Loading...
HomeMy WebLinkAbout1390-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CL~RK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY TH~S CERTIFIES that the building located at ............... ~..~...~0.~!.~...~..A?... Street Map No. ~ ................. Block No...~ ................. Lot No ..... ~ ........ .~...~...~..~.~.O.~.~.. ............................... conforms substantially to the Application for Building Pecmit heretofore filed in this office dated ...................... ~...O.?..~.~...~.~.....~.~., 19...~...0.. pursuant to which Building Permit No...~...~...~..0. .... dated .................... ~ .........~. ............ 19..~., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is ....... ~-~.J~.~.q..01q~..~J,~l,Y.. ~.~..$.~ .~.~4~ ............................................................................ This certificate is issued to .~l~.~D,~'....~.~,~...~..~.~.~. ....................................................... (owner, lessee or tenant) of the aforesaid building. TOWIq O1: ~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? 1390, z Dote .......................... Ma'y ....... ~ ............... 19-6.t.. Permission is hereby granted to: Donald i,~. ed~.itk...A/~ .....A~.th~z~..... ~e Z~nd .. J~ ..... ....... {~.o~tt ho id. ~ ..... ~ ~. ~.~ ..................................... to .. ~Bu.i. ld.- a.n..~d d.l ~.io~..o,n.. an...e~is.tt n :~...d~.e l.ling ....................................................... at premises located at N/f).....So~-~..¥,le~/...AVe ................. i ............................................................. .............................................................. $outh'~ld'f"'"'N ~' ~ ~' .............................................................. pursuant to application dated ............................. NO~e~I)~P"'~'~ ......... 19~O...., and approved by the Building Inspector NOTE: &dditional property hss been purchased to widen original lot to comp]j; with side lines. ~ee $'"~'GO ........... tile oullalng inspector I FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ............. Approved.....~...~ ....................... 19..J...Permit No ................... .~. ......... Application No. ~, ,~.,..,~.,..7 ........... ; .JLz. 137o APPLICATION FOR BUILDING PERMIT Date ............ ~~...../..~...] 9...~...o. .... INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in duplicote 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 Deportment for the issuance of o 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 oil applicable laws, ordinances and regulations. .... ...................................... (Signature of applicant, or name, if o corporation) ........ ....................................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises....~.....~...~.~.~.........~...~..~.-2L''~ ....................................................... 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 ....~./~......~..~......Z~ ...... ..~..~.....~..~..~...~...~.~....~...c...~...~..?/.~" .......... ~..:.~..~... Municipality 2. State existing use and occupancy of pr,emises and intended use and occupancy of proposed construction: a. Existlng use oncJ Occuponcy..,~...;..T.-~..,:.;~"*~".....;......."~Z'"'"'""'"~-- ..................................... ~"" ~' ............................... b. Intended use and occupancy ............... ', ............................................................................ .~. .................................. 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair ............ D......Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost..-...c~.~..o...°..?. ............................................. 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 ......... ...~....'~.. ......... 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 .....:~..-.Z~T- ................ Height ............................ Number of Stories ..~ ......... 9. Size of lot: Front ...... .~.~... ............... Rear ............... ~ ....... Depth ..~....o~..~...~..?..~ ....... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 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./~:...b/....~..~;~;~...~... ............. Address ............................................ Phone NO ..................... Name of Architect.....~..~....C~..~...~....c~T.. ............... Address ............................................ Phone NO ..................... Name of Contractor.....~....~......~.?....~...~....~m.. ........... Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-bock 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,.Yg)BK,,, I,,, _ ) S S ' COUNTY OF ..~,.....) ' ~/~) I_ '~'~,,~,v~_ ~,..C:~C be n ............................ s~v.~_./~..'T,.':..J,..~.,.,.; .............................. ; .........g duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named he-s the ......... ~...~..