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HomeMy WebLinkAbout1525-zFO]~IVi NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z1450 Date October 22 ]9 62 corner Corey Crel~k l~d. & Bayv}..eW.Rd. THIS CERTIFIES that the building ~ocated at '"'~%~ii~Ifl ............................................... ~rr~eer Map No ....................... Block NO ....................... Lot No ......... 6 ...................................... conforma substantially to the Application for Building Permit heretofore filed in this office dated ................... ~.~..cJ'.~.~....~..~ ......................... , 19..~. pursuant to which Building Permit No .......... ..~....~.5~5 dated ........ ~.~....~]~..?...~....~ ........................ , 19.....6~, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ PRIVATE ONE FAMILY DWELLING The certificate is issued to E~a~d R, Hau, o~ener (owner, lessee or tenant) of the aforesa.id building. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS P. ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION_ OF THE WORK AUTHORIZED) N? 1525 Z Date .......................... ~g'~ ~..... ~,.~ ........ Permission is hereby granted to: G o Id S m.J.-.~ .h....B..r..0. fL....~.~...~.....E.d.w~,~...Ha~ ................... ............ ~.ou. thetd- ............................ ~ ................... to Build...ne:~z..c~e...£~mily"...d.~oJ~!i.r. tg ...................................................................................... at premises ]ocoted at ..Ba,~r..%~:f~,~,...Rd...~..~o:pey..(~ree~..tt~ ............... ~ol~e...~.,.D.,A,~.). ......... ............................................... S ~u~;.~o.l~ ~.. J~...~. ................................................................................ pursuant to oppJicotion dated ............................... ~/1.1]~..~ ................... ]9.~.., ond approved by the Building Inspector Fee $...1.Q~O.O ......... FORM NO. 1 '5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. D~sappr, oved a/c ................. -~' - (Building Inspector)~ Application No...r ......................... 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 o detaired descrlption 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 Gertificat.e of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuanoe 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 lows, ordinances and regulations. G~o~.m~. :..... ~¢..:;,~z~. e ... ~.~.'..O_~.~..._~.¢~ (Signature of applicant, or name, if a corporation) ............ ~.rz.~.z~.~.O......~.~. ~.'...~.~ ~.~. .......................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... ~.s.~.z~,~...z. ......... C~/. ~..~..n. ~ .zr. ~.~ ........................................................................................................................ Name of owner of premises ........ ~~.....~,...~. ............................................................................................. If applicant is a corporate, signature of duly authorized officer. ........ ~(Name and title ot corporate officer1 1. Location of land on wh,ch proposed work will be done. Map No: ..~..~..~..~..~ ............... Lot No: ......~ .......... Street and Number ......... ~'~.g~..,....".~......~,~...C~.e.~...~....~'~.....~Z~'....~*(, ................. Municipality 2. State existing use and occupancy of pr.emises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...................... ?. ............................................................................................................. b. Intended use and occupancy...~Z2212Z¢.~ ...... ~'~.~,.~ ............................................................. 3. Nature of work (check which applicable): New Building.....X ........... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost......."~'....~..~....~..,...~..~. ............................... Fee ,.~../..4I~.,~.,, (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 ...... ./..¢,~F~......~. ...... ~'.,4/~.~.-'.'.'.'.'.'.'.'.~ ...... /2'.~/,4.$.t,~ .......................................................................... 6. If business, commercial ar 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 ...... ............ Rear ...,~...~ .............. Depth ..,,,~...-'~...~ .............. Height ......~.~...~ ............. Number of Stories ........ ./ .................. 9. Size of lot: Front ......./.~..,o..~. ........... Rear ...... Z~..~.~.~.~ ...... Depth ..../..~....7..,....~'.~.. ..... 10. Date of Purchase ...t,~,'~,K./'_/.~.O~.~J .............................. Name of Former Owner ........................................................ 11~ Zone or use district in which premises ore situated ............................................................................................... 12,' 'Does proposed construction vi~16te any zoning law, ordinance or regulation? 13. Name of Owner of premises.,~E'..~.~.~......//~.