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HomeMy WebLinkAbout1099-zFO,R~ ~0. 4 TOWN OF SOUTHOLD RUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTI-IOLD, N. Y, CERTIFICATE OF OCCUPANCY · 896 ~ove~ber 7 60 No ......................... Date ............................................................ 19 ...... · Main Street, East Marion THIS CE~FIFIESthatthebuildinglocated at ...................................................................... Street Map No ....................... Block No ..................... L~ No ............................................................................... conforms substantially to the Application for Building Permit heretofore filed in this office June 3 60 ~ 1099 dated ..... ; ........................................ , 19 ........ pursuant to which Building Permit No ......................... ~lated ............ :;.J.u...n-..e....-4 ................. , 19....6.0.., w.as issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is NON-CONFORMI~O MULTIPLE RESIDENCE James and Joan A. Rogers, o~nmrs This certifmale is issued to .......................................................................................................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector FORM[ NO. 2 TOWH 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) N? 1099 Z Date ...................... ~T~e.....~ ................... 19~{~... Permission is hereby granted to: .Jarred..~c~g,~r. ~ ..&**..~f.~.~,,~ ................................. ............... ,..~/~'~.. ~o~d ........................................... ....................... East.. J4a~z~tl ............................... to ...Bu~.~.d...a~.*a&~.t*t~on. "o~' .a.~.. ex~*at4_~g*- ~t.l. tng ...................................................... at premises located et ............... ~*.:Read..*&..~...Orcttar~..t~oa~ ...... : ....................... ............ ................................................................. ~a~t ..~.~f~n ....................................... J ............ : ................ pursuant to <~pplicotion doted ............................. ~T~JlB3~....'~.....;.-.-; ....... 19~,.., and approved by the Building Inspector Fee $....~,,~)Q .......... ~u~amg mspe~:~or FOI~M NO. I Examined ........~M...~......, Approved .................................... , TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFF'CE SOUTHOLD, N. Y, ]9......~..Permit No....r.../...../...~...~...~ ..... Application No ..... L. ?....?....c/. ........... Disapproved a/c ............. ~ .................. (Building InSpector) APPLICATION FOR BUILDING PERMIT Dote ........ ..(~..~. ~ ....... I NSTRU CTI ONS 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 ava.liable 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 $outhold, 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~r 'r~ixif o cor~an) ........... (,~ddress 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) Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number ....~...~.~.....~....~.r......~.'....~........../~...~.'.~D. ........ : ............................................................. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....~.....c~..~.,~......~'~ .................................................................................. b. Intended use and occupancy 3. Nature of work (check which applicable): New Buildin,q .................... Addition...~ ......... Alteration .................... Repair .................... Removal .................... Demolition ........... ~,. ....... Other Work (Describe) .................... 4. Eshmoted Cost ....~.O.,...,'~.. ................................. Fee ~ .................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ ~ ............ Number of dwelling units on each floor.....I ............................ 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.......%t- .................... Rear ...... ~...o..~ ............. Depth. ~ Height ..... .~....o./. ............... Number of Stories ....~......~..,.'~...t.-'~,..,..c~.h4..~:,:.~ .................................................................... Dimensions of same structure with alterations or additions: Front ..... ~..~..' .................... Rear ..... .,,;3..o. ..................... Depth ....,~....q;..i ................... Height ...-~.P..[ ...................... Number of Stories .,.~.,.....~....~...~......~...~f4 8. Dimensions of entire new construction: Front ....~..O..'. ................. Rear .......... LO .............. Depth ...{..~ ..................... Height ............................ Number of Stories ......! ......................... 9. Size of lot: Front ...... ..~..~.~b.~.' ......... Rear .... ~ 5' . .......... Depth ....~...~.~..~..?. ........... 10. Date of Purchase ....~..gzt~ze~..~t...~<......~..~.;..(.~..~.~......Name af Former Owner ...&..-~.~.~.....~..c~ ..................... 11. 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~.?f~...~..'.'.'.~.~ress ..~..,f~.,.~ ............ Phone"~l'~'. Name of Architect .................................................... Address .......................................... Phone NO ..................... Name of Contractor ........ ..~.'....*~.....~. ............................... 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 NEW YORK ) S S COUNTY OF ,.~.'..~...~. ........... ) ' '/~ ........................................................... ~...~...~..-.~....~eing duly sworn, deposes and says that he is the applicant (Name of individual signy('~ 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 al 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. Nota~ Public, State of Hew York Sworn to before me this No. 52-0344963, Suffolk Coanly ~ ~ Commission ~xp s arch ............. r_.......'~-- ~ ~ ~ day ...... ;....~~~~ ....... ............ Notary PubHc~Z,~,,~f~f~,~,.. ~ f applicant) FOEM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved .................................... , I9 ........ Perm t No ................... Application No ..... ?....~....~. · .~. .......... Disapproved a/c ~ .~ ........................... :>,~......~. .............. ~:>,~r~.., ~ .................... .................................... ................. , .... (l~uilding In§pector) APPLICATION FOR BUILDING PERMIT 19...~.... 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 cov. ered 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 ava.liable 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 shah 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. ....... ignature ~ applicant,(~Jr name, if o corl~/ration) ........................ (Addre'~'"-:'-:':"?s"~'f":::ii'~'~'~'ti ................ v, ....... ~', ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ ................................................................................ 0 ...................... ; ......................................................... Name of owner oF premises..~..~..~...,..d.~.?...~.~.~:-.'~...,.~i.:....~..~:...'~....' ........................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work will be done. Mop 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 .....~......~...Z.q..'.~........~...~f..?.~ .......................................................................... b. Intended use and occupancy ............................................... ..~'...~.:~..~/ ............................................................... 3. Nature of work (check which applicable): New Building .................... Addition ...... .¢~............Alteratlon .................... Repair .................... Removal .................... Demolition ............ ~ ....... Other Work (Describe) .................... 4. Estimated Cost ....~....~..Q..Q..:~.'~? ...................................... 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 ...... ..N..~.' ............... Rear ....~...O..' ................. Depth ..... ~'~.~ .................. Height ...~..O. .................... Number of Stories ...~....~...,,~.i.LF...k.....~..'~.f.i.~ ................................................................... Dimensions of same structure with alterations or additions: Front ..... ~...~..~ .................. Rear ..~ ........................... Depth ,5-H ' Height ............................................................... Number of Stories ..."~...:....Lr~...'.?..k..._~.,?..~ 8. Dimensions of entire new construction: Front .,..I...O.. .................. Rear ...L.Q .................... Depth Height ............................ Number of Stories ........ I ....................... 9. Size af lot; Front _~,,,O.:,~,~,~ ............ Rear ._.l...O,.~.~ ................ Depth ...~....ff...~.:~P.. 10. Date of Purchase ../~..~ .............................. r./..~.. ......... Name of Former Owner ..~....'~.,......~..~ ................. 11. Zone or use district in which premises are situated ...................................................... 12. Does proposed construct on v elate any zen ng aw, ord nonce or regu at 13. Name of Owner of premises .................... L. ss ..... ....~..1~..~ Phone NO ..... ?..~..;./.4~.~ Name of Architect .................................................... Address .......................................... Phone NO ..................... Name of Contractor ..... ~ ..................................... 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 n?mbers or description according to deed, and show street names and indicate whether interior or corne,r lot. ~ I. -=~ff-q'. ........................................................... ~...~..,.?/...~.~ff.....~ing duly sworn, deposes and says that he is the applicant (Name of individual sign, i~ application),~/ above named. He ~s 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 manner set forth in the application filed therewith. Sworn to before me this ~0tery Public, State of New ............ .'./~.......~.. day of ............... ~~ ..... 19.~....°.. .... Notary Publ ic, .~.. ~'(.....~~. (Signature of applicant) STATE NEV~ YORK ) S. S. COUNTY OF ~,~ ........ )