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HomeMy WebLinkAbout2701-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ~/~ Kno!lwocd ~ ...... ., .............................................................. Street Map No. ~ ............................................ Block No. ~ Lot No.~ ....... j~,~,.~[~I~j[.~......K~!~.~ ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................................... ~,.[[ ........ ~ ....... , 19.~,.. pursuant to which Building Permit No.....~0,l...?, dated ......................... ~.~.~.~ ....... ~ ......... , 19..~.., 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 ........ The certificate is issued to ~'c~a~'~ V~roo~s (owner ~r teno~t) of the aforesaid building. H.D. approval August $, 196~ by R. Villa , '~ c.-.~o BuHding" Inspectorl FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2701 z Date ............................... ~j]~.~.~....3-O ....... , 19.&~.. Permission is hereby gronted to: ......... · ~e~iehe..~ ............................................ ................ 8 ~,.. Jal~lr ..]i,.Z., ........................... to ...... ]~u/~d..n~w..or~...$~m~ .1.y.. <~®:~.1../~ ................................................................................. ~t premises located at ...~/~...K~1~)1..1~o<~)~....~.1. ................................................................................... ............................................. l~t ~.~.t~ek. ~...... t~. ~-~ ............................................................................... pursuant to application dated ................................... A]~I~.......~! ....... 19.6~.., and approved by the Building Inspector Fee $.10+0J3 .......... 0 ~J 5. 7Z~4'7'10' ' Wo uJ 0 o SCALE: S-9 SCHD SIFFFOLK COUNTY D~PARTM~NT OF HEALTH Date Building Permit No. 2701 Z TO %~EqOM IT MAY CONCEP~N: The sewage disposal facilities for a structure located at (Give deed location) S~,tbside of Knollwood Lane: 1~0~ W~s+. ne Owns ~ttituck~ Town of Southold have been inspected by this Department and found to be satisfactory. District Engineer FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19 ........ Permit No. ,..~....~...,,..~..Z....~_. Disapproved o/c .............................................................................................. (Building Inspector) / Application No....~..~..?.[ ......... APPLICATION FOR BUILDING PERMIT Date ............................................................ 19 ............ INSTRUCTIONS a. T_his 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 location. 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 issuanoe of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or a Iterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable lows, ordinances and regulations. ENnIAND ~O.~.,S, _TNC. (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. Nome of owner of premises..ET{;r~[.~.?~..]~.0~Jg~ ....................................................................................................................... If applicant is a corporate, signat~e gf ~y au~orized officer. (Name and title of corporate office~) 1. h~ation o~ land on w~ic~ proposed work will be done. Map No: ..~scr~..pr.~. .................. Lot ~o: .................... Municipali~ 2. State existing use and occu~ncy of premises and intended use and occupancy of proposed construction: a, Existing ~se a~ occupancy ............................................................................................................................ ~"~'~ .... b. Intended use and ~cupancy .................. dweq]~ .............................................................................................. 3. Nature of work (check which applicable): NeW'Building...~..e.~... ....... Addition .................... Alteration ...: ................ Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost......~.~Q~, .......................................... Fee .......................................................................................... (to be paid on filing this application) · one r 5. If dwelling, number of dwelling umts ................................ Numbe of dwelling units on each floor ............................ If garage, number of cars ........ .q~. .............................................................................................................................. 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 ............................................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... .6.~.? ................ Rear .......6~! ................. Depth ..2..8..~ ...................... Height ......... ~/~..~ .............. Number of Stories ..... .o...t~. .................. 9. Size of lot: Front .....~1,(~..~. ............... Rear ............................ Depth ...2.~..0..~. .................. 10. Date of Purchase ...... .~l~b~q~.%..~.~ ............................ Name of Former Owner .~.]-.b..e...z~b....0.9.Z...~...a~...a..q ......................... # 11. Zone or use district in which premises are situated...~..~.~..~..~..~.....,~'~....~.J,~.~"./.~:£':/~'.~.~. ............................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ........ .~..9. ....................................... 13. Name of Owner of premises..~,~,~.~ta,~.~'.9.9~? .......... Address ._,_____~ng'~,+.'~'~'°'~'~!¢'°'"°~'"'"]~*'Ph°ne N O..~,...-. ~..-..~.8..~... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor..~-.e~.....~..~.~..]~...~.~...~..°...~...8. J.Z...~.g.? ...... Address .~.e:~$.q.b..°...~pk.e.~.S.~.'.~..a~...e..s..Phone NO.~.~.-..5'..-.!]![!I.O.... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner Jot. STATE OF NE'-~L~QI~K,,, /~ ) S S COUNTY OF..~..) . ' . ..................... [., .-. ])~/k..g~O.g,l~ ........................................ r ...... being (Nome of individdal signing application) c duly sworn, deposes and says that he is the applicant is the contractOr ........................................................... above named· He ................................................ i'~'~'r~'~'~ctor, agent, coqborate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file thisiapp icat on; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth n the appl cation filed therewith. Sworn to before me this .~ /,. ............ f.~.' .......... t~,.~ ;,,,1 · ~---i----~(~ign~) ~licant) . of