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HomeMy WebLinkAbout2053-zNO. 4 TOWN OF SOUTHO/D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...Z16.66 .............. Date ........... AiI[~.~IS~....8 ....................... , 19.~.].. THIS CERTIFIES that the building located at ..Vi~,l~e...]~xle. ....................................... Street Village Manor Map No ....................... Block No ........ ~,~ ....... Lot No....~_~ ................. ~.at.~i.t.~ok ..................... conforms ~substantially to the Application for Building Permit heretofore filed in this office dated ................. ~ .................... ~a~. ....... ~.~ ........ , 1cj63.... pursuant to which Building Permit No...~O~'~.. dated .......................... ga~. ......... ,~ .......... , 19.63..., was issued, and conforms to all of the requirements of the applic6ble provisions of the law. The occupancy for which this certificate is issued is ........ (owner, lessee or tena,nt) of the aforesaid building. H.D.Approval August 6 by Ro Villa ! / ..... "'""'"'"'"'"'~"'"~ Building ...... '"'"""'"'""'"'"'"'"'"'Inspector ....... '""~( '"' TOWN OF SOUTHOLD i~UILDING 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? 2053' Z Permission is hereby granted to: E~w. Abit~ · A/{~.....Win ~'...B~t, er...:~r.. &' ..~a. ne..601 teac.. ............. Ma~ti.~uek ............................................. to ..... .Burial.. mew..o~e...£e~..t~. ~,#el.t~t~ ................................................................................ at premises located at ...].O~...;~.-.~'l,]:~:~e-..),~Or ....................................................................... ..................................................... .~i.ttage..~e~ ........ ffa.~t-i.~k ............................................... pursuant to application dated ............................. .~e~. ........ ~ ............... 19..(~., and approved by the Building Inspector Fee $'"'],~)~(~0 ........ ...... ~k~. .......... f ' ' Building nspector *~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. Approved ~ 19...~....Permit No. Disapproved a/c .~~T~:.~..~... .................. (B ......................... Application No. ''~ ~ ~-~ APPLICATION FOR BUILDING PERMIT Date ...................... ??:.~......~. ................. 19 6~ 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 bui]dlngs 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 part of this applica- tion. 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, alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. Edw Abit~ (Signature of applicant, or name, if a, corporation) Mattituck (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................... ~..o.~j;.~ ~,q¢..(?.~ ................................................................................................................. Name of owner of premises ...... .~..,~...,~.8.~.~'.....?.~....~.....L[~.~,~ ..~.o..&]~.c.~ ................................................................................ If applicant is a, corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Location of land on which proposed work will be done. Map No.: ...,¥.~?.:~.~.?..,.~'.J~.o.~ ...... Lot No.: 22 Street and Number ..... .~j_.]_.3,.~,..T~..&..~l.e¢~c;te~8 ..~.1;. ............................................................................. '.~ .......... Municipoity 2. State existing use end occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy ..... i~T.¢~.~'t.-,.....].D.I:; ................................................................................................ b. Intended use and occupancy ............. q~.¥...,C.C,~¢...ll~...c, tw¢.,] .~,1,~,¢ ........................................................... 3. Nature of work (check which applicable): New Building .~..~.~ ......... Addition .................. Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost .............. .]~..~.y©Q~. ................................. Fee ....... (to be paid on filing this application) ,5. If d¢elling, 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 26/2~ Hei~lht .............................. Number of Stories ...o..~..(~ ..................... 9. Size of lot: Front ...... .'1.2,0 ................. Rear .............. ~2.0. ............ Depth ....... ~..0....~.. .......... 10. Date of Purchase ................ ~.9...6..~ ................................ Nam~ of Former Owner ] ~. Zone or use district in which premises are situated .............. !!,~.!~...~.~.~. ............ 12. Does proposed construction violate any zoning law, ordinance or regulation? 13. Nar6e of Owner of premises ;~azJ;p.~..&..G.(~.~..1.o~.. Address ................................................ Phone No. Name of Architect .................................................... Address ................................................ Phone No. Narfe of Contractor ..... ~.....&~..J:.?.;..z. ....................... Address .......~.~;.b.~.',..~.~...e..~. ..................... Phone No. PLOT DIAGRAM Locate clearly and disHnctly ali buildings, whether existing or proposed, and indicate all set-back dimensions f property lines. Give street and block numbers or description .according to deed, and show street names and indi~ whether interior or corner lot. STATE OF ! NEW ~0~t(^ ~. ) ................................................................................................ bein~ duly sworn, deposes ond s~ys ~hot he is the ~pplic~ (~me of individual si~nin~ opplic~tion) (Comr ctor, ent, corporote ..................... of s~id owner or owners, ~nd is duly authorized to perform or hove performed the soid work ~nd to moke ~nd file ~pplicotion; that ~11 stotemen~ contained in this opplic~tion ore true to ~he best of his knowledge and belief; ~h~t ~he work will be performed in the monner set forth in the ~pplic~fio~led therowi~h. Sworn to b~fore me this / ,/ , '.3... da of ............ }~aZ .... , 196~~/ ~~~'