Loading...
HomeMy WebLinkAbout2116-zFOI~[ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ~ 174.~ Date ~NOV~.~ 4 19 63 .... i...~...L ........ '..... ~'..: ~. ............. THIS CERTIFIES that the building located at -qiq',~-'b~ RO~ ~ at~tt~c~ .... Street Mat~ituck Park Prop. 38 .................. Map No ....................... Block-No ....................... Lot No ................................................... conforms substantially to the Application for Building Permit heretofore filed tn this office dated ,~t~I.v 9 19 ~o] pursuant to which Building Permit No. ~ 2116 July 9 ~3 dated ........................................................ , 19.....:.., was issue~, on~ conforms to all of the requirements .. of the a~plicuble provisions of the law. lhe occupancy for which this certificate is issued is ........ ]~IVAT~ ~ ~AI~ILt' DWeLL]LNG The certificate is issued to .......)~r.~.^...~.'.$.~.%.~..~....8.f.,'ht.~J-.~..c.*.,.....q.W.D..e..~.. ........................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector \ '' FO1UYI NO. 2 TOWN OF SOUTHOLD ~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°, 2116 Z Date .............................. Permission is hereby granted to: Stanle~"~gepko .......... .~...~i~ei~.a.....Set~:i. d.t ....... .......... ~m~*~*%uek ................................................ to ..... Bu4.t~ · .a~.. e~td.l ~i.o~ .. ~n.. an.. ~x& s.ti.ng...d~te 11f~ ......... ......................... :.. ............... at premises located at ....,l.o.,b..~8.i......p]a,¢.t,f.~a,,~]~..p.e~.,~,,ep ...................................................... ................................................ ~.X.~ s.l~y...~e~d., ....... ~a~;.t ~.tu~k ...................................................... pursuant to application dated ............................. ~Tt/.1.y ....... ~ ............... 19~..., and approved by the Building Inspector Fee $..~., .................. Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........ ' ? ............ , 19;. ...... Approved ........................................ , 19 ........ Permit No ................................. Application No. ~l I (~ Disapproved a/c ............................................................ : .~m...~..~... · .../4 ............. .......................... ............................................ (Building Ir~spector) APPLICATION FOR BUILDING PERMIT 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 o~ lot and of buildings on p remises, 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 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 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 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 demqlition, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. .......... ~t,a~],e.~.... ,~ e.l~ko .......... 'i .......................................... (Signature of apprJcont, or name, if a corporation) .................. Nat.tl.C.ue~. ................ ......................................... (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, i' (Name and title of corporate officer) !" I Location of land on which proposed work will be done. Map No: ....... ]~&t~,,...,~.a~:...]~o~. Lot No: ...38 ............ Municipality ' ," 2 State existing use and occupancy of premises and intended use and occupancy of prO'posed construction: a. Existing use and occupancy ........ d.~.~.i.~j~ .............................................................. :""u ................................... " W/ Addition " b. Intended use and occupancy ...................................................................................... ? ........................................ 3. Na(ure of work (check which applicable): New Building .................. Addition ....~.... Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost .......:L~.O0.Cl ......................................... Fee ..... (to be paid on filing this application) 5. If dFvelling, number of dwelling units .......Ol'~e ................ 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 .3..0.. .... Height ............................ Number of Stories ..O..~.¢. DJm. ensions of same structure with alterations or additions: Front ................................Rear Depth ............................ Height ................................ Number of Stories ........................................ 8. Dimensions of entire new construction: Front ....... ~,~ .................... Rear ......... .3~. .............. Depth ~..~.~.. Height ............................ Number of Stories ......... 13~ ................. 9. Size of lot: Front ................................ Rear ............................ Depth ........................................ 10. Dat~ of Purchase ........................................................ Name of Former Owner 11. Zode 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 ....~,...~;131¥1~1,~.t;. ........... Address ............................................ Phone No. Name of Architect ...................................................... Address ............................................ Phone No. Name of Contractor ....l~o...~e.13kQ ............................ Address ........... ~.~.1;~.1~.0.~ ........... Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate ali set-back dimensions fr property lines. Give street and block numbers or description according to deed, and show street names (]nd indic whether interior or corner lot. STATE OF NEW YORK, ) COUNTY OF ...... I~.tt~.o],k.....) S.S. ................................. ~.~&]rl~e~'...(~.e.]]~¢t ................................ being duly sworn, deposes and~,~ys that he is the appHcd (Name of individual signing application) above named. He is the .............. O.~Q~ .................................................................... ' (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 f this application; that all statements con~dT, i~ application are true to the best of his knowledge and beli; and that the work will be performeS0t?~ ~o~r'~tV~rth in the application filed therewith. Sworn to biefore me th s ~, 52-0344963,~Suffo~k umlnty ~o~mJssion Exp~e. March 30, 19~ / ~' , Notary Public, ...~...¢..~:.~.,..-r~.~>k~oup~ ~ ~ (Signature' bf ~p~i~;~;'~ ........................