Loading...
HomeMy WebLinkAbout2644-zFOR, B'I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CI~RTIF'ICAT£ OF OCCUPANCY No..~,..23.0L ............ bate .......... ~.V~e.Z:...:~3 ................. , 19.6..5... TH I$ CEP, TI F IES that the building located at .. J/,c]c,l.e.~..~Ol~Cl..l~o&¢l,..S~tl.~,-~lOJ. C],.. Street Map No ...:]0~ .......... Block No .... ~ ......... Lot No .......... ]QOr, ............................................. conforms substantially to the Apphcation for Building Permit heretofore filed m this office doted ........................ .~...e..~..~..~..a...~.~....2..3 ......... , 19. ~.5... pursuant to wh,ch Bu,ld,ng Perm,t No. 2...~.~...4.~. ..... dated ................ ~.e];:l~aZ'~...2.3 ......., 19..~5., was issued, and conforms to all of the requirements of the apphcab[e prowsions of the law. The occupancy for which this certificate is issued ~s ........ ......................... ,,~o,~...~,~ .,~,,z~. ....... Co .,.~...f~..:~:.~.V...). ............ : ......................... The certificate is issued to ...OZ'~:;~I..~..~Q~ ..C,.. ~3~.t,~ ..................................................... (owner, lessee or tenant) of the aforesaid building FOI~lV~ NO. 2 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) N? z Permission is hereby granted to · 43'~'"~t~ ........................................................ .............. ~elee~ .]~r.-.Fc~d...~ ............................. ..................... ~e~t~.].d ....................................... to. ~lentove...pe, v$,. ~.f... e~$~t.~g...el ',te.~.]=~,~ ~...b~.~<l.. ~....ad4~ $.t'-en.. &.. ~!ce .............. ......... a~..tev~t.ien~ ............................................................................................................................ at premises located at ...... W/~.-..~tclcer.]~y-..Pond-.. '~ ............................................................... ......................................................... l~outho:Ld,..3T. ~. ................................................................. pursuant to application dated ................................... ~J~lll~ ......... ,~ .... 19..~., and approved by the Building Inspector Fee $../~.C3.0 ............ ...... ~,.,....; [~ ............. ....-, .. :.~...%...~ ..................... Building Inspector t FOIRDI ~0. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .... ......... ..... Approved ........................................ , 19~...Permit No. ~.~....~.....~.....~ D~sapl~roved a/c .~ ........ ~ ........................................... ................................ ('~'~'~i~i'~ .............................. APPLICATION FOR BUILDING PERMIT Date ...... ..~...~...<~ ..... ~.~ ................... ,,9.~.~.~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin. Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o areas, and giving a detailed description of layout of propertymust be drawn on the diagram which is part of this applicatioe 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. SucJ permit shah 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 Occupanq 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 th: Building Zone Ordinance of the Town of Sauthold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described The applicant agrees to comply with all applicable laws, ordinances, building code and reg_ulations. _ ..... .......... ................ (S~gnature of applicant, or name, if a corporation) ....... ........ /Address of applicant) / State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ................................................. ~.~..~ ./.....~:~~: ...................................................................................... Name of owner of premises ....................... .~ ...... ~.~.....~.. ...... ~(..: ......................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Location of land on which proposed work will be done. Map No' . ...........................................Lot No' . .................. Street and Number .................... ...'~-...~ .......... : .......................................................................................... ~/~ Municipality 2. State ex~sting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................... .../~..,~...~...~.......~. ..... ; ................................................................................. b. Intended use and occupancy ................. ~...~..6..~..../~....~. ........................................................................................ 3. Nature of work (check wMch applicable): New Budding .................. Addihon .................. Alteration ~, .... Repair .................... Re, moral .................... Demolition .................... Other Work (Describe) .................................... 4. Eshmated Cost ...... ,~....-r~...~..¢7). .................................... Fee ...~ ................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling un,ts ............................ 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. D~mens~ons of existing structures, if · ~ ~ any. Front .......~....,~T......C. .... Rear ...... Z;. ................. Depth ...~....f~... .............. Height ....... /..~...~. ........ Number of Stories ......... . .~../tc~..~...:.....(. ...... 2 ................................................................... D,mensions of same structure with alterations or additions: Front ................................ Rear ..... ..~....~...:.~...:.'. .... Depth ......,~..~.....¢...~..;.~ ..... Height ......... ./..2,~,..~¢~.~.f. ..... Number of Stories ......... ..~'.....'~....~.. .................. -?~ ,, /~5-/,~ '/ 8. Dimensions of entire new construction' Front ............................Rear ........ ./ ................. Depth .......................... Height ........ ./...~.....~.~..~./. ..... Number of Stories .... ..~....'3f.....'~=... ......... 9. S~ze of lot. Front ............................ Rear ............................ Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ...................................................... I 1. Zone or use d,stnct ,n which pram,sas are situated ............................................................................................... 12. Does proposed construction wolate any zon ng law, ordinance or regulation? ............................... 13 Name of Owner of pram,sas ..~:..../~...,~..?...~.'...2~.. .............. Address ~.6.?.?.~.;.~.~.~..~.lK¢¢.,r.R?../Xl~Cn~.' ................. Name of Architect ...................................................... Address ............................................ Phone No .................. Name of Contractor ...~...-~'./~...~....,....~....~...'~..f.~: ........... Address ./...x~.~..~..../.~..'f..'.~Z...~..~.~x:~...,~'Phone No..~..~.¢.'.~.~../..~..,,~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro property hnes. Give street and block numbers or description according to deed, and show street names and indica whether interior or corner lot. SlATl OF NEW YORK, 1 S S. COUNTY OF ....... ~u32 f. olk ........ Orban Chase ................................................................................................. be,ng duly sworn, deposes and says that he is the applio (Name of ind,vidual signing application) above named. He is the ...... g.ct~t.11. S.C;t~ .................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the smd work and to make and this apphcation; that all stg~tsq¢ontai~ed in this a~plication are true to the best of his knowledge and bell and that the work wi~a~'rpe~f~rmed in, th~'~anner set forth in the appJ~iog filed therewit~ Sworn to before me th ~ .5~0~.. ~'~.~,~ c~ ~ ~ / ~. / .......... ~..~ ........ day of ..Z~~ .......... , 19.~.~... // /~, ~ ~ , , /0 . ............ ......