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HomeMy WebLinkAbout2267-zFO~ NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE: OF OCCUPANCY THISI~CERTIFIES that the building located of .~Q~..~-~..~O~.,.(~..~]~.~.~.~ .................. Street Map No .......~.-...~.-.~.... Block No..,-~.-..,~,r.-~.~. Lot No ......... ~.~..-..-...-..-..?..-..? ..................................... conforms substontial¥ to the Application for Building Permit heretofore filed in this office dated dated ......... De¢~.z~}m~'...[3.~ ................... , 19...G~I., 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 ........ ........................................................... ............................................................................... The certificate is issued to ..... ~,~'.C~..~j~L~,.~ ........................................................................... (owner, lessee or tenant) of the aforesaid building. FOI~M NO. ~ 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) 2267 Z Permission is hereby granted to: F~ecl...Gc~don ....k,f.C .... ~d,,~a~.d..~tl~eehe~ ..... ............ Oveenf~*.t~ .............................................. to ... ~v.e~.l~.. ~ .. ~],~r...~ ..e~L~t~g...l~u13.~...~o...o~. $~..~vel1~ ..... ~t premises located at ....~r/,~..,..~.~..~Oa~.. ............................................................................ ~ ........ ..................................................... ,G~'~enp ~.~.~,., 3~, .Y.,~ ......................................................................... pursuant to opp{icotion doted ..... ~ ........................ .1;~.....~.~., 19..(~., and approved by the Building Inspector Fee $..~0,.00 .......... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam,ned Approved ........................................ , _19 ........ Per~ff ~o ................................. Disapproved a/c .............. .~:...:.5.~~. ......................... :, ............................ ~- ................. .................................. ~. ....... (Building I n~'~) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This opplication must be complete)y fil~ed 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 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 part for any purpose whatever until a Certificate of Occupancy shall hove 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 name, if a corporotion) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor Name of owner of premises .....~.¢.J~¢,.V.¢],.,....~,P. fL~.GhaS ........................................................................................................... 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,~ ............................ Lot No: ....... ~¢Z~ ..... Street and Number ....I?/.~ N.. o.r ~; 'i ..lj.o..~jd ~ ........ .G..~..e.,.~.~..p.©~?.'.t ................................................................................ Municipality 2. State existing use and occupancy of premises and intended use ond occupancy oF proposed construction: a. Existing use and occupancy vacant buil~J..~.g b. Intended use and occupancy ............. c~e...Z'.atlqJ.~M...d.1~%}Jdq~. ............. 3. NaCure of work (check which applicable): New Building .................. Addition .................. Alteration Rep, air .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Est(mated Cost ~' ' (to be paid on filing this application) 5. If dwelling, number of dwelling units ....QTLO. ................... 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 ....... !+.9....-.....LF ..... Rear ....J+.-~'..-.~ ............ Depth ....... ,~.~..mL.[- ........ Height ....,~..0.. .................. 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 ....:..Q.Q..~P~.[ ........... Rear ............................ Depth ....... ~,~.Q,....~[v[ .............. 10, Dare of Purchase ........................................................ Name of Former Owner ] ]. Zone or use district in wbich premises ore situoted ......................... ~..Y ............... ]2. Do~s proposed construction violote ony zoning law, ordinance or regulation? ......... ~0 ........... PLOT DIAGRAM Locat'e 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, whetber interior or corner lot. STATE OF NEW YO. RK, ) COUNTY OF ...,?,~,zLzloZ~ ........ ) S.S. ..................................... ~]~P.~]..~...¢,O.T'.¢.Q~ .............................. being duly sworn, deposes anc~ ,says that he is the applio (Name of individual signing application) abow," named. He is the .............(:.q:R.~.~:fi.O..~.O.~ ........... ~ (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 this appli6ation; that all statements contained in this application are true to the best of his knowledge and bel and that the work will be perform~r~,~[vn~l~,~l~t~e~,orfkorth in the application filed therewith. Sworn to Before me this..... ~.ll,,h E×p~rcs March 30, ].9/t'~ ¢[//~ " ~ ~ FORM NO. 6 TOWN OF SOUTHOLD Bu~ldlng Department Town Hall $outhold, N.Y. 11271 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. · 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercml bul d ngs, ndustma bud ngs, Multtple Remdences and s~mflar buddings and msta la- tions, a certificate of Code compliance from the Architect or Engineer respons b e for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming u~es, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C, Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling xx~3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date ... ~P.~,~..1.1.,..1,9.8~5 ......... New Building.............OIdorPre-existingBuilding ...~......... Vacant Land ............. Location of Property ...6.56.9.5. . .C.o.u.~.~j. ......,Read' 48~..G.~.e.eDpp.~.,. .~.e.~.. ~.o.~. ........ . .............. House No. Street Ham/et ltOMESTEAD ACRES .AT GREENPORT .I.N.C Owner or Owners of Property ........................... ,. .' .......................... 40 Block .2 Lot .6 .4 County Tax Map No. 1000 Section ................................. · .......... S bdi }IOMESTEAD ACRES AT GREENPORT Filed M p No L t N 6. .4. u vision ................................. a ........... o o.. · ......... Permit No.Z.2.2,6.7 ...... Date of Permit .......... Applicant .... ~;DM2¢g). ¢¢P.~;B¢~¢ ............... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval .. ....................... Planning Board Approval ...................... Request for Temporary Certificate ................ ..... Final Certificate .. ..............-.-...¢/z9°94 dated 2/2/65 Edward Speeches Fee Submitted $ .1...0.0. .... ~%qg .~o.p.y..o.f..Q..O...//~9094 dated 2/2/65) Construction on above described building and permit me~e~ appl~/al~/C~es a~d/~/egulations. _ .. ' /ABIG ~ 'AIL A. WICKHAM P, ppllcant ......... ~/~ -~. .................................... '" "V '"-: :~"~'"'" - ' ~"L;L/ -f!~i -- d: !i ' ~ CHARLES A. WOOD, R. A. PLAN NO. -- ~OF I SCALE: /~'= F '~' DATE i~/~% ^MITYWLL£, N.Y. RiWRHEAD, N. Y.