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HomeMy WebLinkAbout2325-zFO~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z..1989 ............. Date ............................... 0~.tD.'be~..;~., 10....~.br THiS CERTiFiES that the building located at ..~t,~...He,~.et~..~e .................................. Street Ba~ Haven @ Southold Map'tqo ....................... Block No ....................... Lot No. ]~8~.....~e~thot(~ ................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................................... ~JaEe~)Jl,,..,.fl~'....., )9..~br. pursuant to which Building Permit No...~.~..Z dated ........................... [iv~Z)(~}l. ....... ~.~'....., 19....6.~ 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 ........ '" 'Pr iv al;e" 'ome" ~'am.~ ~_y" d'~'¥1i'nE ............................................................................................. The certificate is issued to ....1/~..~.~.i[~.....~e.'l[.l~ ........................... 01~e~. ........................................ (owner, lessee or tena,nt) of the aforesaid building. Building Inspector FORM NO. 2 TOWN OF SouTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 2325 z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREM SES uNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date. ....... :.....i .......... ,.,..~.~11,.... ~..., .~:, Permission is hereby granted to: ..... :,..,1B~7.. ][w~ea....~, ........ ~ ........... :..: .................. : ........................ /tt~ho~td ........ -;~.....: ............... ,.. ..... .; ...... ~ ............................... ~ ................... ~....: .......... ;....,.: ....... :.: ............. ,.~,..:.....: ............ ~.;.....; ............... at premises located ot~..~ ....... ~,.~q/~.:~..B~[~ ................ : ............ ,; .................. : ...... ............ ; ...... : ........................ ~/~ .... ~aF..llaven..;I~ne ......................................... , ............................... ......................................................... ~c~thold.~...li~ ,, ........ ...., .......................... pur~uan! t~ application dated ..... ,..:~..: ....... Building Inspector Fee $:LO~ J~O. ........... 19~t~..., a'hd approved.by the Building: InSpe~:tor / s-9 SC~D SUFFOLK COUNTY DEPARTMENT OF HEALTH Date, ~'R~ ~ Building Permit No. TO WHOM IT NAY CONCERN: The sewage disposal facilities for a structure located at · / (Oive deed location) have been inspected by this Department and found to be satisfactory. TOWN OF SOUTHOLD -BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19 ........ Permit ~o ............................... APPMCATION FOR BUILDING ~ERMIT A 'icetion No INSTRUCTIONS e. This application must be completely filled in by typewriter or in ink ~:nd s_u. bmitted 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 o deteiled description of layout of property must be drown on the diagram which is part of this location. 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 o 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 port for any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of o 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 oil applicable lows, ordinances and regulations. (Signature of applicant, or name, if a corporation) ............... ......................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Build. er- Owner Name of owner of premises ....... ~[.~(.1...1..1. A~!'~-.~.q.1...1..s. ............................................................................................................ If appJicant 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: ....~...~:Y.....~-~a.:Me.~ .............. :.:~. C'(t No: ..... .~...8. .......... Street and Number ....... ~.a,~,.,!.~,,~,e.,~.,~,~:~,~,,.,~,,o.~,,,~,.h,__o,,]:,~. ...................................... : ............. ~i...]...' ........................ Municipality 2. State existing use and occupancy of premises and int&nd~d~use ~nd bcc~pency of proposed construction: Existing use and occupancy ..................................................................................................................................... Intended use and occupancy ......... 2~.~,ff~.lLe....ho;~e .......................................................................................... / 3. Not4re of work (check which applicable): New Building ....... ..~. .......... Addition .................... Alteration Repc~ir .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estir~ated asr ~l] ,~000.,00 Fee ~10,00 (to be paid on filing this application) 5. If dwelling, number of dwelling units ............ &. .................. Number of dwelling units on each floor.. ' 'L If g~rage, number of cars ............................................ 6. If ysiness, commercial or mixed occupancy, specify nature and extent of each type of use ..... 7. Dimlensions of existing structures, if any: Front ............................ Rear ............................ Depth Height ............................ Number of Stories ......................................................................................................... Dimensions of some structure with alterations or additions: Front ................................ Rear Dep,th .............................. Height .............................. Number of Stories ................................ i . . ........................... 59 26 & 22 8. Dirrtens~ons of entire new construction: Front 59 Rear ............................ Depth Height 12 Number of Stories 1 ~ .~2~5 ........... Rear ].2,5 Depth 9. Size of lot: Front ........................................................................ 10. Date of Purchase ............................................. Name of Former Owner Wllli&m 11. Zone or use district in which premises are situated ....... ' ~ ': NO 12, Does proposed construchon violate any zoning [aw, ordinance or regulation? ~,.~ William Wells A,4,4res, Bey Haven pko~ NO 13. Na,~e of Owner of pre,..l~es ................................................ = ......................................... Nar~e of Architect ........................................................ Address ............................................ Phone NO. William Wells ............................................ Phone NO. Name of Contractor .................................................... Address PLOT DIAGRAM Locate clearly and distinctly oil 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, whether iBterior or corner Jot. lO STATE OF NEW YORK. ) S S. COUNTYI OF ...~.g,~'..o..1.~ ........ ) ~ : , ~,'Wl. 1 t&~ Wel].8 ...................... ~e~ng ~ul~.s~orn! deposes and says that he is the oppl ............... }~'~"of i~dividuaJ signing application) above no~ed. He is the.. Owner- Builder (Contractor agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sa d work and to make and this application; that all statements conta ned Jn this application are true to the best of his knowledge and bel and that ;the work will be performed in the manner set forth in the application filed therewith. Sworn to 'before me this _~ ~ ~ ~¢ ~/~ b~c state ~ ~ noture of opphcant) ..... of .... .......................