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HomeMy WebLinkAbout2084-zFOP~i~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No.~....Z.~...q.o. .............. Date ~y a~ ~ 6b TI-IlS CERTIFIES that the building located atE/~..:L~fL~.~..~.~.C.~..,D.9~]g....~.O...~..~.....~.?...~..~treet Map No....~ ........... Block No .......... ~ ..... Lot No. ~ ......... ...[~...~...~.~..,~..~...~..~..~....~..?..~.. ................ conforms substantially to the Application for Building Permit heretofore filed in this office doted ...................................... ~.tme...,.'l.O ........ , 19..6~. pursuant to which BuiJdiiqg Permit No ..... .~...0..8.,~.Z. dated ............................... ~.~.~.....1.0.....,, 1 9.~3..., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ., p~. ~. ~¢e...O~e.. ~.m'~i ],~.. ~lw~ .1J.~ .............................................................................................. The certifidate is issued to .~.~.~ .~ ~.~.C~..~}.I ~...~...g~...~. ...................... ~.e...~..~.. . (owner, lessee or tenant) of the aforesaid building. H.D. Approval April 10, 196~ by H. Villa ............ ................ Building Inspector k 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? 2084, z Date ....................... J~e ....... SO ............ 19.~3.. Permission is hereby granted to: Wait~Z...Q..])~:~ ................................................ .............. .G~ chorus. ........................................... to ..... ~ull. d.. ~e.~.. (~ne...£~£1y...d~e;Ll!~g ................................................................................. at premises located at ..F~.I~.....~:~B.t,..I~ITt~I(~...iIt~.~I)..,H~Le...D~.~ ............................................. .................................................. !~a.tt ttu~k ........................................................................................ pursuant to application doted ............................... J:t~.~.-.-~,0. .............lC).~.~.., and approved by the Building Inspector Fee $1~0~ ........... Building Inspector SCHD SUFFOLK COU~@Y O~P~,~T_ LNT OF HEALTH Date ~pril 10, 1964 Building Permit No. TO ~'~OM IT MAY CONCERN: The sewage disposal facilities for a structure located at ~eep ~olo Drive e/s of West Branch~ Mattituck '" (Give deed location) have been inspected by this Department and found to be satisfactory. District Engineer EL IZ A ~ [:_] T !'i ¢ IAI A [. AT M A ,'F T ; T' L-~ (. k N,Y', GCALE: 40°=1' OT'r~ ~. VAN Tuft ~ SON LICENSED LAND TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...................................... 19 Approved .......................... ~.) ............ , 19 ........ Permit No. Disapproved o/c , .... ~]_/~& ~~- (Building Inspec~r) Application No....o~,.~....Oc.].¢.'~ ........ APPLICATION FOR I~UILDING P~:RMIT Date ...........~.....[....~. .................. , 19..~.~. INSTRUCTIONS o. This opplicotion 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 drown on the diagram which is part of thie 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 applica,nt. 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 pa 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 Budding 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, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or name, if a' corporation) ..... .............. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budder. Name of owner of pre m is es .~.~..~.....~.~... ~.~. ~..~...,~..... ¢:. ~ .¢:r:.. ~ ................................ 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.: ........... ¢:'Jrt~....oL.-¢. .. Lot No Street and Number ..~]~....~....~..~...~ .......................... .~¢~~. ............................... .Municipality 2. State existing use and occupancy of premises 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 .............. ~. Remova! .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost .../..7~..~a ......................................... Fee (to be paid on filin.cl this application) 5. If dw~elling, number of dwelling units ...~..~..~ Number of dwelling units on each If garage, number of cars ......... ~ ........................ 6. If b6siness, 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 some structure with alterations or additions: Front ................................ Rear Depth ................................ Height ................................ Number of Stories 8. Dimensions of entire new construction: Front _......O~.. ................... Rear ...~..-%~.. .................. Depth ......~. ~.. Height ~../..~. ....... Number of Stories ........ / .................... 9. Size of lot: Front ...../: ...................... Rear ...'~.~..,...~..~ ................. Depth ..../...~'.~. .................. 