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HomeMy WebLinkAbout2245-zFOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERKS O~FIC~ SOUTHOLD, N.Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .-~'.}t~.ee..~&~.~....~. ................................ Street M~Qr~ent By the [t~ No ........ ~ .......... Lot No. 3.7- .............. 0~.~.eP.~t.--...N,..'~% ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................................... No.~.em,ber.....~L2 19..63.. pursuant to which Building Permit No...22)~.%~., dated .......................... ]~O~'.~'~e~.....~., 19...~,,'~, 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 ........ .... ~.l~. ~ e...or~e.. £~lly... d~:L Zi~ ............................................................................................ The certificate is issued~ to .....~a.~.~e~..7,j~.~....~.~ ............................. ~,~.~ .................................... (owner, lessee or tenant) of the aforesaid building. H. D. Approva~ June FOF,~[ NO. ~ TOWN OF $OUTHOI.~ BUll. DING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERM|Y (]'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 22 15 Z 'Date .............. ~J~l~'.....]~. ................ , 19.~.~.. Permission is hereby granted to: Tor~ Nel, k-~,~.....A;/~ .. ~a,~t e~ · - ~..-~,.--~ ................. ................. O~r~t r ..N,.~, .................................. to ..Bui.~.d...new.. erie.. ~t~.-~tl~ ......................................................................... ~ .......... at premises located at ....~'j~..3~lr.....i~iel~..j~j~..~,h~..sL~v-~,-~.. ........................................... .................................................. ~ .e..e.....v..~ .~.e,r. ~..,[,e~ne., .............. .O~tent, ....................................... pursuant to application dated ............................ .~O'~JtJ:~elt.....~ .... 19..~3., and approved by the Building inspector Fee $.....~.O,.OJ~ ....... Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTME~ OF HEALTH Date June 5, 1 964 Building permit No. ,, TO ~fHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at Three Waters Lan% Orient by the Sea (Give deed lo0ati0n) have been inspected by this Department and found to be satisfactory. District Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, t4. Y. Approved ............................. i .......... , 19 ........ Permit No. ¢~-_1 z~/~" ,7___ Application No. ~ APPLICATION FOR BUILDING PERMIT Date .................................... ~ ................ , 19..~..~.. ...... I NSTRU CTI ONS 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 Jot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving e 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 prbgress 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 g~anted 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 oil applicable ~aws, ordinances and regulations. ........ ......................... (Sign.otur6/of applicant, or name, if a corporation) ..................................... ..~..~.."'Z..~ ........... ,.. :.,. _~..: ...................... (Address of applicant) State~,.~~ 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. Mop No: ............................................ Lot No: ~ Street and Number ........... c ............................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy ft 3. Nature of work (check which applicable): New Building ..... ~ ...... Addition ................ /. ,~lteration .............. Repair .................... Removal .................... Demo ition .................... Other Work (Describq) ....... 4. Estimated Cost .......(....~'...L..?...~....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 ......................................................................................................................................... 6. If gusiness, 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 ........................................ ~ ' ...... .~....~. ............... Depth ........................ 8. Dimensions of entire new construction: Front ................ ~. ............. Rear I Height ..... /. .................... Number of Stories .......~ ........................ 9. Size of lot: Front ........(...O...~...f ............. Rear ..... /.O...O....t. ........... Depth / '~' ~' I 10. Dote: of Purchase ........................................................ Nome ~f~Former~ Owner ..~...:. 11. Zone or use district in which premises are situated ...... ,¢fi~,~¢~...~. ........................................................................ J... 12. Does proposed construction,,.., ,.,,/,/'/2~vi°l~te ap~y zoning law, ordinance~,,,or regulation? ..... 13. Name of Owner of premises ~../r~..~.....~.....<'~..'.~....~...<'~.....Address .~.~.~..~'-~hone Name of Architect .........~...:......~/..~,~ ............................................ Phone No. Z~. . ............ Address ~) , ................ Name of Contractor ..... .~..~....Address .'.~..~ ........... Phone No.~..f~.~..-./...