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HomeMy WebLinkAbout3444-zFORI~ NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. C/O covers house & Temporary on garage foundation CERTIFICATE OF OCCUPANCY No..Z..339~ ............ Date .....~.~.~3~.....~.~..~ ................... , 19.~... THIS CERTIFIES that the building located at ...~n~e~l..La~e ...................................... Street Map No. 1'~O,~*",'/~1~.... Block No ....................... Lot No. 18&,l.gk....Cut~hogue,..,New...YOr~ ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................... ~,~.tet~r...:..~, .............. , 19..6~.. pursuant to which Building Permit No...~...~..4..4..4 dated .......... ~e_utembex:....:3., ............. , 1968..., 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 ........ ...pz iv.a.te...o~e.. ~am!~y... dw al lin~ ............................................................................................ The certificate is issued to ...Geo~:g~..&..F~:a~Oe~...V.e~r.~t.¥. .......................................................... (owner, lessee or tenant) of the aforesaid building. FO1L~I NO, :~ TOWH OF $OUTHOLD 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? 344~ Z Permission is hereby granted to: Building Inspecto~r. Fee ,....~....~.0...~ ........ at premises located at pursuant to applicatiqn dated .............................. ;.....,'[~.,~l.::,:~x~., 19.~..., and opproved by the ..... ~'~": ....... 7,' ~:': .................... '~'~ ...... ? ............ i~Uilaing, lnspecto~ , [ ' b dE' --' -- I x'Tf') ' ~ / ti Approved ........................................ , 19. Permit No ...................~. Disapproved a/c .................................................... ................ ................................. TOWN OF SOUTHOLD W~ ~, F~ ~ /~ BUILDING DEPARTMENT ~ ~ ~ ~o ~ ~.~ ~..~ TOWN CLERK'S OFFICE ~ ~.~,, ~ ......... APPLICATION FOR BUILDING PERMIT t),:,te ............................. ....... ............ , .... 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, housing code, and regulations. f ................... Gaor~...V. erAt~. ................................................ (Signature of applicant, or name, if a corporation) ltonsell La Cutchowae (Address of appJicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................................................... O~ne~.....huilde~ ........................................................................................................ Name of owner of premises ...... .G...e.?.X'..~.e.....~.....~..r..~.~:.~..e.?...?...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.: ....N.Q~TC)~,~ ................... Lo't No.: .1...8....~.....1..C)...~..~.1Ill Street and Number ...... ~/.~.....~l~.q.~-....~.~ ....... .~...~..~.~..~..O..~t...e.....il ........................ '. ............................................... Municipality 2. State existing use and occupancy of premises and intended use-arid occupancy of proposed construction: o. Existing use and occupancy ..... .~.l}...i['.l~l~,~....~..~..I}~l,~.l~...~.{}....1}...~...~.e...~..o.~.~. ...................................... ~; ~ new one family dwelling ,,. ,n,,nded use ond ................................................................ 3. Nature of work (check which applicable): Ne~ Building .....,,:J~.. ....... Addition .................. Alteration .................. Repair .................. Removal ................. ,. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .... ..~0.,~.....0~....0.....~....~.. ............................. Fee 10 ................................................. (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 rr~xed 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 ..3.~. .................... Depth ...~ ................. Height .................... Number of Stories ........ .1:~ ......................................................................................................... 9. Size of lot: Front .....~0 ................... Rear .................................... Depth ....20.0..~'11i~ ......... 10. Date of Purchase ................. .1..~..~...8. ............................. Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ....?[&...(],l~..~.". .............................................................................. Does proposed ~ "' constru~ztion violate any zoning law, ordinance or regulation? ....~J) ................................................... 13. Name of Owner of premises .....~..~..O.~'g.e.......~..~.Z'..~.~.~..Address .......... ..C.~.~.~.O.~3~. ............ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .....I.,,,~.~. ...................................... Address ............................................ Phone No ..................... Locate clearly and distinctly al property lines. Give street whether interior or car PLOT DIAGRAM proposed, and indicate all set-back dimensions from number or description to deed, and show street names and indicate STATE OF NEW YgRI~. . tS S ........................................... · O..~l[~....~'..~.~.~..~.~....;;;.'...:;..i;~.'!.;[being duly ,~wom;','depose~xand says that he is the applicant (Name of individual signing application) above named. He is the ....................... 0~¢1~' ..... .1Dll~:~3,~l,e.~ ............................................................................................. -, (Contractor, agent, corporate officer, etc.) of said owner or owners; and i's' duly '~ ' ' ' au}hbrlzed to perform or.heVer;Perfb~ed the said work and to make and file this application; that all statements co-rain, ed! in.this c~plicatipr~ oret true to the best of his knowledge and belief; and that the work will be performed in th~ h~dnn~r set Jo'rth" '=~ ~ "' ' ' m the appl[cat~on filed therewith. Sworn to before me this ................ ...... .............. ...... .......... , ..... ............................. NOTARY PUBLIC, State of New York No. 52 3233120 Suffolk County Term £xpi~es M. arch 30, FOigM lq'O. I TOWN OF SOUTHOLD EUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ......................................... 19..L~....Permtt No .... ..~...~,~ Disapproved a/c ~- Application No..~.~TeX.~ .......... APPLICATION FOR EUILDING PERMIT 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 propertymust 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 0r demolition, as herein described. The applicant agrees to comply with all applicable lows, ordinances, building code and regulations. (Signature of applicant, or name, if a corporation) ........ .................................. (Address of al~i~ant) State whether applicant is owner, lessee, agent, archifect, engineer, general contractor, electrician, plumber or builder. Name of a~ner of premises .~,~..~-.,,,,),.~,- ............................................ I ................................................................ 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: ..... /,.,~, .,'~..~,'~,. ....................... Lot No: ,~.~,. ,~,,./,..,~... Street and Number :...~...P..~.~--IJ. ........ L.d...~. ........................................................................................................ Municipality 2. State existing use and occupancy of ~orernises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....L.L ~i[.~..~( ...... T/~....U. · · .~'.. ~...~...~ .e'...5.. ....... ~,~ ................................................................. b. Intended use and occupancy ..................................................... r..% .~..~....;;.~...~........~.....~. ......................................... 3. Nature of work (check which applicable): New Building .................. Addition ..~ ............ Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost .!..~...q...O..:..o...o.. ....................................... 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 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 .................................. 10. Date of Purchase /~' ~... Name of Former Owner ~'/a(~:~} 11. Zone or use district Jn which premises are situated ................................................................................................. 12.' Does proposed construction violate any zoning law, ordinance or regulation? ./~.~ ............................................... 13. Name of Owner of prem ses~.~..r. ..'.~.~,....,~c~,~.;.¢,t-. ...~...~d~ress ~ (AK.~.~I~..... . . ... .....~¢,~...?.~.:.. ..... Phone No. 23.~..' ~:~.~.. ..... . Name of Architect ...................................................... Address ............................................. Phone No ..................... Name of Contractor .................................................... 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 numbers or description according to deed, and show street names and indicate whether interior or corner lot. ? ~ ,~ 'o~ ,~/ ~./ ............................... ...... om, (Name of individua~ signing app~ication~ above ~med. He is the ............... ~..~ ....... ~~ ................................................................... (Contractor, agent, calorie officer, ~c.) of said owner or ~ne~, and is duly authoriz~ to perform or have ~ormed the said work and to ~ and file this application; that all state~nts contain~ in this application are tree to the ~ of his kn~le~e and belief; a~ that the work will be peffo~ in th® manner ~t fo~h in the application filed ther~ith. Sworn to before me this ~ ~ ~ ~ ~ / ~ ,,,9~. .............. ........... .......... ., ..... + ~ - ~ ,~ g~ ~ ~ ......... ~..~~~ .................................... ~oto~ Public,~l~ L~-~.~.~.....~..~.. l~.~ O~ ~ a:e.P~. ~ ~ ~°r~' ~m0 ~.C°un ~[~[~' {~n~tur~ B{ oppli~nt)