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HomeMy WebLinkAbout2476-zFOg~ NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...~4~'.t,h...J~O~l.j...~i~Ol~.~g ..................... Street conforms substantially to the Application for Building Permit heretofore filed in this office dated dated ....&0,9'1~1i;..$ ................................. , 1964..., 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 ........ .................. / ................... nen~con~o~tm~n~..~us&nes~..bu3.~d&n~ .............................................. The certi,ficote is issued to ...................... ~.~Et.~..~ .................................................................... (owner, lessee or tenant) of the aforesaid building. FOI~M NO. ~ 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) 2476/ Z Permission is hereby granted to: ~e.~.~..~..~.~ ...................................................... Southold at premises located at ....S/~..~O~'.~..~OI~ ........................................................................................ ............. ~ .................................... La. ~..o.~,t.q .t......~.'..~ :. .............................................................................. i~ursuant to application doted ................................. ~.~g.~,~.~.....~. ...... 1 .9~......., and approved by the Building Inspector Fee $~.,~0~. ............. Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c ................... ~.~..~*~. ~ ... · ~..~.-~:: ................... zz=~.*~..~- (Building I nspec/j~r) Application N ..... ..~.. Z .............. APPLICATION FOR BUILDING PERMIT 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 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 or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. (Signature of applicant, or name, if a corporation) ............. ~..a ~.~h~. ~o~, d.~..... ~ o.u~holcl ................................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................................... o.~.....-...~tui.ld~ ......................................................................................................................... Name of owner of premises ...... ~e.~,~l.'~...t'I~.ss .................................................................................................................... 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 .¢~j'~.....~m.f,~...z(~.O&Ct, ........................ ~.e~,o~.~ ......................................................................... Mu?icipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~.,.(~.~...~.~J~e.8~..]~.~.~'lCjJ~§ ......................................................................... b. Intended use and occupancy .......... ~.l~......~/:L.f,~..l~l,~b~,J,~)zi. ........................................................................ 3. Nature of work (check which applicable): New Buildlhg .................. Addition ...... :~1t,.7,~.. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated CostS_BO.Q. ............................................... Fee ....... ~.,..0..0.. ......................................................................... (to be paid on filing this' appl,ication) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If g,arage, number of cars ........................................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .,.b...~.~.~.~...e..s.~ ........... 7. Dimensions of existing structures, if any: Front ..~.~. ..................Rear ...... ~0 ............... Depth ...3..0. .................... Height ............................ Number of Stories ...... o~e .................................................................................................. Dimensions of some structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ....... 1~ ................. Rear ........ ],~ ............... Depth ........ 3..0. ............... Height ............................ Number of Stories ....... Q~I .............. 9. Size of lot: Front ........... ~.,0. ............ Rear ............... ~,,0. ........ Depth .......C)0 10. Date of Purchase .............. ~LC~.2 ................................ Name of Former Owner ..~...~..~..~...e....~..~. ................................ 11. Zone or use district in which premises are ated .............. ~.....~t,:Ls~ .................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ...................... D,~ ........................... 13. Name of Owner of premises .~e~'tl~Lt,...~.~,~. ............ Address ............. ~.~.~.f)~L.¢l, ............ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ...,8.~P,~ ....................................... 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. (~*0 STATE OF NEW YORK ) COUNTY OF ...... I~.~.~..0,~ ......... ~ S.S. .................................. ]~l~t~..~S .................................... being duly sworn, deposes and ~ays that he is the applicant (Name of individual signing application) above named. He is the ........... O.~f~'....-....]).l,l.::l,~,~.e,~. .......................................................................................................... (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 and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworntobeforemethis · ,..~ ~ ~ ................... ,.~.... day,of ................. ,~t,1~1.~,~ ............ , 19.~.~.. ~ /'~// ,,~ , . .... ............................. .................................... Notary Public, ..~f~rt~-~~.. County ~c~/~, ~f~ (Signature of applicant) ~ '.,", '.~';" ,~, ~.~, ,,~ dow rk Examined ..................... , 19 ........ ,, ,, ...Z 7 Approved ........................................ , ]0 ........ Permit No ................................. l~Oll3J NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT ~ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved o/c .................... - ..................... _ ..... ................ _ ................................ ~~ctor) ............................. APPLICATION FOR BUILDING PERMIT l z'eb aO ]9 63 Date .. ....................................................... , ................ 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 oremises, 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 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 shal be kept on the premises available for 4nspecti on 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 a Iterations, or for removal o.r demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances_and regulations. (Signature df applicant; or name, if a corporation) (Address ~f applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, :electrician, plumber or builder. Name of owner of premises .