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HomeMy WebLinkAbout3683-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ~.~..~R~t~,~.Ol~. ...................................... Street Map No. .1,672 Block No. Lot No 199 conform~ substantially to the Application for Building Permit heretofore filed in this office dated .............................. .Q~..t,.~.~.~...~.~.m .......... , 19..~.7... pursuant to which Building Permit No.3.6.~.3.....Z.... dated ................... ...O~..~.]~:~...~..~., ......... , 19...~.7..., was issued, a~d conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ....... p.~.~.v. ~.t..e.....o. ~ .e....~m.~..1,~..~...e.,~%~g ................................................................................ The certificate is issued to ..F~',,...&.~.~t~.o...~a~l,~,~l..~iiltl~l~...(,Ctr~lt~$~ah~ ................................... (owner, lessee or tenant) oF the aforesa.id building. FORM NO. 2 'tOWN ,OF SOUTHOLD B~ILDING DEPARTMENT TOWN CLERK'S OFFIGE sOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUSTi~E KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THi~ WORK AUTHORI~ZED) N? 3683 Z ~ O~e ., O*~O~r ~ ,~..~.. Permission is hereby granted to at premises located at ..~,~,~..,..~,~;~..~¢0~ ...................................... .................................................. ................................. N~t,~.~.i......t~.:~. ...................................................................................... pursuan¢ to application doted ......... . .................. OC.t,....~6 .............. , 19...6~., and approved by the Building Inspector. Fee $...~e~j~ ........... ~oa~ so. I / ;~? a ~ ~WN OF SOUTHOLD BUILDING DEPARTMENT TOWN ~LERK'S OFfiCE SOUTHOLD, N. Y. Approved ............................ ~ ......... , 19....]~. Permi~ No......~-.....-.. ~ Disapproved e/c ....~~....~' ................. ......... 2 ......................... (Buildin~ Inspo~or) Application No...,~...f:...~..~ ........... APPLICATION FOR BUILDING PERMIT Dote ' (-~-~/~ ~ ~ 19..~..2... INSTRUCTIONS a. This application must be completely filled in by typewriter or in irik and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relotie~nship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn ap 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 issue ~Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progre~ of the work. e. No building shall be occupied or used in whole or in part for any pu(pose 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 O Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New Yd?rk, and other applicable Laws, Ordinances or Regu arians, for the construction of budd ngs, add t OhS or alterat ons, or fur removal or darnel t on, as herein described. The applicant agrees to comply with ell applicable laws, ordinances, build[hg code, housing code, .and regulations. (Signatur~ of' dpplicont, or name, if o corporation) .R,,Ril - Box 1~,6.~ Roc.k.Z Point, N.Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Builder. ......... Name of owner of premises .......... ..~.,....~.~.(~..l~.~..~.*...g4~II.~.~.l~..~.l~ll.t~'l. ........................................................................... If applicant is o 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.: ...... i...~..6..~.,2. ....... . ............... Lot No.: .~.~J ................ Street and Number .......... ~]~ J ' ~]}'~' J [~'' J J J~'~ ~'~][ ........ ......................................................................... ; , M~nicipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: one-story frame house a. Existing use and occupancy ..................................................... ""7 ........................................................................ b. Intended use and occupancy dinin6-roo~ exte~l,~ 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ..........~..1..~..~.0..:..0...0. ............................ Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ .o.D..9. ............. 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 .......2..8..'. ................ Rear .......... ~.~ ................ Depth .....~.],.'. ........ Height 16' ' Number of Stories o~e Dimensions of same structure with a.lterations or additions: Front . 28 Depth 33' Height .1..6..!.....'. ....... ~.~mber of Stories oD.e ............................................... YS'! ................ 12 ' 8. Dimensions of entire new construction; Front .................................... Rear ............................ Depth ..... ; .................. Height .......1...~..'. ....... Number of Stories ...... PD.~ ......................................................................................................... 9. Size of lot: Front ....... ..1..O..0...J...i ........ Rear ...... .1..~..:~.'. ..................... Depth ....],..~./%.~ ................... April 17, 1952 ame 10. Date of Purchase ........................................................ N of Former Owner ........................................................ ~ ! 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ....... N.~;~.t;%l.tu. ck. ............................ 13. Name of Owner of premises .gq.h...~..z?..l.~.@....S.-m-i..t,.h.; ...... Address ..1..9.~)....R..~..%.~....g...d.,.~ ./ ......... Phone No..~9..~.-.../t.~.Q3 Name of Architect ...................................................... Address ............................................ Phone No ..................... Nartin, Muscheid ,~,o~RR 1-Box 146~Rocky P~o.~.No...~...4..4..-..~..1...4.~. Name of Contractor ......................................................................................... PLOT DIAGRAM 11778 Locate clearly and distinctly all buildings, whether existing or proposed, and indicate ail set-bock dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate :i' "'%,hether interior or corner lot '.