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HomeMy WebLinkAbout2235-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at "~///(~'"'~[O~)J[~BO[I.'"[~ ............... : ............. Street ~ Peeon~c Bay O~s Map No ....................... Block No....~ ........... Lot No ........ ~ ............... ~e.~o~i~. .......................... " conforms substantially to the Application for Building Rermit heretofore filed in'/~his office dated~ doted ......................... ~.~9.~.~.....~....., 19..~.., was ifsued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy .(or which this certificate is issued is ........ (o~ner, lessee or of the aforesaid building. H.D. Approval ~y 18 196~ by R. V~lla 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) 2235 Z Permission is hereby granted to: ............... ~ ~'a~.~o;L~ ............................................. to ..... ~.~.;L.~...r~.v...~r~e.. J:amt ~...~w~:LLL~ ................................................................................. ot premises located at ..... ~...gt...~(tO~,;to..~a~r---O4~k& ................................................................ ......................................... ~o:b~.~zc~n..I~met ............ .~.eeo~¢ ......................................................... pursuant to application dated ............................. .QCt~,O.b~.....~. ..... 19...~., and approved by the Building Inspector Fee $...~LO, 00- ........ Building Inspector S-9 SCHD SUFFOLE COUntY DEPARTF~ OF HEALTH Dat~......May 18.,.1964 Building Permit No.... TO~HOM IT MAY CONCERN: The sewage disposal facilities for a structure located at Robinson Lane, Peconi9 (Gelling) (Give d~Jd location')' have been inspected by this Department and found to be satisfactory. District Engineer FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ......................................... 19 ........ Permit No ................................. Disapproved a/c ;.~~~ ................................. ................................. Application No ............................. APPLICATION FOR BUILDING PERMIT Date ........... ........ ........ 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 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 ali applicable laws, ordinances and regulations. (S~/~oture of applicant, or nome, if a corporation) .... ............. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ............. .~...: ................................................ ............................... If applicant is a corporate, signature of duly authorized officer. ..... (Name and title of corporate o~ icer~ 1. Location of land on which proposed work w~ll be done. Map N ~..~.<.C. . Lot No: ................ Street and Number ........ .~...~..~..~..,V.~..~.~.~.....~..~.~.. ........................................................................... ~wun~cipa~ity 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction: .. [xistin~ use ond occupancy ..... ~..~..~..~.~..~..~? ............................................................................... b, Intended use ond occuponcy ........................~/ ...................................................................................................... 3. Nature of work (check which applicable): New Building ~" Addition Alteration Repair .................... R~oval ................. ~ Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost .............. (.....,~...,( ....... .~. ........................ Fee ,"~ ~' (to be paid on filing this application) 5. If dwelling, number of dwelling units .............................. Number of dwelling units on each floor If g0rage, 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 ........................................ ' ~' " Z~.'~. '~" Depth ..... 8. Dimensions of entire new construction: Front ........ ~......'~.......~.. ...... Rear ......................... Height .,..../....~..'. ............... Number of Stories ........... ..~. .................... sof at Fro.t Rear /> .. 9. : ........... ~'Z',75~; ............ : ..................... ~epr~ ........................................ 10. Dote of Purchase ....~~, ~ ~ .... Nome of Former Owner ....?...~..~":.A..~..~..~..,~ 11. Zone or use district in which premises are s tuated ............................................................................................. 12. Does proposed construction violate any zoning ow, ord nonce or reaulation~ ~? © 13. ~ome ur uwner or premises .............................. : ........ ~,aaress ...... ,.,,...,.,....j ...................... k'hone No. .... ,.. ,,'FI ~j ~ Name of Architect ...................................................... Address ...... :?.:%~."~~ ......... Phone No. Name of ~,onrrac .................................................... Address ............................................ Phone No. 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 whether interior or corner lot. STATE OF, COUNTY 'OF .,...,...,~',,E: .......... ;..,,,) /' ................. : ............................................................................... being duly sworn, deposes and says that he is the (Name of individual sig~g above named. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d~l~r~u~h~d~d to perform or have performed the said work and to make and this application; that all stot~ff~;hfp~'~0~is application are true to the best of his knowledge and b~ and that the work will be perf~r~44~ma~,~ set forth in,the application filed therewith. ........................ ....... ........ ~ ~Z~.~c,'-'.,~[ ,,_,~ ~,M~C (:.,~' /, _...~ ........ ~ ........................................ ~.,~ ............ %,,..~ . No[ory Public,~C ............................. ~ ........................... s.~p ~. (Signature o[ applicant) ~ ~. ~li~nt)