~ ....... Address ~..~_~....~..-~.~..~'...:~/.'2:....Phone ~'~,~'/¢ /~ l ,,%I, Nome of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor.~.'P.,t.,~,~,~ZL..Z~tL~..E~'./~,...Address .~.~.~'~.~ ....................... Phone NO. ~'~...~.'..'.~.~.2,~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, end 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 ~ COUNTY OF ~....) S S., ~ ~, ~o~ ~'~ be nfl duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the.....~.~'.~ ........ ~~ .............................................................................................. (Contractor, agent, corporate off car, etc.) of said owner or owners, and is duly authorized tb perform or have performed the said work and to mgke and file this application; that all statements contained in this application are true to the beet of his knowledge' and belief; and that the work will be performed in the manner set forth Jn the application filed therewith. Sworn tO before, me this " JUD,T~ T, BO~E~ ' .......... -- Nota~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ ]9 ........ Permit No. Z~/ 5) ~--~ Disapproved o/c .......................... ;...? ............. ]:~,.~;,:. ........ ~,.....:.~7¢;./ ........ ....................................................... ............... ........ .... ...... " .............. ~'*"F'(Building ....... "' ........ Inspector) ~' " .......... ' ...... '"' ................ Application No. / 3- 2- ~ 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 qf 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 tb 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 appUcable Laws, Ordinances or Regulations, for the construction of buildings, additions or a Iterations, 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) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... .......... ........................................................................................................................ Nome 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: .,~.~.~.:~..Z..~ ................ Lot No: ..... ~ ........... Street and Number ........ ~:~.:f~.¢:~. ....... 9..~ ...... ~.~:.C~...(.~.C~...~....~/D...../:~UZ~.....~, .................. ~unicipality ~ 2. State existing use and occupancy of p~emises and ~ntended use and occupancy of proposed construction: a. Existing use and occupancy......]' ............. '.~ ............................................................................................................. b. Intended use and occupancy..~.~f~ZZ.~?.~ ...... .............................................................. 3. Nature of work (check which applicable): New Building...../t~'. .......... 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 .......... ..J. ................... Number of dwelling units on each floor ......... /.. ................ If garage, number of cars ...... J...'C~....;.'t ...... /,¢,~/~/r~ ...... ./.,/.¢.~$.~. ....................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .............................. 7. Dimensions of existing structures, Jf 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 ....j,?~.~ ................. Depth ..-,,~,~',~%..~ ............... Height ......./..~...~ ............. Number of Stories ........ ~. .................. 9. Size of lot: Front ....... /'¢..~ .............. Rear ...... Z~..~.~.~./. ...... Depth ....~..~....?:...~.~.. ..... 10. Date of Purchase ...~./2~.~.~',~ .............................. Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ............................................................. ; .................................. 12. 'Does proposed constiuction violate any zoning /aw, ordinance or regulation? ---- ~ ~*'~ -"re ¢~'¢ ¢4/~/¢4.'/.~'~,~ ~Z' Phone NO 13, Name of Owner of premises.~;.~x~.~'.~,,.,...z.~'¢:? ........... Add SS ......... ~?~;,.;¢.Z:,?lq,~.;.~i:)..' ............................. Name of Architect ........................................................ Address ............................................ Phone NO ..................... N~me of Contractor~.~.¢~.~;.,C-//.....~c,~,.~...O~'.~.,...Address ~..~.¢~.,~.~k.~,. ....................... 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. STA~E OF NEW ,Y~D,R~; ,~/ ) S S. COUNTY OF'.,~.~,~,'~..¢!!/..../~.. ...... ) ~/,~ . ..~ ....... ~.~.f~.~.~..(~ ............................. being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ~¢~ ~ ~ O//,~ ................................ ........................... officer, eto. of said owner or owners, and is du[y authorized to perform or have performed the said work and to make and file this application; that ~11 statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the~ n r orth in the application filed th~with~ . e --~ ~i~ ~ot~ry Pubhc, State of New York -~' '~ ~a- of ~6~-~om)~i~, ~u ]~¢~ , ~9 *~ ~ (Signature of applicant) ' Notaw Pub c ,.: ..... ~1 ............................ - , .....