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HomeMy WebLinkAbout2652-zF01%1%! NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ~x/~.. J~oIIt~..VJLe~..A~Te...~...~.~..R~. Street Map No ..;E,I~ ......... Block No ~ ........... Lot No ~ ......... .~O.~.thol~ ..~..~.., ................. conforms substanhally to the Apphcahon for Budding Permit heretofore filed in th~s office dated .............................. ~.~1. ...... ..Lk ........ , 19.~.~. pursuant to wh,ch Bu,lding Permit No ~..~...~.... dated ......................... ...J~..9.~l.....~. ..... , 19 .6.~..., was ,ssued, and conforms to all of the requ,rements of the applicable prowmons of the law The occupancy for which th~s cerhficate m ~ssued m ........ ....... t~.iY. &~ e...one ..fami ]4~... dw~ lling ............................................................................ The certificate ,s issued to .... .V.~h~Io.e~I~..D..1 Ai~UlIt~ .& .~i~e ............ Q-w'T~.erJII. ...................... (owner, lessee or tenant) of the aforesaid building H,D. Approval Feb 15, 1966 by R. Villa FO~!~ 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) ~.o ~2 z ~o,e ........... .~..~..%~ ........... ..V.. .......... ,~....~.~ Permission is hereby flranted to: 'V.,. ~ D' .~ ~..c:..~...T. .... : .... ,~.u~.u.~.~4. ....4..c.... ......... .lt...~..~ ........... .C....,....-...Z..b...~.~.~ ................... to ..... ~..u..~..b.b...... .~....~,..~.. ..... ~...~..C,..?zZ....~.~.:..~.:i....J2...~.~.~.~.:..~..~. ................................. ct premises located at ....~Z~.......~...O. ?.....kJ....~....,~.../..~.'. ?/....., .~.....~..b,~. ..... .¢....e...~...~....~..f..[ ................... ........................................ ~..~.~..~..h .~..~.~.....-. ..... ~,~ ................................................................ pursuant to appl,cotio, dated ..................................... ~.~...J~., 19..~..~Z and approved by the Building Inspector Fee $..L..O....~ii ..... TOWN OF SOUTHOLD Bu,..,.G Town C,E..'S O. lCE SOUTHOLO, N. Y. Examined ..... ..~......¢..~......~.......~.. ....... , 19.~'.~.'~. hPproYed ........................................ , ~ 9 ........ Permit ~o ................................. ApPlication NO. ,..c~...~...%~..~... ,.,.,,,,,.,,,.,,.,...,.,,,,,~,,,,,,,Disapproved a/c ............................................................. i ........... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildi[ Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giving a detailed description of layout of propertymust be drawn on the diagram which is part of this applicatJo 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. Sue 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 ~n part For any purpose whatever until a Certificate of O¢cupan shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Budding Permit pursuant to tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions ar alterations, or for removal or demolition, as herein describe The apphcant agrees to comply w,th all applicable laws, ordinances, building code and regulations. // (S~gnature of applicani(~br name', ,Fa corporation) (Address of applicant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build: Owner and General contractn~ Nome of owner of premises ~!?.~:~.~.~!?..s.~.¥~.~..a.?~..~?.~j.~.~.~.c1.~?~.~.~.s.~.~.?.~ ............................................................... If applicant ~s a corporate, signature of duly authorized officer. (Name and t~tle of corporate officer) 1. Location of land on whmh proposed work will be done. Map kl- $o'a~.d View He~.~h%s · .~, ............................................ Lot No: ................. Street and Number ~.9.~X~.I Mumc~pality 2. State exmting use and occupancy of premises and ~ntended use and occupancy of proposed construction: a. Ex~sting use and occupancy ...... ¥.~.a..~..~.b. ............................................................................................................. b. Intended use and occupancy . ..~,~.~t~,~ ....................................................................................................... .... ~ ~,~,~,'.... Addition Alteration ................. 3. Nature of work (check which applicable). New Budding ~""' ' . ................. Repmr .................... Removal .................... Demolition .................... Other Work (Describe) ..................................... 4. Eshmated Cost ..... $.~.,.0.Q0...0.Q ................................... Fee ......................................................................................... (to be prod on filing this apphcation) ,5 If dwelhng, number of dwelling units ~..~9.9~rl¢$..,~..J~l~.t]3Number of dwelling units on each floor ........ If garage, number of cars ........... ~t~e..Ca~..Ga~ge ................................................................................................. 6. If bus~ness, commercial or mixed occupancy, specify nature and extent of each type of use .--m ........................ 7. D~mensions of existing structures, if any: Front ~ Rear Depth Height :L......;::.::.: ........... Number of Stories ....... ~ ................................................................................... Dimensions of same structure with alterations or additions: Front ...... ~..,,~-.-~,,-r.,~,,: ......... Rear ................. 'fi. ............. Depth ' Height .............................. Number of Stories ....... 60 Fe~,t 60 Feet 26 Fee% 8. Dimensions of entire new construction: Front ............................ Rear ............................ Depth ........................... Height .... 3,?..~=ee.~ ......... Number of Stories ......... 3~ ................ 9. Size of lot: Front ...... .1...0,~.....~.... ........ Rear .~.0.,5......~..... ............. Depth .1..0.~q.....~.... .................. ..... Feb. 23, 1965 ..... G.W. S~ith & sons Inc. 10. uare at I~urcnase ........................................................ ixlame ~ot ~ormer k~vner ....................................................... 11. Zone or use district in which premises are situated ........... tUJ,~,~t~..% .............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation.;> ......... .~..0. t. ...................................... 13. Name of Owner of premises .J,[]~.,&..~,r$...'q'.~...D.!.&3_~_~J~cr~s~. .......... ~Qt~.t,~Q~] ................ Phone No. ~.q5.-.~.75~... Name of Architect ...................................................... Address ............................................ Phone No ................... Name of Contractor ...~,~,..D.~.~t,s.~..~Tr .............. Address ...... fi~.J~b, fl~0, ...................... Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro~ property Jmes. Give street and block numbers or description according to deed, and show street names and indicat whether interior or corner lot. STATE OF NEW yORK.. £~ ~ ~ S couF -Y OF f o. " (Name of inklividual s[gn,rf~ application)~/ above named. He is the .................. ~ ............................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and fil this applicahon, that all statements contained m this applicahon are true to the best of his knowledge and belie and that the work will be performed in the manner set forth in the application filed therewith. Sworn to be, fore me this ~ ~ ~, ......... ..~T....--,~ ...... day of ....... ....~....~..~ff .......... , 19.~.~. ]~, / ~ r~ ~ -~ _ /7 .......... ( (.,J ~,~m ~x~re$ ~a~ 30, ~.~ .................