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HomeMy WebLinkAbout1632-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE: OF OCCUPANCY No. Z 1750 Dote Novembe:~ 4 19...~..3. THIS CERTIFIES that the building located at /%.V.~A ;E~, ~ff.~.~...~.~.~ ............. Street Map No ...........~.a.... Black No ....... *e ........... Lot No ............. ~ ................................................... conforms substantially to the Applicotion for Building Permit heretofore filed in this office dated ......................... ~...~ .............., 19..~.. pursuont to which Building Permit No. ...... dated ................ ~X...~ ............. , ]9..~, wos issued, end conforms to ~11 of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ The ce~ificate is issued to He.~ ~hg~.~,....~.~.~ .............................. (owner, lessee or te~t) of the aforesaid building. Building Inspector. FOR~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS F~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1632' Z Date ................... ])~1~:~....;[~ .... 19.~. Permission is hereby granted to: ~m.~.....~...~..a....~, ...~.. ~..~.. ............................................. ...... ~.~.~..~.~...~.z...a~..cl~ ..... ~,.~, ...................... to .]~q~ .~e.~ .0.~_. ~._~_.~_-.'(]r...d~e~];t.t~ ................................................................................ at premises located at ..~/~....~.{t...~l ........................................................................................... ................................................. ~her~..;T~Za~t ~ ..... ~.~ ........................................................... pursuant to applicahon dated ........................ :]~/~.....~.~/. ................ ]gl~..., and approved by the Budding Inspector F~e $...;I,0,.00.....~1 e~ ' I ' Building Inspector [ ' FOI~M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN C:.ERK'S OmCE SOUTHOLD, N. Y. Examined ~c~ i ~ 19 &( ,, Approved ........................................ , l~..~....~rmit N~ ................................. ^PPUC^T~ON FOR BU"D'NG PErMiT Date ......... /. ?:....-...:~..~. ............................. , 19..(. J. ......... 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 application. 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 ~pplicant. 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 pa rt for any purpose whatever until o 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~ applicj~, or name, if a corporation) (Address 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) 1. Location of land on which proposed work will be done. Map No: ...... ..~.......'/~.. ........................... Lot No: .~.....~. ............. Street and Number ........ ~...~..~.'. ........ ~ ......................... .,/~..I...~...~.....~..f.2...~ ....... ~...~....~...~....~.. ..................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .'~ O ..~ J~.' ............. b. Intended use and occupancy . .~¢'. ~L .~..~.t....~.. ....... 3. Nature of work (check which applicable): New Building ..... .~.. ......... Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ......... ~.~.~.,..~..~ .............................. Fee ....... ...~....~.: .~..~. ........................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... ../. .................. N6mber 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: F~ont Rear ................................ Depth ............................ Height ................................ Number of Stories ........................................ 8. Dimensions of entire new construction: Front....: ...... .~.~..... .......... Rear ...... ,,~....~. .............. Depth .......~...~ ............. Height ....... /'~.../...: ......... Number of Stories .......... ...2~.. ................... 9; Size of lot: Front ........./..f...~'.. .............. Rear .......... (~../...~. .......... Depth .......... ./....I./....~.. ................... 10. Date of Purchase ............. /..~..~.~. .............................. Name of Former Owner .~..~..~.!.¢.~..../~...~...~..../.~...~'~. ............. 11. Zone or use district in which premises are situated ..................... 12. Do~es proposed construction violate any zoning law, ordnance or regu at on? ....... ~....~. ....................................... 13. Name of Owner of premises~..~..~.Z.~.'~.~.~/~i.~..~Address ..(~....~.-.....~.~...~.....~.....: ......... Phone No..~...~....~ ....... Name of Architect ..................................................... ~aaress ........................................ Phone No ..................... Name of Contractor ............... ~. ~...~...~'. ..................... Ad~lress ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate ail set-back dimensions from property lines. Give street and b~ock numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ) COUNTY OF .S~:~.~:..~.~,...) S.S. ....... -~.~,Ka:.~-.q[...-./~..::..~-.~.~'~...~'.~..~.:: ...., ................ being duly sworn~ deposes and soys that he is the applicant i, ux~onl~e or mor,,'~aual s~gnmg appucar~onj above named. He is the ............. l~.~.~ ................................................................................................................. (ControctoF, 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; ~Zdortnhtaot ~)he~or~eV~lisbe p/e_A~formed in, the manner set forth in the application filed therewith. -- .......... ....................