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HomeMy WebLinkAbout1221-zFOII~ N;O. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTNOLD, N. Y. CERTIFICATE OF'OCCUPANCY No....Z..~)be.2. ....... Date .......... t~over~.ber......~ 0 ................. 19..60 THIS CERTIFIES that the building located al ~/~$...~ox..N~.~l~..]~aad ........................... Street Map No. ~ .............. Block No ........~....Lot No.... ~ ............. t~la.t~i.~tek..F....l~.¥~ ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. [~e~g~llll~t"......26 19-60' pursuant to which Building Permit No...Z1,22~. ........ ~lated .......... ,.~....ge.pt:erabeay"2~ 19"60, 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 .............. l~.~..v.a, te..on~...g.am~ty...~e;L.t.~n.g .......................................................................................... This certificate is issued to .g~a~.I. ey..&.l~Iai,~y..Beet~el:, ........ 01~ne~"s .......................................... (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? 1221' Z Date ................. ~ e.~a ~; ~t~e~..... 2,~. ......... 196.0... Permission is hereby granted to: ~t:~...e.~....~:....H.~y......~..e..c~.e.r. .............................. ......... ~.t t& % ~k.~..... ¢{.,.ff~ ................................. to ,,, B~L~,,, ne~,,.one ,, £.a~i.~ ~r... ~.,w~.~.3~ ................................................................................... at premises located at ...¥~./~.....t3.C~..~.c:~..~z~;~a~ .............................................................................. .............................................. .t~.-~ ~..¢..~. ¢.~.~..... ~.~ ~ ............................................................................. pursuant to application dated ...................... ~.e:~embez'......26 ........... 19..~0., and approved by the Building Inspector Fee $.~0.*.0.0. .......... ! ....... L...:..7......'..~ ~ .............. ' ....................................... Building InspectoI TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No. /~'" Approved ....... ..~L....~..... 19....~..°.. Per mit No .............. .z. .............. Disapproved a/c .................. ~ ........................................... (Building Inspecto~-"~'/~/z:zz ........ 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 adioining premises or punic 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 Jn whole or in p art for any purpose whatever until a Certificate of Occupancy shQII 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 buildlngs, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ........... .................... r, Signature oyap~licant, or name, if a corporation) (Address of appli~ont) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises...~~.~...~(~-..~....~..~ ..~...'" --~ .......................... i .................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on whic.h proposed work will be done. Mop No: ............................................ Lot No: .....~../~ .......... Street and Numb~./¥.....~..~(~.~~.~~. 2. State existing use and occupancy of premises and intend~ed us6 end occupancy of proposed construction: a. Existing use end occupancy ..............,~x .................................................................................................................... b. Intended ~]se and occupancy ....... ~~~¥~...~.~.~...~....~. .............. property lines. Give street and whether interior or corner lot. 3. Nature of work (check which applicable): New Building ....... ~. .......... Addition .................... Alteration .................... Repair ................ ~.Removal .................... Demolition ........ ~ ......... Other Work (Describe) .................... ~ Fee .~./...~......Z~..~ - 4. Estimated Cost...../~;~..O....~...~../. ..................................... ............................................................................ (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 ...... Height ' Number of Stories ........ .~. ................. lot: Front ..~.....~....~-...~.. .......... Rear ............ ~..6~.~.... Depth ......./..?.,..'~......(~... ..... 10,9' DateSiZe Ofof ............. ~ ......... ...................... ' ~"// ........ L,~ ................. Purchase~..~..~ Z~..~ L') Name of Former Owner ..~ 12. Does proposed construction viol~t,e any~. /: ,J'~z°nigg I~w, ordinance of' regulation? ...~...~...K~..~..:. .................................. of Owner of premises.~j~..?...~.~..?~~..2..~..,~,Ph°ne NO ..................... 13. Name Name of Architect .......... ,,~ ................. ,....:...../ ............ A-ddress .............................. ~ ............. Phone NO ..................... Name of Contractor.~ ..~..~,..~.~ddress ..'~__~.~..~.~-~ NO ..................... PLOT DIAGRAM Locate clearly and distinctl all buildings, whether existing or proposed, and indicate all set-back dimensions from and show street names and indicate ~lock numbers or description according to deed STATE OF COUNTY O~¢~m'"'z?~'-"~" ....... ) · ................... ~~.~ .......................... be'rig duly sworn, dep,ses and says that he is the applicant (N~~gning application) above name~e 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 m~nner set forth in the application filed therewith. Sworn to befor~ me this ~ , JUDITH T. BOGEN ~_ ~ ~~ ] ~Jc, St~te of New York ~ ~' ' ~ ~f .~~. ]~.~:~9~3, Suffolk Cotmty . ~ (Signature ot app~c~n~ ................. ....