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HomeMy WebLinkAbout2188-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE: OF OCCUPANCY No. '~'"'19~6 ............. Date ............................ .0e.t~o~e~.....~O., lC).~J+.. THIS CERTIFIES that the building located at ..E./J.J~...~.eWn...]~l~.~O~...~,~..~,. ................... Street Map No...~[, ............ Block No. ~ .............. Lot No. ~ ....... ~O~,~J~otl~l,t...~T~.~r. ..................... conforms substantially to the Application for Building Permit heretofore filed Jn this office dated ............................................ J~J}t/.....~.~.., 19../o.~. pursuant to which Building Permit No. dated ................................ J]~lp.~.....1.~J....., 19.(~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 ........ ........ ~ .i.v.a.t,e. · ~ne...~.am.i.l~:.. d.~e..~, .] ..t.~/[ ......................................................................................... The certificate is issued to ....t~:~]:~,~,t~...E.~...~!~pe~.; ...........; .......... ~(~t~,l~,.:~ .............................. [owner, lessee or tenant) of the aforesaid building. H.D. Approval ~an. 20 196~, 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) 2188 Z Date ................... 8ep.~embe~.....l~ ....... 1 Permission is hereby granted to: ~ecurt~.~..Ho~e~...~ne ....... ~.~.~ ....... ~.~.l. lt~..Leppe~t , ........... pg..-..~hez.e...I~ne .................................... ..................... ~ay~h~e .............................................. to ~]3u~..Z~].. ,~e~ .. erie..,~, a.~.~.;l:y,..cl ~e ;l,,~i~g ..................................................... ~...:. ........................ at premises located at .,.]]./.~,,....~.O~.1~l..~,'bo~..,~,~e ....................................................................... ........................................................ ~'o~h~Z'&*"' "]~*"~'o ................................................... '~"~'. .............. pursuant to application doted .................................. ~e-])~ ....... .~.~ ........ lC)..~..~., and ~pproy,,.e,~d by the Building Inspector ~.~ Fee $.....];.Oe.00 ....... Building Inspector TOWN OF SOUTHOLD PROPERTY RECORD CARD DWNER STREET / ~:~ C~).~ VILLAGE DIST, SUB. LOT ~ ~ S W TYPE'OF BUILDING ~S~/~- S~S. VL ,~ FAR~ CO~. CB. ~ISC. ~kt. Value ~ND IMP. TOTAL DATE REMARKS AGE BUILDING CONDITION ~. NORMAL BELOW ABOVE :AR~ Acre Value Per Vetue Acre i[[ob[e [Ioble 2 liable 3 oodland ~ampland FRONTAGE ON WATER ushlond FRONTAGE ON ROAD / ~ ~ ~ ~ //~ )~se Plot DEPTH /~ ~ ~ M. Bldg. Extension Extension Extension Porch Porch Breezewey Garage Patio Total tion Basement. Ext. Walls Fire Place Roof )truer Driveway Floors Interior Finish Ist Floor 2nd Floor BR. SCHD SUFFOLK COUNTY DEPARTmeNT OF HE~TH 196.4' Permit No. ........ TO WHOM IT MAY CONCERN: The sewage disposal facilities for a str~cture located at Town Harbor Lane, Southold - Leoo~.rt. . _ ~ (Give deed locatmon~ · -ha~e been. inspected ..by tlzkS D~parhaent and found to be satisfactory. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ^pproYed ........................................ , 19 ........ Permit No ...... Application No. ( B u i Id in~" j'r~sl~'~ctor)' APPLICATION FOR BUILDING PERMIT Date ........... .c2 ......... Z..: ...... /..¢~. .......... , 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 plon showing Iocotion of lot ond of buildings on premises, relationship to adjoining premises or public streets or oreos, ond giving a detoiled description of Ioyout of property must be drown on the diagrom 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 opproval of this application, the Building Inspector will issue a Building Permit to the opplic~nt. Such permit sholl be kept on the premises ovoilable for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in pa rt for ony purpose whatever until a Certificote of Occuponcy sholl have been granted by the Building Inspector. APPLICATION IS H.EREB¥ MA;DE 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, alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. · -~ z.=cc//e/'~Z Z:/.o,'-'/z--,.s', //vc (Signature of applicant, or name, if (~ corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. N~e o~ owner of premises ................................................. if applicant, is a. corporate, signature of duly authorized officer. (Nome ~itle ~corp~r~ officer) 1.Location of land on which proposed work will be dane. Mop No.:~.~R.~.~.~..~. Lot No.: ...................... Street and Number ~(~ ~fZ.~¢~d.C ~.~ ~).c~o/~ ........ z ...................................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy ............ ~.~.~ .................................................................................................. z b. Intended use and occupancy .. ~ ~ .. ~: ~.~. 3. NatUre of work (check which applicable): New Building ....... ~ ...... Addition .................. Alteration Repair .................. Re.~pva! .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost ........... .x~..~?~,..~..~.~. ............................ Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ............~..~?..¢_.. .......... Number of dwelling units on each floor '~- If garage, number of cars ......... ~ ..~..~Z..P......(;~..~'..~'. ...... 6. f bus~ness, commercia or mixed occupa,ncy, specify nature ~nd 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. Dimensions of entire new construction: Front ..... ."~..~..~..~...:~ ...... Rear ....,~..~...':-...O....(: ........ Depth .~...~..~ ~" Height ....... ./~..~ .............. Number of Stories ...... [..~ ................. 9. Size~of lot: Front ./......~.. .................. Rear ..... /..~.~ ................... Depth ...[..,~...~..-. ............... 10. Date of Purchase ....... .,~..~./~..~..: ............. ./.P.~.~.. ....... Na,m~ of Former Owner './Z~'.~.~.2.~.~......~.,....../~..¢~.~.. 11. Zone or use district in which premises are situated ..... Z'~?..%"..