7°. Date of Purchase ............. Na,m .of Farmer 1 1. Zon~ or use district in which premises are situated....~.~ ........ 12. Doe~ proposed construction violate any zoning !aw, ordinance or regulation~ 13. Na~e of Owner of premises~..~..~ddress ....~.~ ................ Phone Name of Architect ................................................. Address Address Phone PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-back dimen: property I nes. Give street and block numbers or description .according to deed, and show street names and indic whether inter or or corner lot. STATE OF] NE~( YORI~, ) S S COUNTY//'7~---~. '~ ,,L//--,~OF .~.~F.~.o.l<..1%. ...... ..(~ . · ~~...~-:--~.....-...~.~.~ ............... being duly sworn, deposes and says that he is the applicc (Name of individu,~! si~tnin~ation)~// ~ a.bove named. He is the ..~.~...~..'~..~ ~ - ~ ~ (Contractor, agent, corporate officer, etc.) of said owger or owners, and is duly authorized to perform or have performed the said work and to ma¢e and f e application~ that all statements contained in this application are true to the best of his knowledge and be ief; that the wgrk wiil be performed in the manner set forth in the application filed therewith. Sworn to b~fore me this .......... [~.[~: ..... da~ of ~.~ .... 1~ ~ ~ ~ : ~ ~ .~/ :'~', ~A~ ~i~'i~'~A~ ...... ~ ~~ Notary Public ....~O.~.~,w..~J~-~tp.°~'~[' Ygignature of applica.nt) ~/ No. 52-690565~ ~ualified in Suf}olk County Y~,n ~ui~es March 30, 19~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ......................... .U, ............ , 19..,.~...Permit No. Disapproved a/c ..................... ..................... ........................ (Building I nspe,9(or) Application No. O~L O Oe- c/f APPLICATION FOR BUILDING PERMIT ate ............. ~ .................................... , 19 ........ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Bdilding Inspector. b. Plot plan showing location of lot and of buildings on p remises, relationship to adioining 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 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 MA,DE 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, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ......................... (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~....o~...:~.~..:....~...~.......~i~...¢.. ....... ~~ .......................... 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.: ~..c~.. ...................... Lot No.~ ...... Street and Number ~ ........ ~.~.~......~....L.~v ........................ ...~...4~.~~ ........................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy b. Intended use and occupancy ~.,¢~,,,,.,~¢,~,,z¢~,,~...~....~. ........................................................ property whether 3. Nature of work (check which applicable): New Building ....~ ......... Add,ition .................. Alteration Repair ............. ~/. Remova! .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost ~/Y..¢~::~. .............................................. Fee (to be paid on filing this application) 5. If d~elling, number of dwelling units~....Z~,.4~cNumber of dwelling units on each 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 ................ Dim;ensions of same structure with alterations or additions: Front Rear Depih ................................ Height ................................ Number of Stories 8. D~mens~ons of entire new construction: Front ..~..~.. ........ '~ ........... Rear ..... ~ .................... Depth ....... 1 1. Zone or use district in which premises are situated...x~.~... ..... 12. Doe~ proposed construction viol.ate any zor~ing law, ordinance or regulation? 13. Nor~e of Owner of premises~.~.~Address .~ .................... Phone Name of Architect .................................................... Address ................................................ Phone No. Nome of Contractor .,~.~...~.. Address ...~ ................. Phone PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-back ines. Give street and block numbers or description .according to deed, and show street names and STATE OF NEW~,~ORK, ) COUNTY iOF ....~.~.F..F.'~,~,...:,,- ...... ) S.S. .~....~4~..~¥....~A/./....-..~...~~....~:~... ........................ being duly sworn, deposes and soys that he is the applic ~Name of individ abow.~ named. He is the ~ (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 apphcat~o~ that all statements canto ned m th~s apphcat~on are true to the best of h~s knowledge and behef that the work will be performed in the manner set forth in the application fi ed therewith Sworn to ~efore me this ANN .............. ....... /J ~A~ -~-'6~0 , ~ ~ ~- ~. ~ ~ ' Notary Pub,,c .... ./,~[~.....~~e~.. County (S,gnature of appl,ca.n,)