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HomeMy WebLinkAbout2306-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..~/S-...-~*.?,h...~C~d ................................ Street Map No ..... .~ ..........Block No..~ .............. Lot No .....~ .........~e~l~.hO~] ............................ conforms substantially to the Application for Building Permit heretofore filed in this office doted ................................ ]~a'~(~.h .......... ~.0 ....... , 19..~+. pursuant to which Building Permit No. ~,j~{~6~ doted ........................... ~ .................. ~ ....... ~ 19.~..b¢.., 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.~&]F~..~[~e~.e~Ld .............................. 0~A,~, .............................. (owner, lessee or ten.a~). of the aforesaid building. ......... ~-'1~c~' ' .............. Building: Inspec[0r: ................... [" NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...Z],.833,~ .......... Date .................. ~..]~'....~..~.......~.8 , 19....~.... THIS CERTIFIES that the building located at ..J~.....JJiJF.~,h..JJ~iJ ................................Street Map No ..... ~ ...........Block No. ~ .............. Lot No .....~ .........~e~t~JlO~J ............................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................ J{~{l[~ .......... ~.0 ....... , 19..~. pursuant to which Building Permit No. ~30~... dated ........................... .~. ................. ..~. ....... , 19.~2J~.., 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 ........ · ..l~:l.v. at4~ .. eae.-~,~i.t~..d,~e.~.l.~ ............................................................. , ................................. The certificate is issued to ...... C~.I~&..I~&~I~OI.~. ............................. O~ffill~ .............................. (owner, lessee or tenetS,t) of the aforesaid building. ......... ~ ..~.~..,..~..k~.....,~... ~.~..~.'i:~.~,... Building Inspec[b,r FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N, Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 2306 Z Date ...................... ~a ....... 3.0 ............. , 19..~.. Permission is hereby gronted to: ...C3.mm...N~..e wea/.e:[~t ...................................... ........ 897~ ....... ~h4~h..St. ................................... ............. · J~ma'ta~"~'~'i'"--'N~'~ .......................... to ..... Ru~3.d.. an.. add Sti,,on...o~.. a~.. ex/,~m t,t,nR...dw~3.~l~ ..................................................... ot premises located at -.'lei~'~'"~"&"pt'"tS ......... {)ooda'3:e..&..¥o~ ........................................ ............................................. No.~,~,A..R-o~,~ ............... (ieeen~eet,.t, ....................................................... pursuant to application dated ............................. Ma~.Oh.....~.O .......... l~(~J~..., an~ approved by the Building Inspector Fee $...~'.,.00 ........... I ' ~ Buildin~ Inspe~-tor J Examined ..................... , 19 .~.. c/' TOWN OF sOUTHoLD BUILDING DEPARTMENT TOWN CLERK'~ OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19.....'.Permit No ................................. Disapproved a/c ............. Application No ............................. APPLICATION FOR BUILDING PERMIT Date {)/~ ~ .~, ,,0, ............ 19.E.,~.,. INSTRUCTIONS' 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 adjoining premises or public streets or areas, and giving a detailed description of layout of propertymust 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 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, os herein described. The applicant agrees to comply with all applicable laws, ordinan,c.~building~c~e and regulations. ....."-" ................ (S'g a ure of applicant, or name,~ corporation) ................. rn...n. .............. ............................ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.~,,) pram sas ....~....~.......~~~ ........... Name of owner of ~: ................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) whch,praposed work will be done Map No' ..~....~....~..~. ~ .... ~...~..... Lot No/.~...~...~:.Z../~ 1. Location of land on -- . . ..... .' ../.,.,,~,, ~ .................... Street and Number ./...~..~'~...~....~..~.~.t..~...~.,,~...~...~.. ......... ~., ....... , ................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...................................................... b. Intended use and occu~ancv . ~ (~ ~ ~/'/~q~'l ' ' ...................................... 3. Nature of work (check which applicable): New Building .................. Addition ~ Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost [ ¢~'~:~ ~ ~'- (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 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 .............../. ............ 9. Size of lot: Front .......~..~..r....~..?...... Rear ....... ..~....~..~..?.~. ..... Depth ............. .~..?~.,...~..... 10. Date of Purchase ...................................................... N me of Former Owner .~;.....:.~qc;..:. ......... ~ ............. 11. Zone or use district in which premises are situated ........................ ~ ..................................................................... 12. Does proposed construct on v o ate any zon ng aw, ord nonce or reau at on.;> ............ ~ .................................. Name of Owner of premises ~ ~ ?Address... :?.~-.~.~...~....... Phone No ..................... Nome of Architect ...................................................... Addre~ ............................................. Phone No ..................... Name of Contractor ~ ~1 .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back 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. cdp t STATE OF NE'~, ,~..)~.i/..,y~ '( COUNTY ...... s.s. ............................................... being duly sworn, deposes ond says that&e is the applicant (Name of individual s~ning 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 ore 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. Sworn to before me this ~ ............. of ..... ................. , A FOEH NO. 2 TOWN 0F 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. AUTHOR!ZED) No. 2306' z Permission is hereby granted to:' pursuant tO application dated ............................. ~Je,l~(3~,-...~,O .......... lC~.-,, an? approved by the Building Inspector ! BUilding I.spe~ToF FOEM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TO~VN CLERK'S OFFICE SOUTHOLD, N, Y. Application No ............................. APPLICATION FOR BUILDING PERMIT Date ..................... ............ , .... 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 propertymust 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 ~ 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 o 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, ordinon~s, buildin~e and regulations. ......... ................ (Signature of applicai~,t, or name, ~ corporation) ................. ........ ....................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises C~2x~,- %~.. Z~,~Zr...~ ....... 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: ..:~..~..~...~T..~...~' .~....~f...~..... Lot Street and Number Z~ ~ ~ ~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .. ~&~.~%~ ............................. sea n (k ~ ~ ~z ' b. ntended u nd occupa cy ...................... ; ~ ................................................... 3. Nature of work (check which applicable): New Building .................. Addition /""~- Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................................. 4. Est,mated Cost ..... L..~ ........................................ 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 occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front .......................... Rear .......................... Depth ........................ Height ............................ Number of Stories ........................................................................................................... Dimlensions of same structure with alterations or aad't'ons Front ................................ Rear ............................ Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimpnsions of entire new construction: Front ............ ~.. ............. Rear ............................ Depth .....~ .............. Height ....................... }w' Number of Stories ............................ 9. Size of lot: Front .......~L~..c....D..?...... Rear ....... ..~...~.C.~.Z ..... Depth ............. ...x~..,~.~....(,?... 10. Date of Purchase ...................../..~....~..~ ....................... Name of Former Owner .~,..../~.~ .................................... 11. ZenF or use district in which premises are situated ........................ ~ ................................................................. 12. Doe,s proposed construction violate any zoning law, ordinance or regulation? ............. ~). .............................. 13. Name of Owner of premises ................................ :./~;.~aaress ......... /...~/,.~ ........................... I~none mo ................. Name of Architect ...................................................... Address ............................................ Phone No ................. Name of Contractor .................................................... Address ............................................ Phone No ................. PLOT DIAGRAM Locat~j clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frc property lir)es. Give street and block numbers or description according to deed, and show street names and indict whether inferior or corner lat. iSTATE OF NEW. )~R~I..,,/~ ) ~ ~ COUNTY ...... ................ i~J'~'~'~"~"individual s~ning application) being duly sworn, deposes and says that~e is the above nam~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 fil this application; that all statements contained in this application are true to the best of his knowledge and belie and that th~ work will be performed in the manner set forth in the application filed therewith. Sworn to be~or~ me this ............. .... ................. A .. ........... Notary Public, ~t?~'~~" ....... <o~y ~ (Signature ~pplicant)~ / ', No, 52-024~963, SLfffolk Coumy / ~ ~ ', Comm~smon Expires ~4arch 30, Z~