~ .............................................................................................................. (Contractor, agent, co~orate 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 c. ontained in this application are true to the best of his knowledge and belief; and that the work will be performed m the manner set forth in the application filed therewith. Sworn to before me this ............... ~....'~... day of ............ ~ .............. 19...~....0..... (Signature of applicant) Notary Public, . ........................................................... County FORM NO. 1 T~OWN OF $OUTHOLD BUILDING DEPARTJ~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×am,ned ......... , Approved ...~....a...~ ........ , 19~.t'...Permit No. 7--/¢~ ~ 7 Disapproved a/c ..~ ............................. & ................................ ............... ............................... . . (Building t]~ctor)~ Application No...../....,:~....S~...~. ............. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a.. This application mast be completely filled in by typewriter or in ink and ~ubmitted 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 detailed description of layout of prope, rty 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 Bu'ilding Inspector will issue o 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 issuo.nce of o 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. Donald Frederick (Signature of applicant, or name, if o corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporater officer) 1. Location of land on which proposed work will be done. Map No: ..~...~4'~ ............................. i Lot No:..~ ........ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~.~..J,.~.a:b.a...c'Lw~.~L],.l,z).§ ..................................................................................... 3. Nature of work (check whic dicable): New Building tion.....~( ....... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ~..2e.QOQ~OQ..~l.t~..c~...aL~zt-o~.Fee.~:..~;)O .......................................................................... .... ;..' ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units......q~f~ ......... ~...Number of dwelling units on each floor .................................. if garage, number of cars ..................................... ~....~....~.:, .............................................................. 6. If bu~.iness, commercial or mixed occupancy, specify nature and extent of.each type of use.~ .............................. 7. Dimensions of existing structures, if any: Front.....~2fJ; ............. R~ar ......... ~ .................. Depth ...~l.~/.2..br£.t;~,...S[~pe Height ............................ Number of Stories .~.~e ..................................................... Dimensions of same structure with alterotion~ or additions: Front R~ear ................................ Depth ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ..... ].~ .................. Rear ......... ~6 .............. Depth ....2,2 ................... Height .., ........................ Number of Stories......O..~..e........i',: .......... 9. Size of lot: Front .c~'. ...................... Rear ............. ~O111...i... Depth ....... ~./...,~,9.0~t 10. Date of Purchase .................................... . ............. ....... Name ~..Former Owner · "A" Ct 11. Zone or use district in which premises are s~tuated ...................... ~.J~.p. .......................................... 12. Does praised Construction violate any :zoning law, ordinance or regulation.> ............. ~',~$ .................................... 13. Name of Owner of premises.....J...~..~.~.~,~,~...~...~ ....... Address ...~.C~l~(t...~:~e~/..~//~ .....Phone NO ..................... Name of Architect ~ZI,.~_-~z'.ec~.iL~=~ ........... ~........,Add~'ess ............ ~ett~o.'l~ .......... Phone NO. Name o Contractor ~ ................................................... Address .................. ~. ...................... Phone NO. ! PLOT DIAGRAM Locatelcle~rly and distinctly oil buildings, whether existing orproposed, and indicate all set-bock dimens ons .from property lir~S.~ive street and block numbers or description according to deed, and show street nomes and indmate whether Jnt&rio~ or Corner lot. Au'F- STATE OF NEW YORK ) COUN'r~' 'OF .~ttt'~].]~ ....... ) ................... :....:..,..:]~o~].4~,.~e(]~.L~.:l:e~ ..................... ~.....;beipg duly sworn, deposes and says that he is the applicant (Name 'of individd~l signing application) .~ "' ' ~ ".~. ~ above named. He is the ................~.O...~.~.Z'...e...q.~.o..~......~.~.~.....~...../~:~,~...~ ...................................... ~(Contractor, agent, corP°ra/~lcer, etc.) of said owner or owners~ and is duly authorized to perform or have performed (/t~. sai~l .w.o.rk and to make and file this. a. pplicatJon; that all statements contained in this application are tree. to ~e best of his knowledge and belief; and that the. work will be performed in the manner set torth in the appIJcatio~ filed therewith.