~. PLOT DIAGRAM Locate clearly and distinctly all 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 indic~ whether interior or corner lat. /~ ~ STATE OF, NE',~z, Y(~R,,I~,/~ ) S S COUNTY OF ~.._~: ........ ) ' · ............ .?...~...~ ........... ................................being duly sworn, deposes and says that he is the app]ica (Narr~Ja of individual signing application) above named. He is the ....~..~.G/J~:J~_T~.. ................................................................................................ (Contractor, ag~r, carp ..... of~r, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this applicgtion; that all statements contained in tk~is application are true to the best of his knowledge and belibf; and that the work will be performed in the manner set forth in the application filed therewith. / Sworn to before me this ......... ~...z~. ...... day of,,~, , /3 , ,'"~ .................. , 19/~.:~... ....... ~...~...........~..Z~~..'~T~... ......................... Notary ............... county TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ....................................... , 1 9 ........ Approved ........................................ , 19 ........ Permit No ................................. Disapproved a/c ............... .............. (Building Inspef~tor) 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 atJjoining 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 opprovo~ 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 rernoval or demolition, as herein described. The applicant agrees to comply with ~11 applicable laws, ordinances and regulations. ........ ...... ......................... (Signatur~of applicant, or name, if o corporation) ....................... ......... ................... (Address of applicant) State wb~ther appli,~ant, is owner, lessee, aCeht, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..........,,~~.~ ........f, ~,.~.~.. ......--a~.... ........................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) · lan on which ro osed work wdl be done Ma No Lot No / 1 Location of d ' P P ' · P : .................. z, ........................: .................... 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 ......~...~.~..!. .......................................................................................................... 3. Nature of work (check which applicable): New Building ~ Addition Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ....... 4. Estimated Cost ....... ./. . . .¢%. . !....~. ..¢. ,. .0. ................................. 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 natureand 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 ........................................ ~ ' ...... .~....~.. .............. Depth 8. Dimensions of entire new construction: Front ................ .~. ............. Rear ~ t Height ..... /...~.. ................ Number of Stories ......../. ........................ 9. Size of lot: Front ........./.?...O...!. ............ Rear ..... /..¢...¢...~ ........... Depth ..... ./.._'~.....~..../. .................... 10. Date of Purchase ........................................................ Nome of Former Owner ..~....: ......................... ]]. Zone or use district in which premises are situated ....... .~1~..~ ........ ]2. Does proposed construction violate or),y zoning law, ordinance or regulation? ..... ....~..c.~...,. 13. Nome of Owner of premises ...'~...*....~.~.'~..."~I¢~4'.....Address ..~.~.:..~:~.~-~hono No? Name of Arch tect '~ ' ~/~"' Address ......... '~' ........................ ~""'"7 .............................. : ...................... Phone No. Name of Contractor ...~..~.....~.'.~..~'...Address ......... ../~..~ ............... Phone No?..~..?..'..I...~.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or propgsed, and indicate all set-back dimensions fn property lines. Give street and block numbers or description acco/4~f¢ fo deed, and show street names and whether interior or corner lot. .....: . :::_.. -. : :- STATE OF; NEW//YCF~I%,¢ ) c ¢ -~-~z.¢ ~ /.~ ~ ~ ~/~ COUNTY OF ~ .......... ) ~'~' ~ .r'~ *.~ -~ ~ -i~ ......... ;E~..~~ ............................................... being duly sworn deposes and says that he is the ~pplica (N~me of individual signing application) I ~bove named. He s the ...~.~~ ........................................................................................................................ J... (Co ractor, ~~fice~,~w of said owner or owners, and is duly authorized to perform or have performed the said work and to make and this application; that all statements contained in this application are true to the best of his knowledge an i ~nd that the work will be performed in the manner set forth in the application filed therewith. Sworn to Bbfore me this ' ~ ........................ day of .............................................. 1 9.~.. - .......................................... ......................... Notary Public .: ........................................... County (Signature of applicant)