~Z.~..¢.~.'~..Y..~../ ....... 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... ~..O. ...... Phone Na~e of Architect .................................................... Address /~-,',.~hof'~ Phone No, PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-back dimensions property lines· Give street and block numbers or description .according to deed, and show street names and whether interior or corner lot. STATE OF. NEV~ ~/OP~l~f ,~ ) ~ ~ COUNTY ~ .~...)~'~' (Name of ~dividua~ srgning application) named. He is the ............... ~.~~ above (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 application; that ali statements contained in this application are true to the best of his knowledge and belief; that the work will be performed in the manner set forth in the~tion Sworn to ~ me this of Notary Pu~)lic of New York of ap~c Nu. 52-0344963, Suffolk County ~ ~omm~ssmn Expires l~arch 30, ~.9 ~' FOEM NO. 1 TOWN OF $O~TSOLD gG~LD~NG [~PARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam,ned ..... L::?....!..( ......... , Approved ........................................ 19 ........ Permit No. .~/..u~. ~.~.... .... Disapproved a/c ........................................................................................... ~...~..--~ (Building hYspector) Application No. "c~'J"'(';'~ .... APPLICATION FOR BUILDING PERMIT Date .......... ..~)....?.~o..~ .~.. ....... /..~.....~. ...... iNSTRUCTiONS o. 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 applica- tion. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon a.pproval of this application, the Building Inspector will issue o Building Permit to the applic<~,nt. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shah be occupied or used Jn 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 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 o¢ 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 builder. ........................................... . .................................................................... Name of owner of premises .......... ~,~.(~/-~.¢:t.~. ........................................................................ If applican, t is a corporate, signature of duly authorized officer. ./....,... (Name a~d title of c~r~rate officfr) ~/~ ~ ~'~ 1. Location of land on which proposed work will be done. Map No;~<~.~.f...~..~.. Lot No.: ...................... Street and Number '~ Z~Z~~ ~ ~f~oZ~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy ........... Z~'.~./.?..~. ................................................................................................... b. Intended use and occupancy .......... Z......~. ~.~'~ .,:.~.....~Z~. ~ .~<. ~.~ .................................................. 3. Nature of work (check which applicable): New Building ....... ~ ....... Addition .................. Alteration ............ Repair ................. pmoval ..................Demolition .................. Other Work (Describe) .................. 4. Estimated Cost ........,,d'.~,~..~..~d..~... ............................... Fee .................................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units .....~..../FF....~~. ............... Number of dwelling units on each floor ....~. If gd~rage, number of cars ..........Z'-.f~e..~......l~.cr..~'.. ................................................................................................. 6. If bOsiness, commercial or mixed occupancy, specify nature a:nd 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, Dimensions of entire new construction: Front _..~..~. ...................Rear ....~..~..~..~.. ........... Depth ........... F. ............ Height ......... ./..~.. ............... Namber of Stories ..... ./..~, ................... 9. Size:of lot: Front ..... ./......~. .............. Rear ...../.~,?..O.. ................. Depth ...../...~....~. .............. 10. Date of Purchase ....... .~...~/~...~. ............. Z'..~..~.~ ......... Name of Former Owner '~,c~.~.4:....Z~.,....~.47..~'~,~¢ ..... 1 1. Zone ar use district in which premises are situated ..... z~..~.~.~..L..d..~.~....~.Z.~..L. ................................................. 12. Does proposed construction violate any zoning ]aw, ordinance or regulation? ....z~,.O. ..................... 13. Nome of OWner of prem se~4/.-"Z~.~.. .............. ~//,~.. Address .................... ..~.. Name of Architect ......... ........... ~ ................................................ Phone No.>22, ~.~.~. Na~e of Contracto~..~..cL.~/.~'.x'..'.~,~,...~.c~.4-z.z~-~fp~z-~.¢ Address,,~-.~...,~'..¢?.C~......~....O.~ .......... Phone No. ~..~.../. -~- PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or propo~ed, and indicate all set-back dimensions fr property lines. Give street and block numbers or description according to deed, and show street names and indic whether ifiterior br 'corner lot. W STATE OF NEW,/YO,Ry,~,~ ) COUNTY O.F .z~.~......) S.S. ........... . ..~.~...~.....,..o~. ,.~"~ '~~ .............................. being duly sworn, deposes and says that he is the applica (Name of mdividua! s~gning application) ' above 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 application; that all statements contained in this application are true to the best of his knowledge and belief; ar that the work will be performed in the manner set forth in the appli~/d}ion filed therewith. Sworn to be_for~ me this ,// "~ ..... Notary I .. t~e..~-0344963, Suffolk Coun~ ,~lm~'t~lOr~ Expires March 30, 0 4/ 2S L~ " L) ,4 ROAD ~? ~-- C T / O /"/ ,? F © U fU D A T / O I'I P l l i'~ ii/~ ' .pa - ? ,¥ :~Ec2U~ITy HOI'"'ip'S, :I 1I-5 4/ --I ___ .,,LINE OF pOOF ,: / ,,,, u , o~ ~q~CUR~ITY I/'40 'I /¥ EL VAT Oh/, ~LEVATIOt, I feZ'SIDEr,Ic£ FOe? g t'E4= ER/EPA O. /£PPERT ~' _FL -I'q O"l- £ - .~r L ,ff- V A LA ~ L V, IEST ,S/DE L I ¥ F-- LOAI): TOTAL LO/ND PE-~- T~-L~$$ -- Co~p~.~r..s~o~: I'~,~ ~T~Ss = ].~" x l, ooo~' ' ~, g,q o ~/~ ~Se-~- F F T _uss 54- '2..4 7 &4 SrL,l