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HomeMy WebLinkAbout2140-zFOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ....... 1~...~81¢,8 ....... Date ........................... Ap~.tl.....20 ...... , 19.6~... THIS CERTIFIES that the building located at ...~.~.....iB,t/~I;,t..~.i.~.~ ............................ Street ap No ....................... U~OCK ~o ........ ~ ........ Lot No....~ ......... ~e¢.~D.~e.~......~,.~, ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................... ~f~.~.....~. ........ , 19..~.. pursuant to which Building Permit No ..... dated ............................... &~t.[~,~.....~...., 19..~., 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 ........................ ~&gat ~...~e...g~i&tr...d~ ~& &~g ......................................................................... The certificate is issued to ..... ~.~...~...~[t~ ................. ~ ........................................................ (owner, lessee or tenant) of the aforesaid building. FOEH NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS F~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2140 Z Date ................... Permission is hereby granted to: 0eorg~..~hle~.....~¢.....F, 3.,C~y ...................... ............... ~ehegue ........................................... to Bu.Ltd. * .n~w~ne. · .~'..~ .~.ty. · .~we .Lt f~ ~ ........................................................................................ at premises located at .....L~t~...~.f....I~-l~.i. at%..~e~...pa~ ................................................ : ............. ................................................ S~i.t2~..~v.l.v~ ........ P~o~e.,...~'~, .............................................. pursuant to application do~ed . ......................... ~l]~-~St, ...... ~ .............. 19.6.~.., and appraved by the Building Inspector Fee $10.00 ........... Building Inspector~ SUFFOLK COUI~@Y DEPk~,~TIiENT OF HEALTH Date April 16~ 1962 Building Permit No. TO ~v~OM IT ~Y CONCERN: The sewage disposal facilities for a structure located at ~ith's Lane~ Peconic ~ Fo J. Carny .... (Give deed location) have been inspected by this Department and found to be satisfactory. District Engineer TOWN OF SOUTHOLD BUILDING .DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No..~..~..~....~.k.©. ........... APPLICATION FOR BUILDING PERMIT ote .......... .................... , 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 bedrawn on thediagram 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 gnonted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o 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, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulate!ans. ess of applicon Name of owner of premises ................... ..~....:.: ......... .~ ......... ~ ................. p. ................................................... If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed w~k will be done. Map No: ......................................... Lot .tgo: ....~..~. .......... Street and Number ......... ~~......'~.....'~. ................ ~...~..~ ................................................................. Municipality 2. State existing use and occupancy of premises and intended use end occupancy of proposed construction: o. Existing use and occupancy ........................... ~Z~'~ ............................................................................ b. Intended use and occupancy ............................. .'m..~.,.?:~...~.~ .......................................................................... 3, NaCure of work (check which applicable): New Building .................. Addition .................. Alteration .............. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost J~.~O00-- Fee (to be paid on filing this application) 5. If d~velling, number of dwelling units .............. /~ ............. Number of dwelling units on each floor ~"~./.fl..~.....Z...,2,~.~ If ggrage, 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 ............ 7~.:...~. ........ Rear ...... ~i ........ Dep}h ......,~/. .................. Height ........ ~ ................ Number of Stories ..... ~ ......................... 8. Dimensions of entire new construction: Front ............/ ....... 7. ........ Rear ........... .~.~...~ ..... Depth ....~../. ............... I~ Ii Height .......... '.~ ............... Number of Stories ............. /.Z/~ ............... 9. Size of lot: Front ........ /...~..~., ................ Rear ....... Z'.~,0. t./.J. ......... Depth .......... ./..~.~.,..~..~.. ........... 10. Dat,e of Purchase ........................................................ Name of Former Owner ..~¢~......~....~.c, .~.,~ 11. Zode or use district in which premises are situated ............................................................................... 12. Doe's proposed construction violate any zon ng ow, ordnance or ragu at onP , .. 13. Name oF Owner of premises ../;...~......~?.~.~ ................. Address .(.qN~./~;t..'m.¢.,~.~?.f,,.../v..~.... Phone No Name of Architect ...................................................... Address ............................................ Phone No ................. Name of Contractor .. e~ .... C£.S ..................... Address ¢~.~.~..,/~.....(,-~/~(~.$jV..¢.. Phone No....~..~...~..~ PLOT DIAGRAM L_ocatb clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions fn property lines. Give street and block numbers or description according to deed, and show street names and indic( whether interior or corner lot. STATE OF~ NE~ ~OR~,, COUNTY.OF .~~..) S.S. ................... .~..t~'..O..'C..~..~ ....... ..~.~..~../.~.;(..~.. ................................... being duly sworn, deposes and says that he is the applicc (Name aT'individual signing application) above named. He is the ............. ~t.1.~.1~....~....~.~,(. ............................................................................................................. , (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 applic'ption; that all statements contained in this application are true to the best of his knowledge and bell and that the work will be performed in the manndl~l~T~r Tor~6~ the application filed therewith. N'otary Public, State of New York Sworn to J:Jefore me this .../ ~ No. 52-0344963, Suffolk County + ;,-/~ /')// /~ ~ ~./~j_.~f.....z~rmssio~ F~pir~rch 30, ~.9~'~'~~ .t~-_ /ii'/ .............. /fi, ....... do,,' of .~. ............ Notary Public,, ~(~Z' ../'~-~'.~.~..'~ ' ~.: .fi...~ ~9~.ty~ ~~.~...~C ry. ..................... ~'"~'"g~Signoture~"~'~'~of applicant) ..................................