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HomeMy WebLinkAbout1073-zTOWN OF' SOUTHOLD $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ,.~i. J,;l, a5 ........ Date ....................... Sept~elabe~...ll .........19.63,. THIS CERTIFIES that the building located at ~¥~tl. ~ ' l~a,. ~...tvtt~,~: t:; a.t;lt C~ ............ Street Map No ........ .~.~ ........ Block No ........~.~.t ......... Lot No .........~.~'~' .................................................... conforms £ubstantially to the Application for Building Permit heretofore filed in this office dated ................ l~a.y....6 ...................... 19.ti~O.. pursuant to which Building Permit No....~...~,.(~7..~.. dated ................. .~...a.~...~ .................... 19...6...0.., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is i sued is ............................... .................................................. This certificate is issued to~.iL.~i~ZI.ia~,.,OI~llt~ ......... ............................................................. (owner, lessee or tenant) of the aforesaid building. Building Inspector / FOR~I 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 COMRLBTiON OF THE WORK AUTHORIZED) N.o 1073 Z Dote ............................... ~.....6 ............. l~O .... Permission is hereby granted to: P & F Bu.tl~e~.....k/~.....T.....~lo~.i~ ........................ ....... ~Ia.~t .l.~ek.~. · - t~ ,.~., ..................................... to ..Btlilcl..new.~.olle....f..a~lily...che~llinl~ ................................................................................... at premises located at ....l~,/~,....l~U.~til...tl~ ......................................................... . ............................. .............................................. '. ........ F~ ~.ti.t'~k ~ · ..-~,~,. ................................................................... pursuant to applicatio~ dated .............. ................... ~a~/' ...... ~ .............. 1~0{)'"', Building Inspector Fee and approvedby the Building Ihspector ~ Approved .................................... , FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19...~.....Permit No. '~/'~> ~ ~ Application No..../..~....7...?. ............. Disapproved a/c ........................................... ................ ............................. 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 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 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, ordinanFes and regulations. ~ __ ,,-o / ~, (Signature of applicant, or name, if o corporation) (Add~ess of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .......... ~.~..' ...... .~.~...O.,Z~.~.../...~.. ..................................................................................................... If applicant is a corporate, sign_atur~ of duly authorized officer. ...... ...... ...... (Name at. title of corporate otCicer} Loca,,o of'and aa which proposed work will be done. Map No: ............................................. Lot No: ..................... Street and Number ................................. .~ ........................................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..~:/.~.......~..o....~... ............................................................................................... b. Intended use and occupancy ......... .r~.~....~,,~-- ............................................................................................. 3. Nature o~work (check which applicable): New Building ................... .~.... Addition .................... Alteration .................... Repair ...... '. ....... v;~' Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost '.....'.'.'.~..~?...O...¢.':'..:.....--TT.. ................................ Fee .J,.P .................................................................................... (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 ....... .~iJ~jl~:.... Depth ..~ ........... Height ............................ Number of Stories ..~ ........................................................................................... Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth ................................ Height ................................ Number of Stories ................................ .... Depth .... 8. Dimensions of entire new construction: Front ....,.~ ................... Rear .. Height ............................ Number of Stories..........~... ............... 9. Size of lot: Front ..... ./..q..~....~. ........ Rear ...... ./...~....~...(. ......... Depth ..... ./..,~.....~...../. ....... 10. Date of Purchase ........................................................ Name of Former Owner ~,.~C'(,,J C,5.1.: ,' 1 1. Zone or use district in which premises are situated......~/~ ........................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? .................... ..~/..~ ........................... 13. Name of Owner of premises....t~....../:...v~.....'~"...~.. ........... Address .......................................... Phone NO ..................... Name of Architect ................................................... Address .......................................... Phone NO ..................... Name of Contractor .......... ~J.?...~.....~.. ......................... Address .......................................... Phone NO ..................... PLOT DIAGRAM L.ocdte 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,O.O.,A.~, D,'? ) S S COUNTY OF '"'?q~'"'//~")~l/~ '" ' ............................... ./.]. ................ ~.-' ........ .~...~.~:...c~..being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ........................................... ?.. :~. ..................................................................... (Contractor, 6gent, 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 se~rth in the application filed therewith. Sworn to befor~ me this J~ ..................... ," "; ......... ........... ...................... .cz Notary Public, ......~..I.~ ....... County (Signature of a~licant) TOWN O~ $OUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... Approved ........................ I:: ......... , 19.U.....Permit No. ~J..~...~...~. ............. Disapproved a/c ~. ( B~uJ'J'cJ(n g Insp{ctor) Application No.../.~...Z.? ............... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date..~ ..................................................... , 19 ........ 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 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) 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 duty authorized officer. 1. Location of ~ad~ on whic proposed work will be done. Map No: ......................... ; ...... ~...~r.~..... Lot NO: .................... 2. Store existino use ~nd occuponcy o{ premises ond intended use and occuponcy of ~roposed construction: a. Ex[stin~ uso ond occuponcy ................................................................................................................................. 3. Nature of work (check which applicable): New Building ...~....... ........ Addition .................... Alteration .................... Repair ............... ~. Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ....~..~....~....O...q.:.....~... ................................ Fee .L.q .................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ Z .............. 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. D mens ons of ex~shng structures, f any Front ......... ,,~,~,..... Rear ...... ~ ..... Depth .~ ............ Height ............................ Number of Stories .~ ............................................................................................ Dimensions of same structure with alterations or additions: Front ..... ' ........................... Rear ................................ Depth ................................ Height .............................. Number of Stones' ............................... " 8. Dimensions of entire new construction: Front ....~..~..~..~..../~ ..... Rear ...~....~....~-Z..~...~[ ..... Depth .....'~...~..Z...~. ........ Height ............................ Number of Stories.....~ ................ ,, 9. Size of lot: Front ...... /..~.~. ............. Rear ..... .,~'...~....~.../. .......... Depth .....z~....~....~..'~ ........... .... .g£ cI J e Sfc , ' ]0. Date of Purchase ........................................................ l'~omet~ ~ormer ~wner ........................................................ l l. Zone or use district in which premises are situated ..................................................................................................... ]2. Does proposed construction via]ate any zoning Iow, ordinance or regulation? .................... ~ .............................. ];3. Name of Owner of premises.. : ............... Add,ess .......................................... P~one NO ..................... Name af Architect ............................................... Address .......................................... Phone NO ..................... Name of Contractor .....~.....~......~....~' ......................... Address .......................................... Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-bock dimensions from property lines. Give street and block numbers or description according to deed, and show street names end indicate whether interior or corner lot. /bo / STATEOF NEWc~OR,~ -~ ) S S COUNTY OF ..~.G....) ~.. .................................................. ;.c: .~.(~. be ng duly sworn, deposes ond soys thor he is the opplicont (Name of individuol signing opplicotion) ~-, ', above named. He is the .................................... ~<~.~m~ ............................................................................ (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 the application filed therewith. ~ ~blic, S[a ~ of Sworn to before me this ~i~..~g in s~,ol~' c0--~:~ ~ ~/% ~/ ~~~ .................... o,,. ...........