HomeMy WebLinkAbout1998-zFO~ NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
$OUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No. Z 175.8, Date
THIS CERTIFIES that the building located at .Qa~wQ. od,..D~i.~.e..,...~o~%t,h.Ql.¢] .......... Street
Map No. ** Block No. *~ Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.................................... ~.~.~.t.%..~ ............. , 1F9....3.... pursuant to which Building Permit No. ................ ~ 1998
dated .......................... ~[a~C3.%...9 ............ , 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 ........
The certificate is issued to Bernhardt 3~reoll, owner
(owner, lessee or
of the aforesaid building.
FOI~,I~I NO. 2
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)
N.o 1998 Z
Date ............. ~, ....... 9 ....................... 196.~'"
Permission is hereby granted to:
G.'~/. S~I th.. & .. ~.on~ .. ~.C...:B. ernh~.dt .. En~.:~:], ..........
........... ~o~tl-,o Icl .................................................
to ... ~u~;]~...-~e~.. OhS..£~.~ .~-¥...d~e~l~z~ ..................................................................................
at premises located at .l~l~O~d..~'~l/~. ............................................................................................
................................................... · eutb~l.d .........................................................................................
pursuant to applicotion doted ....................... I~F~JjI.....~, ...................... 19~..~.., ond opproved by the
Building Inspector
Fee $].Q,.O.Q ............
TOWN OF 50UTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Exam,ned ......... ....... ...... , ,9.?
Approved L L 19 ....... Permi~ No.
Disapproved a/c .......
APPLICATION FOR BUILDING PERMIT
Applicotion No ..... L~....?..,..~.. ........
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 lot and of buildings on premises, relationship to adioining 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 applica-
tion.
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 applica.nt. 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 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, alterations, or for removal or demolition, as herein described.
ordinances and regulations.
The applicant agrees to comply with all applicable laws,~~"~ ~
(Signetu o applicant, or name, if a corporation)
.............'- ^ - .....................
( ddress of app icant)
State whether aRplicant is owner, lessee, agent, architect, engineer, general contracto!, 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. Map No.: ............... '~. ............ -. ........... Lot No.: ...~ ........
Street and Number ...... ~...~~...]~i~.i~~.....~...?..~..,...'
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction.
a. Existing use and occupancy .................................... ..,. .....................................................................
-- /ti ·
b. Intended use and occupancy ..... ,~>,.. ,.1, ,~, ....,~C,... _~ .~-~..../.. ...... .~.
3, Nature of work (check which applicable): New ~uildin .............. Add,ition .................. Alteration ..................
Repair ............... z~..,Remova! .................. Demolition .................. Other Work (Describe) ..................
4. Est mated Cost 4...,~...?_..~..~ ................................ 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 occupa'ncy, 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 ....... .q~..'~..~'. ............ Depth .....~.....~ ................
Height .............................. Number of Stories
9. Size of lot: Front .....~...~..1~...'. ............ Rear ......... .~....~....~...'. ......... Depth ..... ./...~....~...../. ...........
10. Dote of Purchase ~.~.~ .6. ~ .... ~J~'m~._,~__ --*t'7'°f Former Owner '~/'-'-~.../'~ ............................................
11. Zone or use district in which premises are situated ..... /~...~....~...~...':~.....~'~..~..~./...~.'/'~
12. Does proposed construct on.., ~ ~~_v o.ate any zen nfl aw, arc inance or regu at on? ..... ~.......~. ..............................................
13. Nome of Owner of premises~..,~dress ~.~-~.~"~ '~ ..... Phone No.: ......... ...~....
Nome of Architect ..~ ................ ..,,~.? ......... ~ ........... Address ......... · ................. -(/~..: ........ ,~ ....... Phone No ...................
Name of Address ........
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, o'nd indicate oll set-bock dimensions from
property lines. Give street and block numbers or description according to deed, and show street names and indicate
whether interior or corner lot.
STATE OF NEW YORK, ) c c
COUNTY OF ............................ ) .... - ,
..... ............. '..' ........... oe,ng soys that he the ap 'cont
(Nome of individual sicir~ing application) '
above named. He is the ......... ~......~.........._...........~'....~~ ........................................
(Contractor, agent, c~rlSorote officer, etc.)
of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this
application; that oll statements contained in this application are true to the best of his knowledge and belief; and
that the work will be performed in the manner set forth in the application filed therewith.
......... .......... d~,oy of ...~......,.:........ltt0,;~
Notary Public.~ '.,~~~0~l~t'~' .~4..¥..
, . . (Signature of applicant)
~ Commission ~ires ~ar~h