~..?.~ JJ~Jl8 ' ~ i·~ x If applicant is a corporate, signature of duly authorized officer. (Name and title of corPo~bte officer) ;~ 1. Location of land on which propose8 work will be done· Map No: ' ' ' L~t No:? ...... Street and .................................................................................................... ~ ............................................ Municipalt~ 2. State existing use and ~cupgncy.of premises and intended use ahd ~c~m~.~pr~os~ COnstruction: a. ~isting u~ and ~cupancy ~[ [~ ' . b. Inten~d u~ and ~cupancy ............. ~' ;"~'" ....................................... 3. Nature of work (check which applicable,: New Building ......2r,,,~C.. Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ' 4. Estimated Cost .........~'.~.~'.9..0..~./~ .............................. Fee ....Z'.e~4~.~L.....~;...~.,.C).0. ................................................. (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, speci fy nature and extent of each type of use ....... ~.~,~.~TL~.~,~ ...... 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 ........ 3.~ ................... Rear ........ ,~.C~ ............... Depth ........ ,~.br. ............... Height ...... ~ ............. ~ ....... Number of Stories......O.~.e. ..................... 9. Size of lot: Front ........ .].02 ................ Rear .......... .1.00 ........... Depth ....... ~.0. ............................ 10. Date of Purchase ........................................................ Nome of Former Owner ...... ..W..;...~..~.o.~l~.Q.~ ....................... ] ]. Zone or use district in which premises are s~tuated' ........... t~......~,~j.~f~,,~.S. ................... ~ ......... .................... 12. Does proposed construction violate a:ny zoning law, ordinance or regulation? ....... D,Q .......................................... ]3. Name of Owner of premises ....... ..~.;...~..~..~...S. .................. Address ............ g~'.~.~.Q~.tR. .......... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .................................................... 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. STATE OF NEW YORK, ) COUNTY OF ...~,.u.~...~.6.'.~ ........ ) S.S. ................................ -'T~T-e'I~.12JL..I-~,~,~ ..................................... being duly sworn, deposes and says that he is the applicant (Nome of individual signing application) above named. He is the ......... .0...N~....~'. .................................................................................................................................... (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.ira, tbS;application are true to the best of his knowledge and belief; and that the work will be performed ~.afl~.~z'cxe~j~r~suat~f6~h in the application f ed therewith. Sworn to before me this ' &mi~i~aioa'~-~,~l~ira~'lS~r%l~ ~n~ygG.f"/~ ,~/// / ~ /~ ................. ............... ............ Notary Pub, c, ...~..~.~.~-~.:..~~,~ (Signature of applicant, ......... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. of Application No......~.~.~. ............... Approved · 19 ........ Permit No ......~(~ ............... Disapproved a/c ..................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be complet,ely'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 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, ordinances, building code 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. 0~mer - builde~ .. . Name of owner of premises ........ ~g]~g,~..~ld~lt .................................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Nome ond title of corporate officer) 1. Location of land on which proposed work will be done. Mop No: ......... ~ ............... i.... Lot 'No: ...,lgl~l;~ .... Street and Number ..... ~.....~.~..~ad~.....~l/~o~d ................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... .¥.1~.~.1~1~...~1~ ................................................................................................... b. Intended use and occupancy ..... .Qll~..,~..s~wrl ~....1~¥~].3.,'~ ............................................................................. 3. Nature of work (check which applicable): New Building ......... ~Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost I s .O0 % -renewal (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ 1~1130 ............. 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, Jf 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 ........ ~..0.. .............. Rear .....~.0.. ................. Depth ~lf Height ................... :..:.;... Number of Stories ..;...1:~1~ ............... 9. Size of lot: Front ...~. ................. Rear ....... ~ ..............Depth ...~...~..0. ...................... 10. Date of Purchase ........................................................ Name of Former Owner ......... W.~..~;[J~{I, .................... 11. Zone or use district in which premises are situated .... ~.~..~ ¢1.iS~; . 12. Does proposed constrPction violate any'zoning law, ordinance or regulation? ........... ~.Q ..................................... 13. Name of Owner of premises H. HO. SS SO'It;hold ........................................ Address ............................................ Phone No ..................... Name of Architect .......................... .~. ......................... Address ............................................. PhOne No ..................... Name of Contractor ......................... .". ......................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from descri rio ~occording to deed, and show street names and indicate property lines. Give street and block numbers c~ ~_p~,~ whether interior or c~ rner lot. I'~ ~ STATE OF NEW YORK. COUNTY OF ............ s.s. .......................... ~lJg.~;..Jj~_e~...., ...................................... being duly sworn, deposes and says that he is the applicant (Name of irtdividual signing application) above named. He is the ............ ~....-....~13~,~],ez'. ................................................................................ (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_,app~lation, filed therewith.. SWorn to befdr~ me this "- ..................... ......................... Notary Public ..~ ..~ '~"~~"of ~~'"~" ................... ~ mary ~Ugdic, State of New York ~;o. 52-0344963. Suffolk County .. Comm,ssi0n E~pire~ March 30.