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HomeMy WebLinkAbout985-zFOP4W NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TO~FN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the, building located at ,j~l~e~t.B..~Ot~¢l. ................................. Street M ]~$~he~'man~ Beth, ap INa ......................... ~,OCK No ....... ~ .......... Lot No..~..~¢..~,3.~...0.U.~h~t.....~,.~/'., ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......................... F. ehu.~r.~......2.7...., 19..6i1., pursuant to which Building Permit No...Z...9~.~. ........... dated ................... ~..e..~.~..~l~.~. .......... ~,~).... 19..~..0..., wa~s issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ................ ................. ~.~.~t~.~e .. eno ..~. ~&~ ..d~e.]..Z. ~.~g. .............................................................................. This certificate is issued to ...... ~Ot~e...]?.;~;t~ ............. (...G'~/~:~.) ................................................... (owner, lessee or tenant) of the aforesaid building. .~.Z.~..'~:~.q~.....[ t Building Inspector FOI~M NO. 2 TOWN OF $OUTHOLD 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) 985 Z Permission is hereby granted to: Chet,.. O~.]~0~sl~ ... J~/C ....~r~...Leu~.~e.. l~fe~l~ ............ ........... Ct~tchogu~....~,Y, ..................................... ~/..~.....~l~..~c~ ~, ...~//.~.... ~.. ~. ~ pursuant to application dated ............................. ,~.~al~tl~'y:....,~ ............ 19~...., and approved by the Building Inspector,, ~ ' ~ Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. App roved......~.~...w~z: ~r .~.~.~.~.. 19. ~...~.. Per m it No ........... Disapproved a/c .................................................................................... Application No...f...~....~.:~ ................ (Building Inspector) 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 ~djoining 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 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 name, if a corporation) ~ ((~.):ldress or app,icant) f State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................... ........................................................................................................... Name of owner of premises...i.,~',.,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: ~.~..~..~.~c-'..~.(~.~..?.Z~.~..~...!.~.~l~ot No: ~.2_.~...~..~ Street and Number ... ~~,.,..~~ ...... ~'~' " ~'i' ..... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Ex~st,ng' ' use and occupancy .......~'~ ....................... b. Intended use and occupancy ...... ~;~:'~ ................................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition ..... ~ ........... Alteration .................... Repair ....................Removal .................... Demolition .................... Other Work (Describe) .................... 4, Estimated Cost ............ ,~.~i...c?.~...~? ........ e..~ ....................... Fee ......... ~ ~..-..<L..~R .............................. (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 ,-,~,'~ Z.~ ~ ~z~,.~ ,-I, ~:: ..... £:.~ - 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 .......... ~...~Z~ ..........Height ...... ./....~.. ................. Number of Stories ........ f~ ............... 8 Dimensions of entire new construction: Front .................. ' .......... Rear ............................Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ...... ~.'..~.2..,~..-Z, ..... Rear .......... ./....~,..¢~ ....... Depth ......... ~ .............. 10. Date of Purchase ...... /...~.....~.....~. ................................ Name of Former Owner 11. Zone or use district in which premises are situated ...... ~.~u(y ...................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? 13. Name of Owner of premises.x .~.~...~..:.~Address~/...5...~.,~~...~or~e NO Name of Architect ........................................................ (~ Address ....................... Phone NO ..................... Nome of ControctorC,,~.~...~z;~r~r:~-.(-4~f. ............. Address ...,?,~. ,¢~..:..Phone PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all 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 NEWer'OR-d, ~ ) "S cO~UNTr.' OF ~'~~,....) ~ ' ~ '(ff~ ~._ F~,_ ~,~,~ ben du sworn de oses and sas that he s rhea cant ..... ~ ~t~ ~... ~:/~ ~.~: ........... ;:.....:....f ...............g Y , P Y PP - (Name of indi~icl~l s~gnmg apRucat~on; ..................................................................................................... (Controctor~ agent, corporate officer, etc.) o~ said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this application; ~hat all statements contained in this application are true to the best o~ his knowledge and belief; and that the work will be performed in ~h~ manner set forth in ~he o~licotion fil~the~ewith. Sworn to before methis fl% / &. ~ ~ f' , ........ ......... Notow PUDIIC~&~-/~.~.~ .......... ~ No. 52-C3,1,1963, Suf[oik Calmly.. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUT.OLD, N. 'r. E x a m in e d..~/~.. · .~,d~c~. · .~. · ! .~..~..~... Approved.~...~.?....~..~..19.~.~...Permit No ......... ..~.....~.....~...~.~.-- Disapproved a/c ........ ~;~,~. ~ .............................................. ; ............. ~ (Building Inspector) ,, APPLICATION FOR BUILDING PERMIT INSTRucTioNs a. This application must be completely filled in Ky 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 odioining premises or public streets or areas, and giving o detaiied description of layout of property must be drown on the diagram which is part of this location. c. The work coYered by this application may not be commen~ed 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 progres? of the work. e. No building shall be occupied or used in whole or in part for any purpo~se whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuonoe of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southbld, Suffolk County, New York, and other applicable Lows, 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 oll applicable laws, ordinances/~nd regulations. ................................... '- (S. ignature of a~pHcant, or name, if a corporation) ........ ~.,.,.~...~~..~.~.~ .............. ~ ...................... ~Address of epplicent) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises..~£~/k'.~.::~.~..~-~r~..~......~.~.....~.~,' -~L'',-~..- ........................................................................ 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: .... ........................ ~.r......' ......... kot'N6: ..~;.~....~..?..'.~.. Street and Number ....... ,. · .~.............-.- ........ .: .......................... ' ~wunicipality ' (/ ' . 2. State existing use and occupancy of premises and intended use and occupancy Of proposed construction: o. Existing use and occupancy ...... ~..~,.~!,'~.t,~..¢,.~4....'....~.~.~..~ ....................................................................................... b. Intended use and occupancy .......... ~ ................................................................................................... 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 ............................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .............................. 7. Dimensions of existing structures, if any: Front ......... .,~.....O.. ......... Rear ...... ~...a. ............... Depth .....~-...~..~ ................ Height ...[ ........................ Number of Stories ........... /. ................................................................................................ Dimensions of same structure with alterations or additions: Front .......... .~.~..~.. ............. Rear ...... ,~.~....<:4~.. ................ " ~ ........ ./..~.. ................ Number of Stories ................................ Depth ......... .~ ................. Height '~ 8. Dimensions of entire new construction: Front ............................ Rear ............................ Depth ............................ Height ............................ Number of Stories ............~ ............... 12. Does proposed construction violate any zoning law, ordinance or regulation~ ~ ....................... Name of Architect .......,~ ............................................... Address .................. , .......................... Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all 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 NEW~O~, ~ ) S S COUNTY OF ~/~..) ' (Name of in~idual~gning application~ (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 th~a~licatign file~be~ith.