HomeMy WebLinkAbout3723-zTOWN OF $OUTHOLD
BUILDING DEPARTMElqT
TOWN CLERK'S OFFICE
$OUTHOLD, lq. Y.
CERTIFICATE OF OCCUPANCY
No..~-...32.02 ............. Date ............... Aug'.us.t ..Z'i. ................. ,
THIS CERTIFIES that the building located at ,%3,~..H~al~.t,..lJo~.~ .............................. Street
Map No, ~,O~t'll:le~'~,, Block No ....................... Lot No...[J.~%I.~t~],~...~.~..W....~'..O.~..~.. ........................
]:orates
conform~ substantially to the Application for Building Permit heretofore filed in this office dated
......................... JI~3V~..2.7., ............ , 19..67.. pursuant to which Building Permit No. 3..?.~.3.....~....
daced ............... N~/Yetmh. er...;~.?.~ ........... , 19...62., 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 ........
..... .~r.:l,vat:e..one.,.fam:Ll, y...ct~el,1..tng .........................................................................................
The certificate is issued to ........Thomas...G,...~ynan....(~ner.) ......................................................
(owner, lessee or tenant)
of the aforesaid building.
Building Inspector J ....
· FO~ NO. ~
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
Town CLERK'S OFFICE
SOUTHOI~D, N. Y.
BUILDING PERMIT
(THIS PERMIT MUSTBE KEPT ON THE PREMISEs UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission is hereby granted to: '~
at premises located at ,..,~0.~.,~,....~.0~.~..~,~ .......................... : ..................... ; ................
pursuonrr to opplicotion dated ......................... .~ .........~ .......~...., 19.j~., and approved by the
Building Inspector.
Fee $...~..-~.,. ...........
Building InspectorI
FOKM NOol
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Approved ........................................ , 19..~.~.... Permit No...~.....Z...~...~.~......~
Application r~o .............................
Disapproved a/c ............................................................
................................
APPLICATION FOR BUILDING PERMIT
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
areas, and giving a detailed description of layout of property must be drawn on 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 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 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 and regulations.
.-., ............. > ........ ................................
~') ~r~gnafure of applicant, or name, if a corporation)
State wh~her applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
..m.o'o..ero'..em'.. ........ ......... :. ...... ................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer) f~6/~ ~/j~..£ ~/d:~ ~/~M ~ /~ .
1. Location of land on which proposed work will be done. Map.No.: .................... ~ ................ Lot No.: ........................
~tree, and Number .... Z.:....:....:... ......... ~...:......:.....:....C...>... ....... ~ ...... .O...::~:Z..:/.....,...Z.:..~.: ..........
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 ................... :; .................... .: .................................................................................
3. Nature of work (check which applicable): New Building .................. Addition .....~Alteration ..~.~ .....
Repair .................. Removal .................. Demolition ................. Other Work (Describe) ........................................
Est mated Cost ~/~...L~.~h'~/) ~ O Fee '~'~.~ 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 existingr,structures if any: Front ........y.~.~....o. .......... Rear ....~..,~..,~.~ ................. Depth ...~..?..%~ .......
Height~q.:. ~...~...d.... Number of Stories . .~ ......................... ~ ....................................
w~mens~ons of same structure with a.lterations or additions: Front ......... ~5../..~. ................... Rear ..... ~./.......~. ............
Depth .....~.../..X...~. ............... Height ~.,,~...../'.~...?.,..O.....Number of Stories ....... .z.~F~ ..........
8. Dimensions of entire new construction: Front ........ ../..~:.?r....~...?. ............ Rear ..../...~..,;...0. ............. Depth ....../..~,~...~.. ..
· ~ ~J~" .
Height .../~./. .......... Nurgber ?f Stones ........ "J~'"~:'"'}7 ..................................... ~ ......... ~ ............................................
9. Size of lot: Front .../...~...O.:.~,~. .......... Rear .../.Z~..~. ........................ Depth ,/~ ~-
10. Date of Purchase ........................................................ Name of Former Owner ........................................................
! i. Zone or use district in which premises are situated ............................................ Q_~? ..................................................
12. Does proposed construction v o ate any zon ng aw, ordnance or regular on? ..~..~.~ ..............................................
13. Name of Owner of premises 7~..~'~...5....~ ...... ..~..~..,)k'......Address ..~.../~...~..../~..~.~..¢:.~.:.~..~ ............... Phone No
.~ ~/~' ~ . ~ .....................
NameName of°f Cant ract~..4~g.....~..:../~Architect ..~, .................... i ............................ ....... AddressAddress -/~ k/'~ i i ~i~.' .' .~.~.' i i ~.' ." ~ ..................... ............. PhonePh°ne NoN° .....................
' ....................
PLOT
DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from
property lines. Give street and /~ .... /,ctd~' ~,r ~ ,, show street names and indicate
block number or description according to deed, and
whether i'nterJor or corner lot.
,jo--,, (
/
STATE OF NEW YORK,
COUNTY OF ................................
2o;° f
, /
................................................................................................. being duly sworn, deposes and says that he is the applicant
(Name of individual signing application)
above named. He is the .........................................................................................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or hove 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 Jn the application filed therewith.
Sworn to before me this ,~
Notary ~ubl~~...~~County~Am0N ~. R~,, ..... .~._v.r.~= (S.gnature' of applicant)
"~e¢~ ~xpires ~arch 30, t9 ~: