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HomeMy WebLinkAbout2590-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ....... ~...2127 ........ Date ................. i~l:'~}.'"}.'~ ................... , 19. THIS CERTIFIES that the building located at ~llt:'*V.t~"D:J'J.~llt~,'"JiiJ~l:,:J.~tl¢.~ ....... Street Map No T~JaI.t.t/~... Block No .... ~ ....... Lot No ...........,,~IQOI:~JiX .......................................... conforms substanhally to the Applicahon for Building Permit heretofore filed in this office dated .............................. Nfm'~al~ir...~.'/. ....... , 19.64.. pursuant to which Budding Permit No. dated .................. lJO~l,~e~...2.?. ......... , 19..64., 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 ........ ................................................. ONT" ~Eal~tly"~ell'tn~ .................................................................. The certificate is issued to ..~T~II~..~.,...,~I, leiC ................................................................................. (owner, lessee or ter~t) of the aforesmd building FORH 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? 2590 Z Date .............................. ~i;~l'~e~..... ~., 19..~. Permission is hereby granted to: ~eo~. ~enet~e.~en.. Ce~I~....Av~C..... J~hn Be~er ..................... ~.~he~..~ ................................... ............. ~ve~h~a~.....N~.~ ............................ t o -B~.~[...att..a~td~t ~Lott. ~t~,.a~.. ex~[.s ~.~, ... ~[~e~.~&. ,r~ ....................................................... ~t premises located at ..... ~/~l.--.~lt~lrt~-~..]~z,~ ...................................................................... .......................................................... ~..bt~.-t~aek ............................................................................. pursuant to application dated ................................ ~ltr~,~.....~/' 19....(~ and approved by the Building Inspector Fee $"~,'0~ ............ Building Inspector FOElV/ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ............ .,~..?....~.. ..... 19.(...~.. Approved ........................................ , 19 ........ Permit No. C>~ D,sap roved a/c .... .... [Building I nspec~)~) ._2 5~ c~ Application No ........................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giving a detailed description of layout of propertymust be drawn on the diagram which is part of this applicatio~ 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. Suc permit shall be kept on the premises available for inspection throughout the progress of the work. e No building shall be occupmd or used in whole or m part i~or any purpose whatever until a Certificate of Occupant shell have been granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Budding Permit pursuant to tt Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describec The apphcant agrees to comply w~th oil applicable laws, ordinances, budding code and regulations. ..~..~ s g..o.~....C..o..~.s...¢.~ .:....C...q .................................................... (S~gnature of apphc~nt, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buildc Contrac.t~r ............................................................................................ Name of owner of premises ...~.O~Jk..~...~.~le~ ............................................................................................................. if applicant ~s a corporate, signature of duly authonzed officer. (Name and t~tle of corporate officer) 1. Location of land on which proposed work will be done. Map No ..~..e.§.~...Y..t...e..~.. ..................... Lot No: ....~.. ........... Street and Number ....... ~.c~.....~.f:,~.~,..~.:;te.~..]~.:LMe,~ ..... .}~.t,::L.~c:]c ........................................................ Municipality ' 2. State ex~sting use and occupancy of premises and intended use and occupancy of proposed construction: o. Exishng use and occupancy ........... ~/e~]..'[.:L~g .................................................................................................. b Intended use and occupancy ................ ~,1. ........... .~.,./....~.~..~.~...q~ ................................................................... 3. Nature of work (check which applicable): New Building .................. Addition ....~'~ ...... Alteration ................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ..................................... 4. Estimated Cost ...... ~,~.Q. QQ. ......................................... Fee ......... ~.QQ. ..................................................................... (to be paid on filing this application) .5. If dwelhng, number of dwelling units .... DZIe ................. 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. D,mens~ons of existing structures, if any: Front ......... .~. ........... Re(~r ........ ..~8~ ............ Depth .....~,~. ................ Height ............................ Number of Stories .............................................................................................................. D,mens~ons 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 ....... QTJ. e ............... 9. S~ze of lot. Front ............................ Rear ............................ Depth ................................ 10 Dote of Purchase ........................................................ Name of Former Owner ...................................................... Il. Zone or use district in which premises are situated ..................... .']..~..t.=...~..J-..s..~.. ...................................................... 12 Does proposed construction violate any zoning law, ordinance or regulation? ............ :1~ ................................... 13. Name of Owner of premises .~..O~'9,....D.f~3.ft;t'. .......... Address ................... ,~.~.3i[13.C~... Phone No ................... Nome of Architect ...................................................... Address ............................................ Phone No ................... Name of Contractor ...~=sr'oz~..C~a~,z'. ................. Address ............ ~-].~b, ea.¢l, .......... Phone No ................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro, property lines. Give street and block numbers or description according to deed, and show street names and indical whether interior or corner lot. STATE OF NEW YORK, ~. S.S. COUNTY OF ....... ~u~,f ~lk ....... ...................... .C~z~s.ta~t.'t~e...;~[$~i~ ................................... being duly sw~rn, deposes and says that he is the applio · (Nome of individual s,gn,n~' opphcation) /~ ) above named. He',s the ......... .~.Q~I,(~.~!,~...Q.,.]~,~t.....Qr .... ' iC.l~....~..~ ..... ~.~.....~. ....... ¢~,~t_~ ....... (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and is duly authorized to perform or have performed the said work and to make and th~s apphcation, that all statements contained in this application ore true to the best of his knowledge and bel and that the work will be performed in the manner set forth in the application fi[ed therewith. Sworn to before me this .................. ..2.~... day of ......................... :...~..Q~.9...~%.12.e, zlg...~..Li:.. ~/'C_ , /. _.,/ ~- ~ /,,), t. , No,o .......