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HomeMy WebLinkAbout580-zFOKM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOV/N CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z 587 Date June 7 19...6...0.. THIS CERTIFIES that the building located at ..~.J-...n.c~...~..t.~.e...e.~.~....O...r..Jr..e..n..t..:.....N..-...Y.:. ...... Street Mop ~o ........ .*..*...*. .......... B~ock~o*. ........................ Lot ~o. *...*..*. ............................................................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................ .F...e.?.~..u.a..,~.~....9. ........ , 19...5...9.., pursuant to which Building Permit No. Z 580 dated February ].3 1~.9. was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupa, ncy for which this certificate is issued is ................ PRIVATE ONE FAMILYU~;ELLING This certificate is issued to ...D..o_n..a.1..d...~:,....V..a...n.~..e.~..b..zl:.,]..,~.x...°....w~...e...~. .................................................. (owner, lessee or tenant) of the aforesaid building. Building Inspector FO~M N~. ~ 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'.O 580 z Date ................... ~.?~....~.~. ............ 19~..~. .... Permission is hereby granted to: Dou~l&sl~ot~e~s, a/~ Donald[ B.. Van~e~,b~lt .~..,.~...~.~.0.~.:... ~.:..z..: ....................................... to ............... ~..d.....,.~...,.~.~.,..~....o.~....,.~.~.~..~....d...,.?~.~...~ .................................................. at premises located at ...~...~..~...~...t'.~.~..O...~.,...,O.~.~...~..~..,....~..~1.~....'~'~':1~ .................................................... pursuant to application dated Fei~Ft~tl~ ~ 10 ~J and approved by the Building Inspector F~e $~..'....~.. .............. Building Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .................. Approved ........................................ 19 ........ Permit No. Disapproved a/c .............................................................................................. Application No...'.~',.....0~..,. ............... 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 County, New York, and other cpplicable 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 ali applicable laws, ordinances and regulations. (Address of applicant) State wheth,er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................... ,~...~¢e¢.... ~.. :.!, ' ~- ~/~ ~~. '~.~..~..~ ........................... ~ ............... ~ ........ ~,. ......... ~.~.~z .................................................................. Name of owner or premises ........ ~XL~ .~.~..c..~.,~..~.~. ...... ~. ' .: .. .......................................................................... 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: .................... Street and Number ............................................................... c~.~ ............................... ' / Municipality 2. State existing use and od:upancy o~or, emises an~ntended use and occupancy of proposed construction: a. Existing use and occupancy.m,~~.~¢..~..'./.'~ ............................................................................................ // b. Intended use and occupancy ............................ ; ................................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Ren~val .................... Demolition .................... OtherJ~/ork (~escribe) .................... 4. Estimated Cost .............'.r_ ./..~.¥ ............................... Fee ..................... ,~..~¥, .-.~. ..................................................... (to be paid on filing this application) r 5, If dwelling, number of dwelling umts ..........~.....; ...... Numbe 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....~.C~.....' .......... Depth .,~'~..~. .................. Height ......... .~.. ............... Number of Stories ............ ~ ..................................................................................... Dimensions of same structure with alterations or additions: Front ....... J.~.~ ................. Rear ..... ~,~..~. .................... Depth ........ ..~..~i..~ ............ Height ..................... Number of Stories ~ ' ............................ Depth 8. Dimensions of entire new construction: Front ............................Rear Height ...... ...~...~.. ............. Number of Stories ....... ~ .......... 9. Size o,f lot: Front ....... ~.' ............. Rear ........ ~..~.~. .......Depth .....~....~. ....... 10. Dote of Purchase "'u,"*" -6.~:.M(~ ........ ...~..~...~...~Name of Former Owner ....... L~.~.r'~.../.t~.~Z~...~.~.rr~..~-. .......... 11. Zone or use district i h premises are situated ..................................................................... 12. Does proposed construction violate gny~,onir~ law, orJinance or regulation?~,......~...~Z. ................................ 13. Name of Owner of premises ....... .. ,- ;,zc.~ ~/'~7~.~-- ~..:.,./...~[....~.~.,,K~./~..~K,jdress ....... .~..~__/,2~.../..' ............. Phone NO ..................... Name of Architect ..................................... _) .................. Address ................ ~ .......... ~ ............. Phone NO ..................... Name of Controctor.....~','.?~,~/../z/..~/.~?'~,..~.:l,~,.~ ....... Address .....Z'~.~.., .,-"~.....~...r ....... Phone NO. PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether inter/ar or corner lot. 1 STATE OF~ '~ --NEW~,~I~/xt/ > S S COUNTY 0 l~'~-r~....~ ...... ) ' (Nam~of individual ~gning~wap~licat~on) 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 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 se~th in the application filed t~erewit~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........................................ 19 ........ Approved ........................................ 19 ........ Permit No ............................... Application No ............................. Disapproved a/c ..~...~.....~7~;:~.._.~..,:-~.~ ........ ~. ................................ ........................ ................................. APPLICATION FOR BUILDING PERMIT Date......~..~.....~... ................................... 19..?.z~...... 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 Sou'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 of/applicant, or nadne, 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 ........................................................................................................................................ : .... 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: .................... Street and Number ............... ../,~'~.~...~ .................... .~...C~..:~ .............................................................. ' / Municipality 2. State existing use and occupancy of premi,ses and intendedj~se and occupancy of proposed construction: /? a. Existing use and occupancy ....... ~c~'~....~T~ .................................................................. b. Intended use and occupancy ................................................................................................................................ property lines. Give whether interior or 3. Nature of work (check which applicable): New Building .................... Addition ...~ ........ Alteration .................... Repair .................... Removal .................... Demolition ................. ~¢,,Other Work (Describe) .................... 4. Estimated Cost ................ .~...c[.?.. ................................ 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 ...~..o.f. ............... Height ....... ../...~.. .............. Number of Stories ............ ~ ....................................................................................... Dimensions of same structure with alterations or additions: Front ...... ..~..~...( ............... Rear ........ .?.~..x. .............. Depth .............. ,.~...~.../. ....... Height .............................. Number of Stories i ........... ~ ........... 8. Dimensions of entire new construction: Eront ....... ~.. ................. Rear ............................ Depth ............................ Height /g / Number of Stories 9. Size of lot: Front .......~ ................. Rear ............................ Depth ............................ 11. Zone or use district in which premises are situated.....~ .......................................................................................... 12. Does proposed construction violate any zoning law, o[dj~qance oj~, regulatigj? ....... ~ ..................................... ·x///~/'/~ ~' . '-~ ' '~-"(~' Phone O 13. Name of Owner of prem,ses.....;.y:.~.r..:.~.:...~ess ............................................ N ..................... Name of Architect .................................... ~-~ ............... Address ............................................ Phone NO. .................... Name of Contractor ......... .~..~..~/~' ....... ...~.~.~ ...... Address ...... ~...,....~?./~¢;/-~.~.: ........... Phone NO. PLOT DIAGRAM Locate dearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from treet and block numbers or description according to deed, and show street names and indicate :orner lot. ' ' ! Ac'/~JII'rl/~lA''' -- i z T 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; i~ii~p~!e~.~!i!~i!ii!ili~!!~0!~at/.ur~e of a~p~ica/~nt)i.l.d...t.lla.t...t..h,i...~ork will b..i.lerf, l.r..~e.d.f..i..t..h.i....~.~.~ner .,~t .f..ilr...!i~...,i..:~ii..e ipplica, ti~,~iled,therewit~..