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HomeMy WebLinkAbout1430-z?OWI~ OF EOU?HOLD t1UILDING DEPARTMENT TOWel CI~ERK'$ OFFICE SOUTHOLD, N. Y. CEHTIFICATE OF OCCUPANCY No. ~ .~..Q~. ........... Date ................... .~..L~g.~.q .~.. _ ...~.~. ............... 19.~ TH~S CERTIFIES that the building located at .~].l~...~,'.o~11a..~a~bo~...~a~ ......... Street :Map No. 05r.~.%~11 ...... Block No. ~ ................Lot No. 20~ .~O. Llth~],~ ...................... conforms substantially to the Application ~or Building Permit heretofore filed in this office dated .................... ~.!Mla ........ ] .......... 19..~.~ pursuant to which Building Permit No..~!~.~ ...... ~tated .................... ~.....~ ........... 19~k.., was issne6, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ..~I'i.~,~.%.~...o21~...~.aYal~,~,.¥...~.W.q,,.~l,&~g. ................................................................................ This certificate is issued to .~.g~,...~...]~l,e~.....}J~..%.~.~t.q~. ................... ...O~..~.e.~..~. ................. (owner, lessee or tenant) of the afoeesaid building. ii,D, OK/ Aug, 16,'61 FORUM NO. ~ 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.o 1430 Z Date ........................... ,~1~......~ ............. ] 9~... Permission is hereby granted to: Chet Or:l~w~k~,....~fP-..l~au.1...l~l.t, eh~ll .................... .... Cutehog~e ~-.-N.,.Y-, ........................................ to ....Bu;I,3.d.. ae~..~ne..£a~.1¥...d~e~:]&~ .................................................................................. at premises located at ....L~t..~.~..&]~o..~..~.....~Tor,~thart..O~el, tdl~..mll~.~, ............................. .......................................... I/8...Tov~. ~,.. Lane~. ......... ~eutt~o.ld ....................................... pursuant to application dated ....................................... ,,~I~,~.....].. ....... 196]..., and approved by the Building Inspector Fee $].0+0~1.. t:~d.. ~heck FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ×om,ne° ........ ..... ............ ii .... pproved ........................................ 19.../....Permit No ............................... Disapproved a/c .................. ~~ ............. ........................ (i~'5;~'~'~~ ............................... / ' O Application No. ....................... 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 availabl~ 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 issu~nc.e 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regdations. ...... ................................. (Signature pf applicant, or name, if a corporation) .......... ~.:¢z.z,~,~/..,,~,,~.. :~.,. ~., ....... ,~..,.~. ........... / (Address of a~plicant) / State whethe?, applicant is own,er, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ........ ~...~..2..~:.~.i~ ................... Lot NoSL....~..~..Z' ..... Street and Number ....... ~..O..(<.~..~.........~...~..~...O..~.....,~../J.~..e~...'.".:...:'.~.~..(/.J/z/..~/.-.~ ............................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................. Ir~4~.~2.1.~.. ..................................... ' ....................................................... b. Intended use and occupancy ............ .~)..~.~ ....... .~.~....~..~./../..?.......'~/..O.:~/F..~ ........ ~'~./f~ .../.~-~/~./2//. ¢.~..~..~..~f~.. . .. ........ .... 3. Nature of work (check whick~ applicable): New Building ....... ~. ................................ Addition Alteratio~ .._: ............... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ........... ~,~2..~¢.~.~. ............................... Fee ............ ,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 .......................... ~.:. Z. Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth ............................ Height ............................ Number of Stories ............................................................................................................ DiFnensions of same structure with alterations or additions: Front ................................Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front ....... ..~.~. ............... Rear ..... ~. .................... Depth ....~...~.. ................. He,ight ..................... '../..,~.. Number of Stories ........./.....~_.O...~....~..). 9. Size of lot: Front .......~,,,~..../. ............. Rear ....]7.~.~...~ .............. Depth .._i..'~.....2~.../. ............. _. ' 10. Date of Purchase ....... ~t,~..Iz'......~..'7 ....... ~.~,.~. ............ Name of Former Owner 11. Zone or use district in which premises are situated .......... 12. Doe~ p'rop~)sed construction v~olate qny,,.;pni~.g~ la,w, ordinance or reg, u. lqtion~=......~..~.~..e, ............................. · ~' (Z'/ IL, ////-Ib~u,~t/, //,~ t,l~e~'~'-~,e"~'7"'~ecT" 13. Name of Owner of premlses...~..e.~:C.~..~..,..)~.~.~.c.,~el~ddress ........I~.~....~.,,J......~,.f. ............ hone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor...~..~,.~.~...(~..¥..I..o...c~..?..~.t..i.....Address .~..u.?v...7.~./;.m'/...~....c...,J.Y.,.¥.,~..Phone 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. /,/Vi STATE QF NEW YORK, ) S S, COUNT~ ~J~ ........ ~...~...~.) '~ ~)~ .~.. ben~ dulysworn, deposes and says that he is the app[icant ...................~a m e'~ ''' --~w':~' ' ~ndJw~u~gnmg ~ application) ...... :'"": .................... u above named. He is the ............ ~...~...~..~.~. ...................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perfoFm or h~ve performed the said work find to make and file this application; that ail 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 t~ith. ~ ~ Sworn to before me this & [ ~ ,, ~ ~, ~-/, ~- ,2' ~- o~ ~-~ .. 19.~.{..... (S gnQture of epplicant) ......................., Nota~ RuNic, ..~ ~{~?- ~ ..~..~. ff ff ....... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. · (Jm,,..*.. D'I Examined ....... d" ............ ; ....... '~ ...... 19Z; ...... ~-*'/ /¥ 3 Approved ......................... ~..~ ............ 19 ........ Permit No ............................... Application No. //~j '~' `rD Disapproved a/c ...................... v~'..~ ............... ~ ............ .m......../..,~.. .................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Dote.....~.....?. .............................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 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations· ..... ........................................... (Signature of a~h~;ant, or name, if o corporation) Stc~te whether a~plicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................... ........................................... ,. .................................................................. ,me ................. If ~ppllc~nt is a corporate, signature of duly a~thorized 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 e0'~ ~ ro Municipality 2. State existing use and occupancy of pr. emises and intended use and occupancy of proposed construction: o. Existinguseandoccupancy .............. .~..~.~...~.]~...~.,.......~. ..................... : ................................................................. b. Intended use and occupancy ......... ~...~.~.~..~...)~./~...~....~...~..~...~...~/~........~'.~........~..~.~/.~./.L.~..~.~.~/.~ .......... 3. Nature of work (check which applicable/: New Buiiding........'~..... ....... Addition .................... A,l{~r~ig~ ~ . .. Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Est i mated Cost ...~'.~.~.~.~ ......................................... 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 ~pe 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 ...... ~f.,.~) ........ v.. Rear ....... 3.¢...~ .......... Depth ............................ Height ............................ Number of Stories ...... (....L.~/... 11. Zone or use district in which premises are situated ......... ~.~..~¢~.E~...~'.g.~.~.~/~Z.~ ........................... 12. Does proposed construction vio~te ¢ny z~n~ I~w,~ordinance or regulat~n?~...,~.~. .................................. 13. Name of Owner of premises....~/.e.~...~..~4.¢~.¢/Address ......... ~(~.~.~;~C~...Phone NO. ~:.~.~ Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor..~,.~.~./.9..~.~.~.c ....... Address .Di~.%~4.,/..~..¢.J~...~...Pho,~ NO.~..~ 7~..~.~ PLOT DIAGRAM Locate clearly and distinctly aH 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 ihterior or corner lot. f STATE OF NEW YORK ! S S COUNTY OF .,C>~ .................. g¥} , ' ....................... ]~.."f'~.....~...~..r..~...~...~ ........................ being duly sworn, deposes and says that he is the applicant (Nome of individual signing application) above named. He is the ....... ~..~..%..~..F. ........................................................................................................................... (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 Berformed in the manner set forth in the application filed therewith. Sworn to before me this .............. ' ....... ~ ~4¢r/ ~ota~, Public ~.¢~(~..~.~,.~:~.~...~'~.~ouCy