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HomeMy WebLinkAbout2255-zNO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...S~aa~ood..rtr~.ve.,...Southol.d ........... Street Seawood Map No ........... A~.~ Block No ..... .?..-..-...-..-..-...-.. Lot No ........ /.'~. ........................................................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. JJo.v. elllbe,T..19 .......................... , 19.~.. pursuant to which Building Permit No. datedN.QV~_~he~'...l~J .............................. , ] 96,~...., 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 ........ one family, dwelling. The certificate is issued to ............................... l%.~b.e.K.t...Z.~..~ltl ...................................................... (owner, lessee or tenter) of the aforesaid building. (No healt department approval) 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) 2255 Z Date .................. Permission is hereby granted to: ...... t[e'l~.e ~.~.. ~,S.e~. ea .......................................... .................... ;B~...V. ie~..Ave .............................. ............................... ..,..~m~or.~ ....................... to... ~13~1.{L .~.e.w...el~,e.. f. aai3~.,.. ~l.~el l~g ................................................................................... at premises located at .......... ~Ot.....~Tt ....... ~J~O(J..-~e~ .............................. ~ ......................... ......................................... ~/~.....8~3o~...Z:~,vev ......... ~o~1~ ............................................. pursuant to application dated ................................ ]~elttl~3~.....j,~ 19...~..~, crud approved by the Building Inspector Fee $... ~.O.e.O0. ........ Building Inspector, FOEM NO, I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c ..¢ ...................... '~::.~ ...........~ .......... Application No .......~ .~-~.....'~.. (Building Inspector) APPLIC~ATION FOR BUILDING PERMIT 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 o detailed description of layout of property must be drawn on the diagram which is port 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. (Signature of applicant, or nome, if o corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................. ~Wl%~ .................................................................................................................................................... Nome of owner of prem ses ],~.O.~P.~.~ ~i.eI'~q.i'l. .................................. 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: ...~.f!:&.l~.z.°...q.d.....J'.~.°..~..s. ......... Lot No: ......].'.~ .......... Street and Number ~ ./.,.<. ,~-Z.~f~.O.~..~.).L;k¥;~.~ ........... .O.~.~.q~ ..................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy V~oa'~% ].ShC~. b. Intended use and occupancy one ~'szniZT~ ~,~]_l$.n~ 3. Nature of work (check which applicable): New Building ...~:.f).t.~i~... Addition .................. Alteration .............. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ..........~.~..~.~..0...0._~../..~.~. ......................... Fee ...... .Ir...O. ........................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...P~, ......... ' ........... 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, Jf 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....°..~.e. ........................ 9. Size of lot: Front ...... [(~.0. .................. Rear ...... .]..(.)..0. ....... Depth ......~.~.C).. ............................ 10. Date of Purchase ......... ~.9~} ..................................... Name of Former Owner .................................................... 1 1. Zone or use district in which premises are s~tuated ..................... ~.....~.,.,,. ......................................................... 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? ............... ~..o. ............................ 13. Name of Owner of premises ..... .f?.~...~.Jr...e..z~.~.:!~. ........ Address .....~.~it! ................................ Phone No ............... Name of Architect ...................................................... Address ............................................ Phone No ................. Name of Contractor ~ldge t~or~.s Address f:~yVil ] e 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 indic, whether inter or or corner lot. STATE OF NEWr,~QJ~+4~.~, ) ......................... ~O~.~7~.~.~;L~...O,D, .......................................... being duly sworn, deposes and says that he is the applice (Name of individual signing application) above named. He is the ........ .O. IfDfl~' ................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owper or owners, and is duly authorized to ~erform or have performed the said work and to make and file this applicbtion; that all statements contained i~.~is,oppllcation are true to the best of his knowledge and belibf; and that the worktiwill be performe~i,p~?~t~j~,~'~(~'~fort h8°~ ss ~' ~-~' '' '''~ in the application filed therewith. J Sworn to b~efore me h's ~'pres ~alch 30, 19(~~' ~'~ t J ........................ ........ . ....... ............................ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. _/_~ .~. Examined ................. .~'..//.../.,. ' ........ , 19..~:.'.. / , Approved ....................... Disapproved a/c .................. :~._. ............... :- r.~':~;:-~.~ ............................................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ...................... Nov. erabe~. ....... 19..., 19.6.3 ........... 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, relotionship to odioining premises or public streets or areas, and giving o detailed description of layout of property must be drawn on the diagram which is port of this application c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this applicotion, 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 whotever until o Certificote of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance 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 or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ..Rober.t,..Z:Ler. an ............................................................... (Signature of applicant, or name, if o corporation) ......... ~a.~..V.i.e~..Ave .......... ~,ee..nper..t ........................... · (Address or oppdcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................. O~r~eZ~ .................................................................................................................................................... Name of owner of premises Robe~'.t,..Z~.e~,a.n ..................................................................................................................... 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: ...Se&~.oo£1...A(~['.e~ .......... Lot No: ....~i~. ........... Street and Number ..~/.I~....~e/~GDcl....])~J.¥'~I .......... S.OI~.:b~'t.G~.~ .......................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .....~.~t.~.¢n.~'~...],~l]. ............. b. Intended use and occupancy ....... o~e...£~'~t~,'L~z...~e~.*L$~l~ ............................................................................ 3. Nature of work (check which applicable): New Building ..:.....~ Addition .................. Alteration ............. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ............ '1-~.~00..~/~[ ....................... Fee ........ .1.0 ........................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... Ot~e .................. Number of dwelling units on each floor ....................... If garage, number of cars ......................................................................................................................................... 6. If I~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....Otle ....................... 9. Size of lot: Front ...... :~00 ................. Rear ....... '[00 .............. Depth ..... .~1.~0 ........................... 10. Date of Purchase ..........~'96,.~ .................................... Name of Former Owner .................................................... 1 1. Zone or use district in which premises are situated .................... Ii~;ll..~,e~ ........................................................ ]2. Does proposed construction violate any zoning law, ordinance or regulation? ............... ~. ............................. 13. Name of Owner of premises ...... ~..~.~1~.~,~'~ ....... Address ...... (~.~'1~ ............................... Phone No ................. Name of Architect ...................................................... Address ............................................ Phone No ................ Name of Contractor ...... ~.~,c~e..~o~te. II ................... Address ...... ~&~,~..'t.].e ................... Phone No ................. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions f~ property lines. Give street and block numbers or description according to deed, and show street names and indic, whether interior or corner lot. oooc[ STATE OF NEW_YQI~K,, ) COUNTY 'OF ..~:.~.~'~.°..&K. ......... ) S.S. ........................ [~o.~e~.~;~:[e~.8,1~ ........................................... being duly sworn, deposes and says that he is the applicc (Name of individual signing application) above named. He is the ....... O~e~. ................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners and is duly authorized to [~erform or have performed the said work and to make and f this application; that all statements contained ,i[~t~is application are true to the best of his knowledge and beli. and that the work w be performed ~l~,,[~l~tr~l~ry§~t forth in the application filed therewith. Sworn to before me this ~f;