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HomeMy WebLinkAbout2203-z FOPoM NO. 4 TOWN OF SOUTH~OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, .~1. y. C~'RTIF'ICATE OF OCCUPANCY THIS CERTIFIES that the building located at '"'E'/8"-'-P:~n~wcyod'"Read: ...................... Street Map No.....ll,,I.<40~ ...... Block No .......... ~ ..... Lot No....~ ............ ~%%.~,¢~o~.U~:t...~ .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......................................... O~'t~O~'""3" 19"6]}' pursuant to which Building Permit No. "~'~0.~ .... dated ................................. O~o~e~'"~', 19'-63' was issued, end conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ................... ~ivat'e"'on~" ~am±iy"dw~, it~g ................................................................... The certificate is issued to '"~e~'"'}~'tl~l~C]'"l~l~ ........... i .............. .~)~l~k~' ............................. towner, lessee or ~enar~T) of the aforesaid building. H.D.Approval Mareh 26, 196~ ............... ...... .......... Build ng Inspector FOI~[ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS ~ERMIT.MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2203. z Date .................. Oet~ebe~.....3 ................ 19...63. Permission is hereby granted to: ......... Aq~begt~e ................................................. to l~u~Id...z~e.w...one.. £.amtl~... clwe~L ling. ..................................................................... ................. at premises located at '-"~//~""'PJ,'~e'-'~od-"~,~ ........................................................................... ....................................... · Fl~e.~s.'..Neek.~...~.ut ehog~e ................................ : ................................... pursuant to application dated ................................... 0c~t~o.l~e~.....~......19...6L~., and appi:oved by the Building Inspector Fee $..]LO, O.O .......... SCHD SUFFOLK COUt,~Y D£P~.kTI~LNT OF HEALTH Date 3/26/62 Building Permit No. 2203Z TO ~OMIT~Y OO¥~CERN: The sewage disposal facilities for a structure located at Pinewood Rd~ Floets Neck~ Cutchogue '~'(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. Examined ..................... ./', ,Q~/~, ~.~..,.;., Approved ............................... ~, 19...~...?Permit No ..... ..'~-....~....~....~......~... Disapproved a/c ............................................................................................ (Building ~4spector) 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 of lot and of buildings on p remises, relationship to adioining 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 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, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ........... ? ...... ............................................. (At'dress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If ~can, isa corpora~t~/?gnatu2 of duly authorized officer. (Name and title of corporate office ) - , ~ 1. Location of land on which proposed work will be done. Map No: ~..~..~...H~.~.~.~:~....~.~...' Lot No: .................... ' ' .~ ....... ~C~ ,~ .... Street and Number ~.)...~.~..~.e..gL.~. ....... ~ ~. ~ ....... ~?...~ ....................................................... Municipality 2. State existing use and occupancy of premises a~d intended use and occupancy of proposed construction: o. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy .... ~ ...... b ~ ::~_~ ..................................................... 3. Nature of work (check which applicable): New Building ~'~ Addition Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ................... /..i~:....~....~....c?. ................... 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 ......................................................................................................................................... 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. Dimensions of entire new construction: Front ..............~....~. ............ Rear ......... ../~....?. ........... Depth ....... ~../.........~.... Height ............................ Number of Stories ....... ~ .......... 9. Size of lot: Front ............... ~...~...0....'.... Rear ....L~ .............. Depth ...... ../...?..?.Z../..'.~..,.G. .......... 10, Date of Purchase J..~. ~ .,~. NQme of Former Owner .... !..:.,.~ ........... II. Zone or use district in which premises are situated ........ ~ ................................................................ ....,............ 12. Does proposed construction ~,lo, te~,,~any zoning law, ordinance ~ .............. .~....~. ......................... 13. NN~mmm~ ~ff ,~Wrcnj~irt;~t premises .~.~....~.?.../~J'~.~ AAdd~.i~i~.~.~(D~,.. pp~ NN~ ................. Name of Controcto;".~.~i~.~Zii~iii~.'~.".'.~.iiilAddress iiii~.'.'.';~.'~i~i~i)[ii[iiiii[i Phone No[ [[i[iiiii[[[iii[ PLOT DIAGRA,M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions er( 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,...¥,OR~ ~, ) ,, ,. COUNTY ~ ...~-~.....c:.~..l.~.-~..'x.....) 3')' ......................................... ........................................ g duly swo n, deposes and says that he is the applicc/' (~,a~e of individual signing a~lication) ' -'-'" ' t' above nameo, me ~s ne ...... ,~.~ ......... ~ ............................................................................................................................. (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 applicbtion; that all statements containe,~ in this application are true to the best of his knowledge and bell, and that the work will be performed in~,~ ~,~J~.~..sLtf~.~6rth n the application filed therewith. Sworn to before me th s /) ~0 ~ Oc~4 ...... .............. ............. z/_ / pub,c, .................... Notary TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......................... .,,~..O~.....~..., 19...~...~r% Approved ......................... .,~'...~.~....'~...., 19..~.,-?.Permit No....~?~....,~....8.....,~. ........ Disapproved o/c ........... ~~ .......................................................... ~ Application No. ~9 o ~ 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 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 bo 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 gconted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment 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, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ....... .............................................. :S~gn.ature or apphcont, or name, ~f a corporahon) ~" - -(~ (A~dresSOf State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . ~!.: ......... ~.~.': ...... ~c~..,: .: ......................................................... If applicant is a corporate, signature of duly authorized officer. .......... ~ ...................... ': ..................................... (7 '~ ................ : (Name add tit[e of corporate officer) 1. Location of land on which proposed work will be done. Map No: .~,.-: ................................... Lot No ..................... Street and Number ...r .......................................................................... 0 .......................................................... MunicipalIty 2. Sto~e eXiS¢jog ~Se nod occupoocy of premiSeS nod io}e~ded ose nod occupancy of proposed consPruoPioo~ a. Existing use and occupancy ................................................................................................................................... .Co / A b, Intended use and occupancy ..... ~ ........... ., .............. ~;:~,~ .............. ...~. .................................................... 3. Nature of work (check which applicable): New Building ._.~ ....... Addition .................. AIterati'on ............. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ................... ./..***.%.,..~..6.o...¢~ ................... 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:zM.~.. ......................................................................................................... 6. If ~usiness, 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 ....... ~ ......... ............................. ...... ....... 12. Does proposed construction v~/~late~:~ny zonin~g law, ordinance %~.e,.~ ............. ~,~./.....~). ........................ Name of Contractor ~ ~4~ ,- ~Z'c0 ,, d.~fl.~.. Address ~×/',~.'~ ~-~.---' Phone No PLOT DIAGRAM Locate dearly and distinctly ail buildings, whether existing or proposed, and indicate oil 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~ORI~:~ t ) SS ( o~e of individual signin~ above nam'ed. 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 f this application; that all statements contained~l~J~hi~. ~l~:~cation are true to the best of his knowledge and bell, and that the work will be performed in t~]~rS~of~y~the application f ed therew th. Sworn to before me this ~ ('o,, ¥~;j ~ Y -- .............. ~ o, .............. ................ , ,o,.,y ~....~, .......................... ~.~,...~, ...... ~o,.,~ .,~_,:. ,~i,.~,,~~.' ..............