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HomeMy WebLinkAbout2502-zFOP~I~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ....1~//.~;.....~.~cozlf~....L.e.~e ......................... Street Map No.......lf.~. ........... Block No ......~:X .......... Lot No. ~ ....... .p. ee~)12.~;~.t...~,..~., ...................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................................... .At~.~.~; ....... ~.0., 1~)..64.. pursuant to which Building Permit No...2.~02..Z dated .......................... Att,~.tt~[.....~,7......, 19...~.~., was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ ..... P.~lv. ate ..en~ ..~: e.~i. ty...~].~e t.1. ~.ng ............................................................................................ The certificate is issued to ...~t,~l~l.]..~.~....~.:[e.~.~h.....&..W.~ ....................................................... (owner, lessee or tenant) of the aforesaid building. by R.Vitla ........ ..................... Building Inspector FOP~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 F:ULL COMPLETION OF THE WORK AUTHORIZED) N? 2502 Z Date ...................... &V~U~t .....~.~. ............. , 19..6~.. Permission is hereby granted to: Four 5 t,~,...~es ...Y, ne· .A/C.. ~ ta~e~..C~er, aeh .......... .~7.~..~t~.aw/ ................................. .................. Sh~t®y~.-.l~,,¥~. ............................... to ...... B~.~t&..~e~..o~e'"famt'X'Y"~l~ett'~t'~ ................................................................................. ct premises Iocoted at ..~/J~.....J~etl~l...]C,~"~e .................................................................................. .......................................... Peeea~ey ....... .N,-g, .................................................................................... pursuant to application dated .............................. A~.~,.....~0 ....... 19.6¥., and approved by the Building Inspector Fee $..]:.(~,.00 .......... FORNI NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. Approved ~ ~' ~ .~...~ O ~=~ ~ 19 ........ Perm t No ............................. (Building Inspector) Application No..~.....~...(~..~ ....... 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 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 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. Oon~0r ~ c±,oz Name of owner of prem'ses ,'¢.i',¢z;lu;r Gi~:~l~ ......................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on ~v_h, jch/~z/¢ proposed work will be d~ Map ,N,~o: ............................................ Lot No: gf .....n~ k,._ker'.~...'.Peconic I,a~.a o_ '.' -.'.~" , ~' Routc 2~ & 2]A~ .... ~.. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy //A ~L A ~ ~ b. Intended use and occupancy ............................................................................................................................. 3. Nature of work (check which applicable): New Building ..... lJ .......... Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost ........... JJ3.gagg~. .................................. 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 ...~..<~.l~..gll~jpl ............................................................................................................... 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 ...3,.~.~J,J~r..hoJl ................................ ....~ ........ ..................................... 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 df Stories 9. Size of lot: Front ....... (j~ ............... Rear .................... Depth ................................ 10. Date of Purchase ...................................................... Name of Former.~:A/~ner ........ , ................................. 1 1. Zone or use district in which premises are situated ....................................................... L....t ................................... 12. Does proposed construction violate any zoning law, ordinance or regulation.;> ...................................................... 13. Nam~ Of Owner of premises ~ ....................................... Address ................ i... ................... Phone No ..................... Stan~oy (3~eraeh _.. ~'elton~.~ Lonj Box 120R Name of Contractor .~,]~ld..iiJ~A~l:l.&. .................... Address ............................................ Phone No ..................... F6~r J%al-H~r~ Zn~l. 77~; l~ontauk Hgt~ [3h.~.~y 2~o7600 PLOT DIAGRAM Locate': clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lin~es, Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW./~.O.P,I~,,~ ,, ~, ~. COUNTY OF s.s. .....~'"'?~'~J~'''""iJ~'r:n-~'~f i~'~i~i~'L;ol s:g ' g app' ' i'""'--'" .......... being duly sworn, deposes and sa~;t that he is the applicant 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 and belief; and that th'e work will be performed.in the manner set forth in the application filed therewith. Sworn to before me this .~ -- ...... Notary Publi~, .~/.~....~:.~e~ICou~,/~f/'(Signature of applicant) /ia, 52-3~331.20 Sulfol/( C0mlt~ .~ ~/ MAP OF PROPERTY RICHARD WILHELM '~I~I I . [ L, S, CONSULTANTS CENTER MORI~:HES & PATCHOGUE NE'~N YORK MAP OF PROPERTY TOWN SUFFOLK COUNTY, GUARANTEED RICHARD WILHELM,~ L. CONSULTANTS CENTER MORICHES 8c PATCHOGUE NEYV 'YORK $-9 ~ TO WHOM IT MAY CONCERN: / SUFFOLK COUNTY DEPARTMENT OF HEALTH Date ,/~/~/ Building Permit ~o. Th~ sewage disposal facilities for a struct~ve located at (Give deed locatfon) have been inspected by this Department and found to be satisfactory. District Engineer MAR 2 5 1965