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HomeMy WebLinkAbout2197-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. Z. 3~3 ..... Date ......... ,Tllly ....17 ........ , 19.. 70 THIS CERTIFIES that the building located at ... Kenny..Ro~tl ............ Street Map N .e~er~y~.o..od... Block No ........... Lot No.. 16 ........ ~ou~hold .... 1~,~.o. .... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ~.pt.. 27. , 19 6_~. pursuant to which Building Permit No. dated ......... Sept ..... 30. , 19.63., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .... pr.!v.a..t.e..o~.e..£~nll,,:, dw.e.!l~.ug .................................... The certificate is issued to ...Ch.arle$. ii~rkle~. ......... 0wnex, .................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval l~y..1~.~..~96~+...by. Ho. ~illa ....... ........ :!,..: .,(.. ?. ........ Building Inspector tfouse #$93~ FO~M NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS I~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No, 2197, Z Date .......................... j] ~])~t~TDe~...,~O... ] 9.~3.. Permission is hereby granted to: Ch~s,,..~.cke~.....A/fa..C~s..~ ................. .............. ~outh~ld .............................................. to · .Build.. ~e~.. ~n~..$~ly...d~e.lti~g .................................................................................... at premises located at ....~g~..~.~ ....... ~~ ........................................................................... ..................................... ~..Xe~y..~g.a~, ....... ~t~t...~..~. .............................................. pursuan~ to application dated ....................... ~...,~....~ ................. Jg~..., and approved by the Building Inspector Fee $..1.0. O0 .......... Building Inspector NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. TE~PORAR~ CERTIFICATE Of OCCUPANCY No...~1~31~. ............. Date .......................... ~ ..........6 ........... , 19.~.. THIS CERTIFIES that the building located at .~/~.....~.~..~...~.~..~..~ ................................ Street Map~l~.~.O...O..~.. ........ Block No ..... ~-,~X~, ....... Lot No..1~ ......... ~OUthO~.9...}~',.~, ................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................. .~.~t.e~b. er.....2~.., 19..~)3. pursuant to which Building Permit No ..... 2~,9~.~ dated .......................... i~.e~.t, emb~.......3.g t9.6~..., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ....... ..~....t..v..~.'f..e.....o.~.e.... ~.~.$ .!~.. ~.e..!.!~.~g. ......................................................................................... The certificate is issued to .,.~.~.~,.,~,,~e~, ............................. 0~;'t~. .................................... (owner, lessee or tenant) of the aforesaid building. H.D. approval ~a~ by R. Villa .................... Building Inspector S-9 TO ~J~OM IT MAY CONCERN: S~FFOLK CO~*ZO~RT~ O~H~L~H Date May 4. 1~$4, Building Permit No.. ..... 2197Z The sewage disposal facilities for a structure located at Lett 16 ef Kennwood Subdivision,, Kenny Read (Barkl~y) ' (Gi've-~J~ lOcation) ....... have been inspected by this Department and found to be satisfactory, District Engineer TOWN O,F SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLO, N. Y. Approved ........................................ , 19 ........ Permit No ................................. Disapproved a/c ~ ..................... (Building Inspecto¥) Application No...~.....1....?...~. ...... APPLICATION FOR BUILDING PERMIT Date .................... ~ ....... ..~.,-~.,, 19,.. -~..%~. ...... 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 end 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 demolition, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulatiges. (Signature of applicant, or name, if a corporation) ............... ........ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, e~ectrician, plumber or builder. Name of owner of premises ..................................................................................................................................................... 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 No: '~ Street and Number ~'~- ~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy ~,,(~,~7z;'~c~- ~'~-k~/~/~'~, . 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .~..~......%... Repair ................. ¢~ Removal ......~ ....... De~molition .................... Other Work (Describe) ........................ 4. Estimated Cost ..... ..~...~ ...... ~.~.4./.. .... Fee (to be paid on filing this application} S. If dwelling, number of dwelling units ......... /.. .................. Number of dwelling units on each floor ........ ~ .............. If garage, number of cars ................ ~..~....~-t~.,~(~ .... 6. Ilc 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. Dimensions of entire new construction: Front ......... ~ ....'~.~ ...... Rear .,~-~....~'~...,~.. ........... Depth ,.~...'~...~...¥..../~ ..... Height ..... ../,¥',,'~..~ ....... Number of Stories ............ ./.. ................... 9. Size of lot: Front ..... .7~..~..."..7~.. ............ Rear ...... ..7..~..~ ............. Depth ..,..Z...~...~.'~. .................. ]0. Dat~ of Purchase ..... ./..?..~..?. ........................................ Name of Former Owner .~'~./2z/~/~:.Z.....~.../.z.././.~.,'~:. .......... 11. Zone or use district in which premises are situated .......... .~,~....7(~.(¢Z..77.......~... ................................................ 12. Does proposed construction violate (my zoning law, ordinance or regulation? ............ ...~.~,.: ............................. 13. Name of Owner of premises ~.~..~..<C.~..'..~¢~..,(~'~.~ddress .~".~....~.~,.C....2:~......7~..~.i~./~/~e~#1~' i'.~.~.~.~..".'~. ..... Name of Architect ..... .~..~,.,~,.,...~E~'~ ........... Address ("~-_Z',,~'- '~ ' -~'~'~zT/~ , ,~1~' c_.-,', ~,~..~...¢,..,¢.,~...... ," Phone No .... Name of Contractor .~...~,..,~...,~...~...4~,..~....~.~.. ................. Address "',~$'~,~'~'-'~'~ ",~;~ ..... -'~-"~'~"/-~ ....... :..~-... ~. ~..~'.......'Z. ~.¢,~ ...... Phone ~'~o ............... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, 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 interior or corner lot. STATE OF NEW ~YO~,,I~, ../, ) S S COUNTY OF .,,,~,~.~.~,,~'~......) '' ...... ~'~....~...,.~.. ,~....../~..?.. ........................................ being duly sworn, deposes and says that he is the applicc (Nome of individual signing application) above named. He is the ..... ...~~ ................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and f this application; that all statements contained in t~is application are true to the best of his knowledge and bell, ~nd that ~h~ work w~ll' be performed i~ t~ a~9?~h,,, ~,,~ o, ~ ~0rkin the application filed therewith. ~worn to~o~me this ~ ,,.~.,~2s'~4~0~3, su~,o,k Cou.tv ~/ /) ~ ~ .1 ................. % ¢ ........... , No, rv (Sign., ,e of .pp"ca.,) .................