~A~,~_)~ I'AI~'E O~ h:E;V VC, R:~ ),c e COU NT'~,~F ................................ ~ V v .............. .~../.....,]~...~.~.i...~.....l~.~..S..O...h..e.~..d. ....................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) B~Jllder C~. ............................................. 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 ~is gpplication; 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. '~Swom to before me this .... ........................ day ...... ................. , Notary Public .~~ ....................... ~,~CoL~'ntg"'Im'";'."*:,~.#'~' Ne'~;'~'N?~"~"c;~(~i~'~a-~ure;"~"g~l~ii~'~'~'i ............................. ' ,',,',i !~ Suffolk Courlty ~ Co :,.~,.,;; expires March 30, FOI',~I NO. 1 TO~;¥N OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Yo Examined (~)~'~©-/~'~ ~.) (o 19.. ?~.~".~.~ Approved ........................................ , 19....~.~. Permit No...........................? Disapproved a/c ................................. ....... ......................... Application No. 55' ~ ~'~ ~ .......... APPLICATION FOR BUILDING PERMIT Date ................... .......... , INSTRUCTIONS a. This application must be completely filled in by typewriter or in i~k 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 qn the diagram which is part of this application. c. The work covered by this application may not be commenced befor~ issue.nee of Building Permit. apphcabon, the Budd,ng inspector wdl ~ssue o Budding Permit to the applicant. Such permit d. Upa_ri, approval of this ...... I . . · shall be kep~ on the premises ova ab e for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in port 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 is'~uance of ~ 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 alterations, or f6r removal pr demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buildihg code, housing code, and regulations. (Sig~natune of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generalf contractor, electrician, plumber or builder. Bu&lder Nome of owner of premises ........... .~...~.:.,_.a..n...d....(~..~.~..,....g...h~..,?..]:.O.~..8...~..&...t-h.. .......................................................................... If applicant is o corporate, signature of duly authorized officer. (Name end title of corporate officer) 1. Location of land on which proposed work will be done..Map No.: ].67,2 Lot No.: *1~ . Street ond Number ........... .]:.?.?.,...R.~.~..t..h....!.t.o...~..~..~....~.a..~.t.~.~.~..C..k. ...... ' ......................................................................... Municipality 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy o~®-~to~y ffl~® hot ~e b. Intended use and occupancy .......... ~.~..~..~..~-..~0..??....?.~...~.?..~. !~.~?..~.. .................................................................... 3. Nature of work (check which applicable): New Building .................. Addition ........ ~ ....... Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ...........~.~.~.]Q.,.Q.Q ............................ Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ olde ............. 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 ..... 28.~. ................ Rear ......... ~.! ................ Depth .....~.l.S. ........ ' Height...........16~ ....... Number of Stories ......... °3re .............................. ' .................................................................. Dimensions of same structure with alterations or additions: Front .......... RS.! ................... Rear ......... .1(~.~ ............ Depth ....... ~...~..t. .................. Height ....... ].~ ................. Number of Stories ..... ~1~ ................... 8. Dimensions of entire new construction: Front ].0 ~ Rear. .],0 t Height ...... ~.~'.:. ....... Number of Stories ..... ~]ne ........................................ ; ................................................................ 10. Date of Purchase ..... .A.~?.~...~.~.~...~.~.~ ................. Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... ~..[~.j..~ ............................. 13. Name of Owner of premises .~[1,1A~].~..~1.th ........ Address ~,~9..R.~i%~'-R~.r/ .......... Phone No. Name of Architect ...................................................... Address ............................................ Phone No ..................... PLOT D~AGRAM 1~778 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 c~ccording to deed, and show street names and indicate whether interior or corner lot. ~kJ ~ ~ J~ e ~k ~') ..... COUNTY ~ ................................ ~'~' - ................ 3L..~.~..}~.~.~. .............................._.....~ being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ................ ~.~.~.~ ......................................... ~..~x~. ........................................... (Contractor,-- ~-a~ent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make ~nd file this opplication; that all statements contained in this application are true to ~he best of his knowledge and belief; and ~hat the work will be performed in the manner set forth in the application filed therewith. . '~worri to before me this ............ .......... ~ - ~ ........... ~ ..... J'"X ...................................................... Motory Public .... ~......~..~.~ ...... t ............. ~O~g ~ (Si~noturo of opplic~nt) ~ ~,.~, b"'3/02125 Co~;,;,,,~.,o;; expires March 30, 19~ UnauIT~ofiz~d alteration or oclcl~tion ~o this survey is a ~ection 7209 of lbo New york 5 ot~ E-duc~hon Lc~w ' , ~ 4 ' CopiOs of this su~e~ map noi boaHng JJm kind surveyo¢~ ' ~ RuTH \ ia.? ioi' 198 NIOIF