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HomeMy WebLinkAbout2945-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. CERTIFICATE OF OC:CUPANC:Y THIS CERTIFIES that the building located at ..... W~.~.....~c.t,o;~.~'..~lre .......................... Street Map No...~.~.~. ............ Block No.~Z ................Lot No...~:~ ..........]~t.~.~..~.~ll~}~...,~,.~. ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................................... D.~f~.e.~];),~r...*l....., 19.~.. pursuant to which Building Permit No..~..b¢~...~. doted ............................. ~e.~e~lb.e~..,~.., 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 ........ ...l~.i.v.a~e...one.. f. amil~...~wel ling.....(Manse.) ....................................................................... The certificate is issued to ..T~i~...I~I~tb.'L~.~...(~,~I~.OI~ ........................... (~w~0.er. ........................... (owner, lessee or tenoht) of the aforesaid building. H. D. Approve 1 ~anuary 17, 1966 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) N? 2945 z Date ...................... Daaeabe~ ....... 3, ........ , 19..6~. Permission is hereby granted to: ...... ]~al.t~., t~.ptJ, at..Ch urn. eh ......................... ............. Nntt ~t,!nlrs.....l~./.'. ............................ to ....~....~...1...d.....n..e. ~.. ~3.e....,t'.e~tl~...~,~ell~& ................................................................................... at premises located at ...~/~t.....~m.t~r~...Av.e ..................................................................................... .................................................. l~.~.~.uck,.....R.L ........................................................................... pursuant to application dated .......................... J)~C. el~e.~.....~. ........ 19~)~'..., and approved by the Building Inspector Fee $.~.e...~.. ........... Building Inspector SU~FOLK COU~ DEPARTMEI~T OF ItEILTH Permit NO~~~ ~- TO WHOM IT MAY CONCERN: sewage disposal facilities for a structure located at have been inspected by thais Department ap~ found to ~e satisfactory, D sir c En~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y.~ xamlnecJ ........................................ , Approved ........................................ , 19 ........ Permit ~1 ................... ~; ......... Application No..'.~...~]..W..~.'.:. ......... Disapproved a/c ............. LL'~- ................. ~' ........................ _ ~ ............................... (Building In,hector) APPLICATION FOR BUILDING PERMIT Date .................... ~).~fi.~.~.~.....~. ............. , 19~..~'. ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink end 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 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 oil applicable laws, ordinances, building code and regulations. (Signature of applicant, or nome, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Agent of owners Name of owner of premises ...... ~r.d.~y..J:2.~p.tJ.s.t..~h~.~r.o~r~, .............................................................................................. 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.: .......... ~;f,'4 ...................... Lot No.: .....'Ic..~.~. ............ Street and Number ...~:;./~L....O,~.a~..t,c~.:r'.y...A~r.c~..~.)....T.,,..I. jLLo.;~_ ................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........... .~Z~%.¢.~.~L..~.fl.~ ............................................................................................. b. Intended use and occupancy .............. .q~.e,..J.'.~¥ofi~.l,7...~J.we.1]~L'~tg ..................................................................... 3. Nature of work (check which applicable): New Building ...... .~.-..~.~.~.. Addition .................. Alteration Rel~air .................. Removal .................. Demolition .................. Other Work (Describe) 4. Esti~mated Cost ......... ~.~.~..0..0....?./..~: .............................. Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... .o.~.e: .............. 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 Hei'ght ........................ Number of Stories .......................................................................................................... DiMensions of same structure with alterations or additions: Front ....................................Rear Del~th ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ............... ,..LF ................. Rear ............... .~+ Depth ..... ~..0.. Height Number of Stories 9. Size. of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner 11. Zor~e or use district in which premises are situated ....... ,~ ....... .~...,.~ ..... . ............... 12. Do~s proposed construction violate any zoning law, ordinance or regulation? .......... 13. Name of Owner of premises l[lr~.~,.~.y:..]zte,]~.~.~...q~...C:h.~.~ttJiless ........... J~'I~.'~.~$.$~]Z¢..~. ........... Phone No. Name of Architect ..................... ,~.~.~ .................... Address ............................................ Phone No. Name of Contractor ~ame .................................................... Address ............................................ Phone No. PLOT DIAGRAM Locatl~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-6ack dimensions f property lines. Give street and block number or description according to deed, and show and indi, whether i,nterior or corner lot. STATE OF; NEW YORK¢ / ¢ c ....................................... .g.f~'.0, g:f)...~.~!.O...~..~.~.O.~ .......................... being duly sworn, deposes an~f says that he is the applic (Name of individual signing application) above narded. He is the ............ Cb~t~.c~...Q~.iL~,~ .m A~.¢Tt.~..o.~'....o...~..n.~Lz]~ .................................................... (Contractor, agent, corporate officer, etc.) of said owher or owners, and is duly authorized to perform or have performed the said work and to m.a:ke and this application; that all statements contained in this application are true to the best o'f his knowledge and belief; that the work will be performed in the manner set forth in the application filed therewith. Sworn to b~fore me this ~ Hr~y of Dec,tabour 19 6~ · / ....................... n' ......... , ........ Notary Pub c, ~ ~4-r~... ......................... ' ' ,~ ......... ~[, ....... C.p~r~v/ ~.,~ (~ignature of applicant) ; [,,,.~[r) PUbbC, State of New York /,~--//r~"-'-' ~v TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ..~..c..~.,...../. ................ , 19.~.:.~.' Approved ........................................ , 19...~. .... Permit No .. . Application N o. £~...?...~.7...~ .............. APPLICATION FOR BUILDING PERMIT Deeeml~e~ Z 6~ Date INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink end 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. l~nity BaPtist Church (Signature of applicant, or name, if a corporation) Factory A~e, ~att~tuek (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Agent of owners Unity Baptist Church Nome of owner of premises .................................................................................................................................................... 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..Mop No.' ........................................Lot No.: ........................ Street and Number ~g/J~ Factory Ave @ Municipality 2. State existing use and occupancy of premises and intended use and Occupancy of proposed construction: vaeant land a, Existing use and occupancy ................................................................................................................................... one family dwelling b. Intended use and occupancy ................................................................................................................................. 3. Nature of work (check which applicable): New Building ....... X,X~r,. Addition .................. Alteration Repair .................. Removal . ................. Demolition .................. Other Work (Describe) 4. Estimated Cost .......... ~.t.~.t~O..~/M ............................ Fee .......... ~ ............ i (to be paid on filing this application) 5. If d'welling, number of dwelling units ....... .~11~11 ............. Number of dwelling units dn each floor If gbroge, number of cars ................ 6. If Business, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dir~ensions of existing structures, Jf any: Front ............................ Rear ................................ Depth Height ........................ Number of Stories DJm, ensions of same structure with a.lterations or additions: Front .................................... Rear Dap!th ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ............... ~1~ ................ Rear ............... ~1, ....... Depth ..... .gO .......... Height .................... Number of Stories ....Qlle .............................................. 9. Size~ of lot: Front ............................ Rear .................................... Depth 10. Date of Purchase ........................................................ Name of Former Owner 11. Zone or use district in which premises are situated ..... 12. Does proposed construction violate any zoning law, ordinance or regulation? .......... ]3. Na+e of Owner of premises [/tl$~;~..~t,~.~..~]l~/~l~less ........... M/l~/;~./;tl~' ........... Phone No. Na~e of A~hitect .................... ~L~ ....................... Address ................................ : ........... Phone No. Name of Contractor ..................... ~,e ..................... Address ............................................ Phone No, PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-bock dimensions property lines. Give street and block number or description according to deed, and show street names and indic, whether i'nterior or corner lot. STATE OF NEW YORK, ~ ¢ ¢ COUNTY ~,OF ...~'1~'~..~111e ........... ~*'*. i ', ................. i ................... .1~.~:~-.0...~.1~1~.~ ............................ being duly sworn, depose~/~nd says that he,is the appli. !(Name of individual signing application) above named. He is the .......... ~V~.~l~..O~£~?......-~...l~.~lt,..O.e...~.~ ......... 'i (Contractor, agent~ corporate officer of said owner or owners, and is duly authorized to perform or have performed the s~id work and to and this application; that oil statements contained in this application are true to the best of his knowledge an~ belief; that the wgrk will be performed in the manner set forth in the application filed therewith. Sworn to/~.~fore me this ..day of De.o..e.mlle.' , ~.~ .... otar ................ ........ : ........ ...... .................. .