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HomeMy WebLinkAbout2799-zFOE~I NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at -N/&...-.Lee.t, ett...D~:Lve ............................ Street Map No ...... X:X ............ Block No ............ ~,~ ...... Lot No..-alL~- ......... ~Ollt, b,O~Ct, ............................. conforms substantially to the Application for Building Permit heretofore filed Jn this office dated ...................................... ,,T~,l,~ .......... 2.~...., 19.(~.~.. pursuant to which Building Permit No ..... dated .............................. ~l/J~e ....... ~...., 19..6~'., was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ........... ~az, iva~e...on~.. ~am~..Zy.. ~e,.~:.Z.~ng ................................................. : ................................... The certificate is issued to ..... ]g~ene,.Oa~o.~,.:t ........... '(';~';}'~'r',"i~';~'~;'~;~";~';~'~'~¥i .............................. of the aforesaid building. FORM NO. 2 TOWN OF $OUTHOLD 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) Permission is hereby granted to: o ................. Be~t, he~6 ............................................ to. l]~l~t., e~. &dili.ttela.. ~n...e~. ,exitet.iag.-tlt~e.l.:~/[~ ............. .......... ~ ................................ at premises located at ...... L~tI~OI~..I)~.~VO .................................................................................... i ...... ......................................................... ~th~it~.....t~.Z., ......... ~ ................................. : ......................... pursuanf t0 opplidofion doted ................................ ~ttl~....~.,~.~. ...... 19.~., crud approved by the Building Inspector Fee $..,~00 ........ Building Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE e /,,~ ..,~...~.~ SOUTHOLD, N. Y. Examin C~,~' 19 6)~' Approve~ .................................... , 19...]~.. Permit No ........................... Disapproved a/c .............................................................................................. ................................ ............................. 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 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 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 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, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. ~o~a].d 1~.~ efl.ar.l.ck ................ ~ .............................. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi'neer, general contractor, electrician, plumber or builder. Contr. ctor Name of owner of premises ....... El~a...C. ar.o~ If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) 1. Location of land on which proposed work will be done..Map No.' .....~.....~f.. ..................... Lot No.: .~ ............. Street and Number ...~.e.~o~..l).lT,~..Y.e ............ ~$.O.ILt~O~Ld ............... .. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy d.~ze3 ],&.~g ............................ - b. Intended use and occupancy ......... ~Lc-a,.~...e......W~..~..B~....~c.~..8..$.~g.i...o..~. .................................................................. property lines. Give street and block number whether interior or corner lot. 3. Natgre of work (check which applicable): New Building .................. Addition .....:~¢~... Alteration .............. Rep6ir .................. Removal .................. Demolition .................. Other Work (Describe) .................................... 4. E~tir~ated Cost ....l~g. O0.....~.~ ............................... Fee (to be paid on filing this application} 5. If d~'elling, number of dwelling units .....O.~e ................. Number of dwelling units on each floor ........................ If g?rage, number of cars ......................................................................................................................................... 6. If b~usiness, commercial or mixed occupancy, specify nature and extent of each type of use ........................ 7. Dimensions of ex~stmg structures, ~f any: Front ............................ Rear ................................ Depth .................... Heig, ht ........................ Number of Stories .............................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear Depth ................................ Height ............................ Number of Stories ................................ 8. Dimbnsions of entire new construction: Front ~. ............................... Rear ..... z..LI: .................. Depth ....,.~..0. ........... Height .................... Number of Stories ..... .Q:Qe ..................................................................................................... 9. Size!of lot: Front ............................ Rear .................................... Depth ................................ 10. Data of Purchase ........................................................ Name of Former Owner ................................................... 1 1. Zon~ or use district in which premises are situated ......... A.....d,J.s~t ...................................................................... 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? ....................... .mO ........................... 13. Name of Owner of premises ...~?-.~.~...e.....~..~.?..9~.~.....Address ........ ~..°..~...'g.~.°..~ ................. Phone No ................ Name of Architect ...................................................... Address ............................................ Phone No.....; .......... Nar~e of Contractor .D.,...D.~.~.r~,~'.ZLC.~; ...................... Address ........ [~.C~¢o.[t::] ................. Phone No ................. PLOT DIAGRAM L.ocat~ clearly and distinctly all buildings, whether existing or proposed, and indicate ell set-back dimensions fr or description according to deed, and show street names and indic, STATE OF NEW YORK, } S S COUNTY DF$.aZ~£O3,]~ ................. ~ ' ' ...................................... ]DQ~a.].cl...D~.ecl_~,~£c~ ................... being duly sworn, deposes and says that he is the applic ](Name of ndividua signing application) above nerved. He is the ....... C.o~..J;~L;a,C.~)~ ..................................................................................................................... (Contractor, agent, corporate officer, etc.) of said o~ner or owners, end is duly authorized to perform or have performed the said work and to make ond th s opp c.ation; that ali statements conta:ined in this application are true to the best of his knowledge and belief; that the work will be in set , performed the manner forth in the ~lication filed therew Sworn to before me this ................ l..-°.~, day of ................. ~.~ ................. , Notary Pu Ii qature of applicant) ] No. 52-0618100 SuffoJk Count. y// JComm]sslon Exptres M~rch 30, 19 ~ FOItM NO. I TOWN OF SOUTHOL. D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examine .4.~..~..,~ ...,,.). ...... , 19....~..) ApproveO(~-~ .................. , ............... , 19.....':... Permit No. ~,6,:~).~....~.' ~: Disapproved o/c .............................................................................................. ............................................ .~,~ ..M>.,...-?,,,,:,, ~,~ ............................ (Building Inspector) / Application No..~.~74...~:..~ ....... 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 property must be drown on the diagram which is part of this application. c. The work covered by this application may not be commenced before issua,nce 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 shaJI be occupied or used in whole or in port 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) Southold (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi'neer, general contractor, electrician, pluml~er or builder. Contr' ctor Nome of owner of prem ses .~/Ag~9~e 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 ~0~ D[~.1~ Southold ~ Municipality~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction; a. Existing use and occupancy ....... ~e~ .................................................................. ~ .............. : ....................... b, Intended use and'~cupancy 6~e with a~ additiol~ ~, L.ocati property Ii whether i'nJ 3. Nature of work (check which applicable): New Building .................. Addition .....~,~,.X~.. Alteratio~ Repc~ir .................. Removal ..................Demolition .................. Other Work (Describe) 4. Estimated~ Cost ..... Z~.~0.....P~.~ .............................. Fee ........... (o'~'~' be paid on filing this application) ] 5. If d~velling, number of dwelling units ..... O.~e. ........... ....Number of dwelling units on each floor If g6rage, 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 Hein~ht ........................ Number of Stories Dimensions of same structure with alterations or additions: Front ....................................Rear ] Depih ................................ Height ............................ Number of Stories ................................ 8. Dim.bnsions of entire new construction: Front ~..~ ............................... Rear ..... ~..~. ................. Depth ..... ~L.¢t .......... ' Height ......... ........... Number of Stories ...... 9. Sizeof lot: Front ............................ Rear .................................... Depth ................................ 10. Dot~ of Purchase ........................................................ Name of Former Owner 1 1. Zone or use district in which premises are situated ....... 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? ........................ 13. Not, et of Owner of premises ,....~....~.~...~..~.....~.~.~..O...~..].......Address ........ ~.0~1,~0.~-.~ ................. Phone No. Name~ of Architect ...................................................... Address ............................................ Phone No. Na~e of Contractor ....,....~.'~'.e.q.~.~e)~ ...................... Address ........ S.OlZt)~:z]L~ ................ Phone No. PLOT DIAGRAM clearly and distinctly all buildings, whether existing or proposed, and indicate ali set.back dimensions fr ~es. Give street and block number or description according to deed, and show street names and indic erior or corner lot. STATE OP~ NEW YORK, COUNTY IOII~.~]~¢ .................. ~ ~'~' ................. ! .................... ~g~...~.~a~ .................... being duly sworn, deposes and says ~ha¢ he is the applic ~(Name of individual signing 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 this appli(ation; that all statements contained in this application are true to the best of his knowledge and belief; that the w~rk will be performed in the manner set fo~h in the c ~lication filed Sworn to before me this ................ ~.. day of ................ ~ .................. , 19.~.. ~ignature of applicant)