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HomeMy WebLinkAbout3984-zTOWN OF $OUTHOLD BUILDING DEPARTMEN1 TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No....Z..,~2.~.5 .......... Date ............ ~ ....... AuguS.t..2~J~ ............ , 19.68._ THIS CERTIFIES that the building located ut ~8~l. salJ..~,..J~¢Ji~l.c~,J~.~l~'J:~JnJ~gj..~ Street Map No. R~EI&U ....... Block No ....................... Lot No. 15.~.,..!~'u,t:(~ho~.u~_,...NeT~....~rk ............ conforms su~§tan~t~c~J~°to the Application for Building Permit heretofore filed in this office dated ......................... · ,~gt.~t....6, ................... , 19..6J~.. pursuant to ~vhich Building Permit No....3...~....~.....~. dated ............... ~1g'~1~,...'/.~ .................. , ] 9...68., was issued, add conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ pz~L%t~te...gar~ge....(acces~.y...]~u~l~ln.g) ................... : .......................................................... The certificate is issued to ........ F~.o.~...~/~t~.~.Oh~ ........................................................................... (owner, lessee or tenant) of the aforesaid building. .......... ./. ........ ................. ' Building Inspector ~ k F~RM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at JJ~&tl..,L~l~,...J[CJ&JJ~,~lJZ'~l~Jll~[l~J~..J~J~ Street conforms ~/5§ta~J~'c~J~°to the Application for Building Permit heretofore filed in this office dated dated ............... ~cJ~lil~,...~.~ .................. , 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 ........ pi:J.v~t.8~..gaz fLga ...(&cclieJor. y... ]~luJ,i.d~lAg J .............................................................................. The certificate is issued to ........ J[,.C,...G~I~.t~'~.OJ1,1, .............................. (owner, lessee or tenant) of the aforesa, id building. FOl~,~[ 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? 3984 Z Permission is hereby granted to: ........................ ~.~.~ &u.. ~ ~ ,, .t.. ~a .............. ............ .ik'~t~hD g~ie .............................................. to ....... .~.. ~,.. t~J~J. ;L~O~D... C~.. B~.. ~!:1~ S t,,~,.~... ~,~ e~/~l:~.. ~ ....................... at premises located at ...... .~..O...t...~.~.'~. ....... .~..~.~.~.~'~..~.~;JJJ3.~...~;J~J~ .................................................... pursuant to applicotion doted .............................. .~..'~...,,~t~,.~. ....... ~......, I0...(3...8.., and opproved by the Building Inspector. Fee $....~..?...0~... ........... Building Inspector / TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. ........................................ , 19 ........ Permit No ............................. Disapproved a/c ........................ APPLICATION FOR BUILDING PERMIT Date August 6 19..6,..8. ...... 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 areas, and giving a detailed description of layout of property must be drawn on the diagram which is port 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 o 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 all applicable laws, ordinances, building code, housing code, and regulations. Ellsworth Grathwohl (Signature of applicant, or name, if a corporation) Cutchogue N .Y. /~L ~ ~> (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor Name of owner of premises E.C .Orathw. o.h..1. .................................... 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.: ...... .~...~..s..s...~..~....~.o...j:.~..~.?.Zk~No.: ...1.~..~. ............... Street and Number Nassau Point Road & Carpenter Road Cutchogue Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy d.~.~.~,;~,~l[....~...~.~.C..~.~.[~.9.~..Y...~,~, ................................................ ...... same v;ith an addition on accessory bldE b. Intended use and ~,~.pan~; . ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................. Addition ~ Alteration Z3iZ Repair .................. Removal .................. Dernolitian .................. Other Work (Describe) ........................................ 4. Estimated Cost ......~.,~.0...0..0....?.,,~,. .................................. Fee ...~,t.0..0.. (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, jf 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 .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ..... ].~, ................ Rear ........].~..~. ................... Depth ,..~..0~......~.~.~ .... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated "~," d-ist 12. Does proposed construction violate any zoning law, ordinance or regulation? ........... nO ............................................ 13. Name of Owner of pram sas .~.:..C...'.§~.~..h..K,o.~.% ....... Address ...... .q~.~.o.~..o.~.~.e. ................. Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ...... .s...~..~...e. .................................... Address ............................................ Phone No ..................... 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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW Y~)RIC, ~, t__ ~i~UI I O.h~ ~ ~ COUNTY OF ................................ ~' · ' E .C · Grathwohl ................................................................................................. being duly sworn, d~oses and says t~t he is the applicant (Name of individual signing application) above named. He is the . ~ner - builder (Contractor, ~gent, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke 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 Jn the manner set forth in the application filed therewith. Swam to before me this ................. o, ............. No,. ....... ...................... , .................................... ~~H,,,~-~ ~sgnature at applicant) ~R~ Pu commission ~p~r~ ...... / TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN GLERK'$ OFFIGE SOUTHOLD, N. y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMIS~,S UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: pursuan~ to application dated ..................................................... .....a~ approv~ by the Building Inspector. ;i Building Snspect0r Approved ......................................... ]9 ........ Permit No ......................... FOEM NO, 1 '~O~'N OF SOUTHOLD BUILDING DEPARTMEN~ TOWN GLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c ........ APPLICATION FOR BUILDING pERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in i,nk and submitted in duplicate to the Building Inspector. b. Plot plan showing location of tot 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 ~n 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 issueia 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 pt rpose 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 Buitding Zone Ordinance of the Town of Southold, Suffolk County, New h !ark, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or ~or removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buik.ing code, housing code, and regulations. Ellsw~rth Grathwohl Cutchogue N.Y. ,, ~ . : (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi.~aar, g~ara( co~tractor, electrician, plumber or builder. Cont r8 c tot Name of owner of premises ...~.?.~.:..G...z:~.~.}{.o.~t.~ .................................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ..... :~]~..~.~.s...a:.~..~.°...i..Zl...~..~ZL~]PNo.: ..]...~.~. ............... Street and Number 1g~a, ssA~4 Poln% RoAd & garpez]te~ ~oAd Oueabogu_e Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... ~.~:(.e.].~g....~...~.9.(,Le..5.~.9.~..i~.c]~, ............................................................... b. Intended use and occupancy ....... .s..~.z~.~.}~j;..b.m~.~.a`..~.~.z..~?;~.q`~.~`~.~.~:~.e...s.~.~.~.~]:~.~. ........................... 3. Nature of work (check which applicable): New Building .................. Addition 7;:Y,~ Alteration :~:~C Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ......2.,~.0...0..0.....~.,/.~. .................................. Fee ...~..,..O..C). ............................................................................. (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 additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front .....].0~ ................ Rear .......... /J.~+ .......... Depth ...j~..0./......~.~..~ ....... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ] ]. Zone or use district in which premises are situated .....~)~)!...C]~.~. ............................................................................. 12. Does proposed construction violate any zoning Iow, ordinance or regulation? ........... mO ............................................ 13. Name of Owner of premises ..~,..'..C...'.G..~..~..h..~.r,9.,~.~ ....... Address .......C.,~..~.c...b:.°.L~,e, ................. Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Nome of Contractor ...... .S...~.~..e ..................................... Address ............................................ Phone No ..................... 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 number or description according to deed, and show street names and indicate whether i.nterior or corner lot. STATE OF NEW Y~)RI(~. COUNTY OF ....... ~ .-~...z..?..o. ,.J:~ ......... ................................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ...................... ..0~f~.z'.....-.....b.~$~.~.e..~ .............................................................................................. (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 ore 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 ................. day of ....................... ......... , Notor Pub c ........ ..................... y , · .................................. .~ ~..~" . . ~ _.~nt~ (Signature of applicant)