Loading...
HomeMy WebLinkAbout3279-zFORM NO. 4. TOWN OF SOUTHOLD BUILDING D~PARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. I~.EI~TIFInATE OF oCCUPANCY No. Z. ~,~0 ..... Date ........... 0c~;o]~er.. 20 .... , 19.6.~. THIS CERTIY{ES that the building located at B.*.O ,~J,..0....~.gl~. Bo~d Street Map No...:~x ..... Block No.. XZ,~ ....... Lot No.x:OC.. Glce.ei~pO~t ~. ~%,Y, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... 0c.t · - 18 - ·., 19 66. pursuant to which Building Permit No.. dated ........... 0o~ .... 1[~..., 19 66., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .t~i~rate. one). £~i1~/~. dw~,~..i:.~.g. ~,~lth · a- '.ce = so:~y, b.ldg ............... The certificate is issued to Ma~?;. G.%t~.d~.o.e ....... 0~.~ ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..... .I~,.t.l:, ......................... TOWN OF SOUTHOLD BUILDING DEPARTMENT ~"OWN CLERK'S OFFICE SOUTHOLD. N. Y. OI~I~TIFI[IATI~' OF' OI]P. UI:ANI~Y No. Z.. ~.6.6. ~. :. Date ............. F. eb.llra~y...2.S .... 19.67. THIS CERTIFIES that the building located at PV~.ROad..E/~ng.~ers .La.... Street Map No.. XX~ .. ..... Block No... EX ....... Lot No. ~ .... G~'oer~.por.t~ · ~,M., ....... conforms substantially to the Applicati,on for Building Permit heretofore file.d in this office dated ..... 011~;..-'-..~ .......... 19.6~. pursuant to which Building Permit No..~2~).~. dated J}Jlll~l~Irl&O~l..0~} .......... 19.6(~, was issued, and conforms to all of the require- ments ,of the .applicable provisions of the law. The .occupancy for which this certificate is issued is ...Pri. va.~e. ~oee5 sony..(, z~orag~) · ]~i~[~irrg ........................... ........................... The certificate is issued t,o .l~I~.:py. (lt~Cl~lOe ..... }'i lessee or tenant) of the afore.said building. .Suffolk County Department of Health Appr, oval .... ~.~ ................................ Building Inspector FOR~ 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? 3279 Z Permission is hereby granted to: ..... · aG r~n~...~a~...~/~....~a~y.. Gu~ic e Greenpor~ to ~i~.. a~.. ad4Li.~i[,z~..~..~, ..e:~..~t ~g.. d,~;~l?,&z~ ...................................................... at premises located at "~w~'"O~'"A~'E~rS' "~a .......................................................................... ...................................... ~B.~n~O~t .................................................... ; ............................................... pursuan~ to application dated ............................... ~e~. ....... ~ ......... , 19.6~.., and approv~ by the Building Inspector. Fee $..~*0a ............. Building Inspector./ FOCal NO, ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Exemined ~:;*~ / ~ 19 ~ ~ SOUTHOLD, N. ¥. Approved ........................................ , ]9 ........ Permit No ................................. .......................... ..................................... .......... ................... ........ ............................ APPLICATION FOR BUILDING PERMIT Application No ............................. October 18 1966 Date .................................. .' ......................... , 19 ............ 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 ereos, and giving o detailed description of layout of propertymust be drown on the diagram which is port of this epplicotion. 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 ovoileble 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 o Certificate of Occupancy shall hove 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 lows, ordinances, building code and regulations. LaGrant Chapman (Signature of applicant, or name, if a corporation) Greenport, N.Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor Name of owner of premises ............... ~ar.y...~ui~i~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 .......... .~.~...A..~.~g.~..e..~.~.~..~...a.p..e.~:.~."~..~.~.e..e`..~.~..~.~.?..:~.t~.~ ........... .~ ........... ~ ...... ~.....i ................... . ..... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: · . a. Existing use and occupancy ................ "" '"'" b. Intended use and occupancy ............ .?..o..o...]:....~..~.?...~. .... --'-- ~- ............................................................. 3. Nature of work (check which applicable): New Building New Addition Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 5.00 4. Estimated Cost ............................................................ Fee ........................................................................... : .............. (to be paid on filing this application) 5. If dwelling, number of dwelling units .................. ' .......... 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 ............................ Height ............................ Number of Stories ............................................................................................................... Dimensions of same structure with alterations or aad't'ons Front ................................ Rear ................................ Depth .............................. Height ....................... i ...... Number of Stories ........................................ 8. Dimensions of entire new construction: Front ....f~.'.' .................... Redr .J~.'.' ....................... Depth ...... 8.'~ .................. Height ............................ Number of Stories '1 9. Size of lot: Front ............................ Rear ............................ Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 1. Zone or use district in which premises are situated ......... ]~.~.~., ............................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ......... .n...o. ........................................ 13. Name of Owner of premises ~Y.....~.g.~..d-Jr.q.e. ........... Address ....... ~.r..e.~.qp.9.~.~,.~.¥.,.... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Lagrant Chapman _,, greenport,N.Y. Name of Contractor .................................................... naaress ............................................ Phone No. 0666 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 NEW YORK, } COUNTY OF ....... S~f~.q~k ........~ S.S. I LaGrant chapman b~ n- duly sworn, deposes and says that he is the applicant (Name of individual signing application) Cant ' r 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 file this application; 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 in the application filed therewith. Sworn to before me this ~ ~ 19....6~ ........ ~...18 day ~)f ... Qg.~.,Q~gf~r. ......... , ., ........ ............. .. Notary Public, .~~"~..~ .~.':~'~'.. Count~ (Signature o