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HomeMy WebLinkAbout2078-zFOI~Y/ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ,W..,/,.~.....W..,/.l?~?:.~...~.,~...,,~..e.,?.~.....~.,,o..~.e....~,~ ......... Street Map No, ~:~ Block No. ~ Lot No. ~ ~:~lD.l~t;i1~l].13]~ conforms substantially to the Application for Building Permit heretofore filed in this office dated 963 . pursuant to which Building Permit No. ~0~ dated ........................... .~...~. ........... , 19..~.., was issued, and conforms fo ~11 of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ~ivate one family dwellin~ The certificate is issued toOhar~°tte O~Keefe ~e~ (owner, lessee or tenant) of the aforesaid building. N. D. Approval ? OCtObe~:2~ FOi~I~I NO. 2 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? 2078 Z ~ne 22. Permission is hereby granted to: Date .......................................................... 19 ........ ].963 to... B mild.. ~ew...one...familI~...d~llirzg .................................................................................. at premises located at ..... ~/..~.~..~...e..~...~.....~.[.a...~3g..h.~....D...e..e.JE...~.~..~...e....D...~. ................................. Mattituck, N.Y. pursuant to application dated .............................. .~..a.~....3...~. .................... 19~..., and approved by the Building Inspector Fee $ ..~ 0..,..0...O...E .~....¢b3¢ ........ : ...... :.....-..,. ........... Bud ng nspector I FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ....~.~.....~..~. ........ , ~9.~..,~. Approved .......... ~.~......c~....[....., 19..E~..Permit No ...... ..~....c.~Z..~. ..... Disapproved a/c .:.~/rf/Z,.~.~....~...~......~..x~...........~....~....."....~......~..... Application No..~...~)..?....~ ......... APPLICATION FOR BUILDING PERMIT Dote ........ ,~,-... ........... ~. ............................ , ................ 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 application. c. The work covered by this application may not be commenced before issuance of Building I)ermit. d. Upon approval of this application, the Building 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 po rt 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 alterations, 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) z.... ........ 1.,. , (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 corporate officer) 1. Location of land on which proposed work will be done. Map No: .~?.[?..(. ............................... Lot No: .................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ..... ~...~...ICZT~:~.. .............................. Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ..~.. ......................... Number cf dwelling units on each floor ..... ~ .............. If garage, number of ...... ~ ........................................................................................................................ 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 J 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 .../..~..-~.. ................ Depth/~...,~........f.~.......,~.....~...~.. ........ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are s~tuated ....... /~. ............. .~.~~ ............................. 12. Does proposed construction violate any zoninn aw ordnance or renu et on;~ 13. Name of Owner of pram ses~..~.~ .~Address$ ~S .~..r-, ¢/c ~. Phone No Name of Architect ......................................................Address ............................................Phone No ..................... Name of C~ntract~r~.'~.~.~.~?.~t~.T~...Z~.~:...~.~.~2~.~.~Address/~..~"25....--x~.~.:~....~.~a~&~.~h~ne No. ~.~.~'~.--c.. .... PLOT DIAGRAM Locate clearly and distinctly oll buildings, whether existing or proposed, and indicate oll 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. tj~ STATE OF NEW ¥ORI~,~ t ) S S ................ ~f~,,:~a~...~.'....q:6.~/c~,:~/,.(~.~.~.,rt'~,~. ........................ being duly sworn, deposes and says that he is the applicant CNa:me of individual signing application) above named. He is the ......... ~.*~-~-, ,'6'~~ .......................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or,owhers, and is duly authorized to perform or have performed the said work and to make and file this application; that all sta:tements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the application filed therewith. Sworn to before~e this ~0.--~'~'"' u~ ~ew ~or~52.0344863 Suffolk County ~ , /~ ~ ~ - ~ ~/~ ~ ............. ~/....~d~y of ...... -z ................ ZZ.~.¢~..., 19....~ ~ ~ ' ~ // / ~ . ; .... ....., . ............... ...............