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HomeMy WebLinkAbout2021-z TOWN OF SOU BUILDING DF-PA TOWN CLF.RK'S SOUTHOL,D, rHOLD RTMENT OFFICF. I~EI~TIFII~AT£ rIF rIB~UPANP.¥ No..Z.. ?,~.6~... Date ... ~.'~t~t~....~ ..... 19~6. THIS CERTIFIES that the building located at . .~/..~...~..II.],.0.~..I.~.Q .E.~ .... S~reet conforms substantially to the Applicati, on for Building Permit herCtof, ore filed in this office dated ......... Ap~:%'l...~ ..... , 19.6.3. pursuant to which Buildirlg Permit No.202~.. g.. dated ......... 4~l~.:V][~l, .. ~. ...... 19~3., was issued, and conforms to all of the require- ments .of the .applicable provisions' of the law. The .o.ecupaney f.0r which this certificate is (owner, less, ce or tenant) of the aforesaid building. ,Suffolk County Department of Health Approval . Building Inspector FORM NO, 2 TOWN OF $OUTHOLD 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? 2o21, Z Date .................... Apl'.~.l,.... ~. .................. 19...6.,~. Permission is hereby granted to: 8tanXe~...Gr. eze.~k .................................................... .... :L3¥3 _ ]~. ~ek.:L.v-a. 4k~te ................................... ......... ~rook:k1~t..3 ~...]t..Y. ................................. to ....b~3A..new..an~..£an&.~-]r...dwe;L!~ .................................................................................. at premises located at .~.8...~J3].e.t..,].al3e..~x,t~t,J, ol3 ................................................................. ............................................... G~-eenpo~'.t ........................................................................................... pursuant to application dated .............................. ~.p,Fil.....~. .............. 1~,,~....., and approved by the Building inspector Fee $11~oOO..~l...cash FOI~i~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ....~./.~......,~.~...~t.~..~...e...~]~..~..~.~.O..~. ...... Street Map No....~ ........... Block No...~ ............ Lot No ......~.....0~.ft.~,,~P.O.~.t.~*.~.? ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......................................... ~.~.~Z.....~ ...... , 1~ .... pursuant to which Building Permit No...~.~.~.. dated ............................. &~Z~ ....... p......, 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 ...~.~...~.~ ...................... ~..~ ........................................... (owner, lessee or tena,nt) of the aforesaid building. H.D. Approval ~une 26~ 1963 by P. MaJ~oWski Building Inspector FO~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. Examined ................. [J .'~.....'~...~ ........ ~., ........ Approved J~ 19 ~....PermH No. ,~]]2-~) D~I Disapproved a/c .............. ~. ......................... ........................ APPLICATION FOR BUILDING PERMIT Date .................................................. 19 ...~..,/~1~-/ ~ ........ 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 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 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 o 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 alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ......... ......... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor electrician, plumber or builder. ........................ .............................................................................................................................................. Name of owner of premises ..~...~.f.4.~/L ~..~... If applicant is o 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 ~',wT~/$i~/,/z~ ................................................................................ ........ 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 .................. RemQval .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cast .......... .v~',..,~..Z,.O,...O,..~. ................................ Fee .~l,a..~.. ............................................................................... (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 ...... ../~...o....,,~...~...~ ............ 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 ~,o - o Rear ............................................................ Depth Z Z Height /4/~ o" Number of Stories 9. Size of lot: Front /0°~'~ /~'~ ° I' .............................. Rear ................................. Depth .............................. 10. Date of Purchase ............,~...~. .......... ~ ..'~'.~ ./..?.~.~ ............. Name of Former Owner ....~..~...7'...~¢,.....~..: ..... ~..o....~....~...; ........... 11. Zone or use district in which premises are situated~ "/~" 12. Does proposed construction violate any zoning ]aw, ordinance or regulation? ...... ..A/.....C~.. ............................................. 13. Name of Owner of premises ..5~/.~,?..~..?..~.~...~..~..z...~..~/..~... Address ('.'¢....~.~,.~.~..?..*..~...~.~..~'....~..~.~...t..~.~'~o;~No ~ 74'~,'~. Name of Architect ~ ~ Address .................................................................................................... Phone No ................... Name of Contractor Address .................................................................................................. Phone No .................. PLOT DIAGRAM Loca,te clearly and distinctly all buildings, whether existing or proposed, a'nd indicate all set-back dimensions from property lines. Giye street and block numbers or description according to deed, and show street names and indicate whether linterioc at corner lot. 227.7Z~ ^/ STATE OF NEW ~O, IRJ<, ,.,/} / ) o ~. COUhlTY OF~..) '~'~. .............................. .~......7'~..,~....~...L....~;..¥.........~,.'..,~...Z....~..~..:./..,~,,. ......... being duly sworn, deposes and soys that he is the applicant (Name of individual si'gning application) above named. He is the ~ ~ ~'/ ~/'~ , (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 file this application; that all statements contained in this application are true to the best of his knowledge end belief; and that the work will be performed in the manner set forth in the application filed therewith, Sworn to, ~me this . ~, . . ............... ...................... . ....................