn, deposes end says that he is the applicant (Name' of individual signing application) above named. He is the..0.3.m...e.~....9.K..9~?...9.~....~..,e. ................................................................................................................... (Contractor, agent, corporate officer, etc.) of sai~mc=Cor owners, and is duly authorized to perform or have performed the said work and to make and file application; that all statements contained in this application .are tr~e to the best of his knowledge and belief; tahnic~ that the work will be performed in thwog~Lg~r~,,?rc~se~f~rth in the application filed there~t'k/~ ............... ........... f 7 FOP~I~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam.ed .......... ....... Approved ........................................ ]9 ........ Permit No ............................... ....................... ................... ( ............ 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 p art 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 Counfy, New York, and other applicable Laws, Ordinances or Regulations, for the construction of b~ 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 corporation) ...... ....................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises..~.~*~'*~..~L.;~.~.~*~..~ ........................................................................ If applicant is o 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: .................... Street and Number .~tP..~'..~g~..~....~,~,.~....~,.~.-~.g~r~O~,,~,~'~ .......... ' ........... Municipa!ity 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy.~.-~.,,..liol~.~:I~l~t~..~.e~a..ee.t~..t~.e,ze.~'.:L~ ................................................. b. Intended use and occupancy....g.~.~.~..-~l,~k~:~.~..~l[~b~..~ .............................................. whether interior or corner lot. 3.Nature of work (check which applicable): New Building .................... Addition X.JJJ~ea~.....Alterotlon .................... Repair .................... Removal .Z~...~.J~l~'.Demolition..~~ther Work (Describe) .................... · 4. Estimated Cost ....... /.y ................................................... Fe~(~ ................................................................................... (to be paid on filing this application) ,5. If dwelling, number of dwelling units...~ ...................... Number of dwelling units on each fioor....0,?~ .................. If garage, number of cars ............................................................................................................................................ 6. If business, 'cc~mmercial or mixed occup, ancy, specify nature and extent of each typ, e of usc~.~ .... 7. Dimensions of existing structures, if any: Front..~ ...................... Rear...~.. ....................... Depth ...~f~.. ...................... Height ............................ Number of Stories .~j~ ....................................................................................................... Dimensions of some structure with alterations or additions: Front ...I~ ........................ Rear ~ ............................ Depth .~... ........................ Height .............................. Number of Stories ...~i' ....................... .. 8. Dimensions of entire new construction: Front....~,~. ................... Rear ......... ~,t~ ............... Depth 1/, ......................... Height ............................ Number of Stories "~i~ ..................... 9. Size of lot: Front ...~....~ ...............Rear .....~.~.~.... ........ Depth .~P.~...I~....I.~B@ ..... 10. Date of Purchase ..... .1~)4:~, .......................................... Name of Former Owner ........ N"~w"Ja~ ............. , ................. 11. Zone or use district in which premises are situated .............. ~A~..~I~,~%~.e~ .......................................................... 12. Does proposed construchon; wolate' any zoning law, ordinance or regulation? .~l~.~,.~,~t,~ ......................... '" ............ 13. Name of Owner of premises.~, *..J~l~....AddressJl~.~.J~.'~g~/~.~t..g;J,~/Phone NO~r~.~.. Name of Architect...~.~.~?:~.~....~...h.~..J~..~ .......... Address ...... ~ .............................. Phone NO ....... !k ........... Name of Contracto/~'..~..%l~.....~ ................................ Address ~ ........................................ '...-mane NO .. ' PLOT DIAGRAM , ' . . \, , Locate clearly and distinctly all buildings, whether existing or proposed; and indicate all set-back aimensi~ns tram property lines. Give street and block numbers or description according to' deed, and show street names and !ndicate E STATE OF NEW YORK, ) S S. COUNTY OF "1~J%~ ........... , be na duly deposes and says that he is the applicant .......... ~O~l~l~t,. ,.~... ~.._....: .~ ,.~~ .................................................... -, sworn, -"~r~'m'[~o~.~JJ~Bt1~al signing application) above named. He is the.~...~%,.~c~r~,~J~..J~Jl~ ................................................................................................................... (Contractor, agent, corporate officer, etc.) of sai~J,~&~;)~or owners, and is duly authorized to perform or have performed the said work and to make and file this ap'~'rllC'~lt~; that all statements cootained in this application ore true to the best of his knowJedge and belief; and that the work will be performed in the manr~r ~et forth in the application filed there,with. Sworn to before me this Notary ~blic, ~i~~yoi~ ~.~, ~ ' ~( ,,~gn~P/~-~rit~ ~, ~x ,' ......... i..~.~ ............ :. i~ ';'~-.'"':i ""' '!~', :'.), ',: ..... "