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HomeMy WebLinkAbout1335-zFORM ~0. 4 TOWN OF SOUTHOLD RUILDING DEPARTMENT 'I'OWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z ..'l'Oi~,3 .......... Date ........................ ~.t~Ly. ......... 31 .......... 19.~1 TH~S CERTIFIES that the building located atE/~q..,...F'~;Lla.,~Oad ........................ Street Map No.:]C~ ................Block No. ~ ................Lot No...;rdg:~ ....... ~x~tt~J.d ............................... conforms subslantially to the Application for Building Permit heretofore filed in this office dated .................... ~a:lych...:~L~ .......... 19..6.3.. pursuant to which Building Permit No. ~;~L~.~. ...... dated .................. 14a~ah .......... .2.~...., 19...6~, 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 ..l~. US~.ll~$...b12.:L.q41.~.ll~ ...... s~;Or~.. &..o2~:Lo~ .............................................................. This certificate is issued to .6.~...~/.~...8n~t-%h..&..Son.~...tne.~ ................... 0vrnez,. .............. (owner, lessee or tenant) of the aforesaid building. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTNOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1335 z ~ote ........................ i~Ia-~el'~.-...-2~ ............ 19~.% .... Permission is hereby granted to: George' "W';"*S~±¢h"'&" ~ons"ffn~ ............................. ................. S'ou~ho~d'~-'-"-~'4'~'; ........................... to ....... Bu.l.t~...a~t .. ~ d {.~-i.~t ..ot~ .. an.' ~x~.s ~ tn~...bt~.si~e ~.s..-bttTtd-ing ............................ ot premises located at~/~.....Ma.~t~...R~ad ............................................................................................ .................................................. Seu. t. het~.~.....-~..-~£.~ ........................................................................... pursuant to application doted ............................. ~l~h.....~;~j~ .............. 19.6.t.., and qpproved by the Building Inspector Fee $ .~..t O0 .............. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLDr, N. Y. Exam i ned .......~.....~...'-~.....~...~...., ,~...Z.... 19..~... (. ~oved ........................................ ~ ........ ~e~t ~o ............................... ...................... ....................................... Application No. '~...~...~...~ .......... APPLICATION FOR BUILDING PERMIT °ate ....... ....... ................. ..... INSTRUCTIONS a. This application must be completely filled in bv 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 drown on the diagram which is port of this location. c. The work covered bv this application may not be commenced before issuance of Building Permit. d. Upon approval of this opplicotion~ 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 who~e or in p art for any pu?pose whatever until a Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuono¢ of a Building Permit pursuant to the Building Zone Ordinance of the Town of $outhold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described. ordinances .,and regulations. /// The applicant agrees to comply with all applicable laws, (SignolCire of applicant, or name, if a corpora ' ) ..... .................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. if applicant, is o corporate,.~ sig~J~ture of duly authorized officer. ...... (Nome and tith~ of corporate officer) 1. Lacatien of land on which.._.....~ ~,~.~-Pr°P°sed work will be done. Mop No:~/~~.~.......} ........................... lot No: .................... Street and Number ...... ....~?.~......~...,..r. ........ .~.~, ..~~..~..~... .......................................... 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 ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition....~.... ........... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ....... ~...~. ............................................. Fee .......................................................................................... (to be paid an 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..~?..~..~..~.~'..t..~... 7. Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth ............................ # Height ............................ Number of Stories ....... '.,?.'~.~,, ........................................................................................... Dimensions of same structure wffh alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ ~ ................ Rear ........ ~.. ................. Depth . ./...~. .................... Height .../...~....~ .............. Number of Stories ..~'t.~ ............. 9. Size of lot: Front ..../~.~. .............. Rear ....~K'...~..~ ............. Depth .../..]:...~.. ............... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ....... ~.~r'x¢.~.'~z~rr.~,-~,~ ........................................................... ]2. Does proposed canstruction v'olate any zoMpg aw, ordnance or regulaton~ . 13. Name of Owner of prem.ses,~.~r~. ..Address ............................................ Phone NO.~..~...~.~ ....... 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 properly 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 yOP~I~ .~j_. ) S S -~ COUNTY OF ..~,~...) 2 -',//~' . (Name of individual signing application) ' above named. He is the ...... ~~ .............................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove 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 knowle~e and belief; and that the work will be performed in the manner set forth in the application fil~ therewith· Sworn to before me this ~Z ~ ~ UD ff T. BOKEN .......... o, .......... .......