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HomeMy WebLinkAbout1042-zFOR~ N'O. 4 TOVJN OF SOUTHOLD TOWN CL~:RK'S OFFXCE $OUTHOLD, ~, Y, CERT~.FXCAT~ OF' OCCUPANCY No...~..2.0.~ ........ Date ...................... THIS CE1TPIFIES that the building located al .:qe~.t...L$24~..Dr.i~¢o. ............................... Street Ceader Beach Park Map No ....................... Block No.....XXX ........ Lot No. ~.8 ........... S~uth~.ld~.....3¢,.Z, ...................... conforms substsntially to the Appiication for B~fldiug Permit heretofore flied in this office dated .................... ~,~'.~,~... _~1,9..., ~9.6.0.. pursuant to which Building Permit No..~:1~. ......... dated ................. ~.~.~'......~ ....... 19.~., was ~ssued, and conforms to all of the requirements of the app!icable provisions of the law. The occupancy for which this certificate is issued is ..................... .p..r...i.~..t.~... o.~.e,.. £ m~Li 13r....dwe~l.].ing ................................................................................... This eertifleaie is issued to ....D..{~..~ ................ (O~qlq~r.} ................................................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector 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? 104 Z Permission is hereby granted to: " ~,W,Smi.th..&..Son~..~/.~..Da£....~y. ..................... .......... Southe t~.~.....t~,.~., .................................. / '~. Building Inspector Fee $ · .]1;0,'00 .......... purguant to application dated ...i ............................ ,t~;Ft.~......~ .......... 1960..., and aFJprove~l by the FOI~M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... .~:~.......~./~..... 19 .~..~... Approved .......... .~Z~..~....../...~.... 1 9~.¢J:,.Pe rm it No .......... ~.../.g.~-~ / Disapproved a/c .f::~ ._. ....... ...... ~ ................................. ~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ' .?.~ ..,~... 19 ~o INSTRUCTIONS a. This c~pplication 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 public streets or areas, and giving o detailed description of layout of property must be drawn on the diagram which is port 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 13ui[ding 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.Certifi~ate 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, ah~J t~th~ ap~lidable 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. (SignetS're of applicant, or name, if o corporation) ....... ......................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. Nome of owner of premises ........ ~...C~..~.~..~ .......................................................................... ......... If applicant is a corporate, signature of duly authorized officer. 1.Location of IonS on which proposed work will be done. Mop No~..~..~...~..~B¢~.'~....../.~.~.. ................... Street and Number ....~J~.....~....~~ ................................................................................. 2. State existing use and occupancy of premiese,s and intended use and occupancy of proposed construction: o. Existing 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 ,r...,,~,--~.~..~.. (to be paid on filing this application) FEES: 5. If dwelling, number of dwelling units ....... ~ ........ Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................................................ 6. If business, commerical 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....~...7 .............. Rear ~,~..~.7.. .................. Depth ......"~..~... ............... Height ...~...~...../ ............. Number of Stories ...... ~ 9. Size of lot: Front ...../..~¢..¢~. ............ Rear ...~....~....~. ............. Depth . ./.~...'.~.¥. ................ 10. Zone or use district in which premises are stuated ~.~:~.~.x~....~....'~-.. .................................................... 11. Does proposed construction violate any zoning law, ordinance or regulation?......~ ........................................ 12. Name of Owner of premises.~.x.~.Z~.~.~. ................ Address~..~...~..~..~'...~.~..'....'~.~...~.: .......... Phone Name of Architect ...................................................... Address ............................................ Phone NO ..................... Name of Contractor./~.~¢.~,~¢.~i(.:.~.fwcde~..~.¢.~.¢/.~..Address .~.~...,w../T-~..~.Z../'J. ................ Phone N .O~...~';..~.~...~.. 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 decld, ~nd show street names and indicate whether interior or corner lot. Sworn to before me this ............ Z./....:*.. doy of ................................... 19.....~.,?.,. Notory Public,.. STATE OF NEW.yORK ~ _'"'"~-~'~-,~ ~ COUNTY OF y~','~':~%~ .~~ . being deposes and says that he is the applicant .......... ~; ....... ;....: ........ ~.....: ..................duly sworn, (Name of ~nd~wdual s~gnmg apphcat~on) above named. He is the ...........~~ ................................................... (Contractor, agent, dorporate 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 the application filed therewith. NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exom .ed ........... Ap~proved ................ ~z ~" ~'..~.../../...?.~19...~....C.'.~Permlt No ........ ~'~...(./../..~.,~. Disapproved a/c ............................................................................................ Application No ......../..~...~.~. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date /,.~... 19~0 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 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. Up,on 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 purpdse whatever until a Certificbte of ©ccupancy 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. ...... ........ .......... ..... .. ...................... ~ ~ ~- ~¥cr'd~s~f applican[[~)~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. Nome of owner of premises ......... .~...-r .............................................................................................. i ......... If applicant is a corporate, signature of duly authorized officer. ~xl~r~e~fitle ~ corporate officer) Street and Number .......................................................................................... 2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction: o. Ex[sting use and occuponc¥ ........................................................................................................................... : ...... b. Intended use and p y ................................................................................................................................ 3. Nature of work (check which applicable): New Building ...... ~.....Addition ...............'.....Alteration .................... Repair .................... Removal .................... Demolition. ................... Other Work (Describe) .................... 4. Estimated Cost ..... ~..~.~.~.~. ................................... bee ............ ~..~'.. ...................................................................... (to be paid on filing this application) FEES: $. If dwelling, number of dwelling units ....... ~ ........ Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................................................ 6. If business, commerical or mixed occupancy, specify nature and extent of each type of use ................................ 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 -~Z..,~.. .................. Depth .....'~...~... ............... Height ...~...~.....~ ............. Number of Stories ...... ~ ....... 9. Size of lot: Front .....,2'..~...~. ............ Rear ...,~...~..~. ............. Depth ./.~..-.~ ................ 10. Zone or use district in which premises are situated.....~'~.~..i~.~'..~f..,¢....~.. ........................................................ 1 I. Does proposed construction violate any zoning law, ordinance or regulation?...../.'..~.. ................ '. ....................... 12. Name of Owner of premises..Z~./.mZ'Z.~.~. ................ Address~..~'..~l~...~....J'...7'.:....~.~.~., .......... Phone Name of Architect ...................................................... Address ............................................ Phone NO ..................... Name of Contractor.~.~,-~.,,~..~...._~,~',*~.e..J~o.~..Address .-.~..~...Z-z~..~.K./~/. ................ Phone NOr~..'.-K/r.~..~.~.~.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, land indicate all set-back dimensions from property lines. Give street and block numbers or description according to de~d, ~nd show street names and indicate whether interior or corner lot. I ......... ~~)'~' ~/~ ~'~ ~ .................. being duly sworn, deposes and says that he is the applicant (Name of individual signing application) 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; and that the work will be performed Jn the manner ~et forth in the application filed therewith, Swc~rn to before me this ................. .'T,,,. day of ............. f......~ ...... 19....?....,.,~. ~otary P~blJc, Stste of New Yor~ Nm 52-0344963, S.Holk Comity ($1ngature of applicant)