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HomeMy WebLinkAbout2146-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPAR. TMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...~..2.0(~t ........... ,~- J~ate .............................. 0.¢t~),be~.,,2,8,., 19,..6.br. THIS CERTIFIES that the building located at .:.~/~.!...0ak..~.t ........................................ Street Map No....~T',X ...........Block No ........ ~ ........ Lot No......N,~ ....... J~.~-t~,.'J;g.~...~,~.~e ............... conforms substantially to the Application for Building Permit heretofore filed in this office doted ...................................... Aria. US.t,.....8 ....... 19..63.. pursudnt to which Building Permit No..21.~.6..~ doted ................................. ~1~. ....... ~.~..., ] 9...6.]., 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.r~lAt~,t e...o~e...~.am~,3.~., c~we~ l.~ng;. ....................................................................................... The certificate is issued to ...~.s.,...Al~'~.e~..A~.ll~tOr~tB.~, ................... (~.. .................................. (owner, lessee or te~nt) of the aforesaid building. ....... i. 3.: :~. ;...... ~ ............... .%r.'v~../..~,,::-,.:~,~ .......................... Building Inspecto~x FO~M 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? 2146 Z rate ................. ~.~.~.~.._..~ ................ ~9....6.3. Permission is hereby granted to: )t~s ....~r.~ ..~r~. ~.~ ........................................ .~ax...~..~t ................................................... ................... ~attitue~ ....................................... to ....~u.~&d...a~..a~d.i.t Sen.. ~.. ~a~.. e~-~.stt~. · ~.~.t&i.n~ ................. : .................................... at premises located at ...'l~//~:....-O~..,~-.~ .................................................. t ......................................... .................... : ....................... ..~.at~i~.u~k ................ : ...................................... i ..................................... pursuant to application dated ................. ........... /),~lJ.,~ ....... ~ ............ 19.6~.., and approved by the Building Inspector Fee $....~,00 ........... Building Inspector Approved ........................................ , TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19,..'.,...Permit No. '~ j /"l (~ Application No. ~'~ I /~( k, APPLICATION FOR BUILDING PEP. MIT Dote ............................... ~l~J~l~..... 8..., 19~k,~ ........... 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 Permit. d. Upon approval of this application, the Building Inspector will issu~ 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 shah have been g~onted 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 co(~struction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to' comply with ali applicable laws, ordinances and regulations· ~ · ............................... (Signature of applicant, or name, if a corporation) (Address of a~pplicant) State whether applicant ~s 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 Na: Street and Number t ~at¢~t~ ~ :. ~ .... . , ¢, ~ I unic a 2. State exis!ing use an~l occupancy of premises and J ntended use and occupancy, of propos~'d construction: Exist ng use and occupancy Garage used as dwellinE b. Intende~d use'and occupancy ~DJtle ~l~h an additio..~ .~ 3. Nature of work (check which applicable): New Building .................. Addition ....;g..l~: ...... Alteration .............. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. ¢~Estimated Cost ....... ..~...~..~...~. ........................................ Fee ..... ~..~,00 .................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ....Ot~ .................. Number of dwelling units on each floor ........................ If gbrage, 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. Dirdenslons of entire new construction: Front ......... ./.~....,~-.'~'. ......... Rear ../.~..¢~-..~.. ............. Depth .¢~...~....~.. ........... Height ....../.~....'f'.Z~.. .......... Number of Stories...../.. .......................... ~9. Siz~ of lot: Front ...../~..~...,'~'...'./'. ............ Rear ....Z.~.(-2....,~F.~.. ......... Depth ..../.~?~;~...~"..~... .................. 10~ Date of Purchase ........................................................ Name of Former Owner ................................................... 11. Zone or use district in which premises are situated ........... ll.A.tt d.~,S.~,~ ............... : ............ 12. Does proposed construction violate any zoning law, ordinance or regulation? ......... I~O ..................................... ~'¢~3. Nam Owner of prem~se~.... .................................... Address .....,~'X.~c.;c'.~,,~.,V~¢~'., Phone No.'~4~..,~.-~'.~,.~. Nar~e of Architect ...................................................... Address ............................................ Phone No ................. Name of Contractor .................................................... Address Pho~e No ................. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-b~ck dimensions fr, property lines. Give street and block numbers or description according to deed, and show street and indic~ whether interior or corner lot. STATE OF'NEW YORK, ' ) S.S. COUNTY OF ...]~t~.~.O .~ ........ ) h~ is th~ applica~ ................... '-.~.....~.~;;~i ........ : .................................... being duly sworn, deposes a't~d says thc (Name of indigidual signing application) ' above named. He is the ........... ,a,~e~,...o~...o.!~l~ ........................................................... (Contractor, agent, corporate affiX:er,:~'~'i. ........................... of said owner or owners and is duly authorized to perform or have performed the said work, 'and td make and fi this applicqtion; that dl statements contained in this application are true to the bes~t of his' knowledg& and bell( and that the work will b'9 performed in the manner set forth in the application filed therewith.' '¢ I Sworn to b~fore me.this , ........ .,~ '~ ~' ~ / '1 ~ /./,/ ,~ \ I ,~....~...!. ~EN . ....-.. ......... ....... ; ~n,,isst~F..l~l~, so, 106~ ~',) / .~/k'~ ........... '~"*": ...... :....../~....L)..'~....~/.{. .......... .~...\ ........ :~......~L Notary Pub~lic, . ...... ~._..,~:!;.;~.~;~p.../~:.~,~/f,4;~v,~ounty ~3ignatur~ bt: applico~ ..... ~. .........