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HomeMy WebLinkAbout3378-zl~)l%IVl NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOU'i'HOLD, N. Y. CERTIFICATE OF OCCUPANCY No ~..~O~0 ............. Date ................... ~ ....... ~.,],~ ............... , ]c).~.l~... THIS CERTIFIES that the building located at ......... .~'~.~..q.]¢,....A...v..~..~.u...e. ............................... Street Map No. ~o.~,...~aD.d Block No ....................... Lot No. _~?.&.SS.,...C.u:l;.ChQgtze~...NP..~...]~O~7~ ........ Sec. T'r conforms substantially to the Apphcahon for Budding Permit heretofore filed in this off,ce dated ...................... Ee.br. uar. y..~D., ............... , 19.~51.. pursuant to which Building Permit No .~3.~.7..~...~. dated ............ ~'.e~zu~. 21~ ........... , 19~? .....was ~ssued, and conforms to all of the requirements of the apphcable provisions of the law. The occupancy for which this cerhficate is issued ~s ........ ................................... 5~ r.~,Y ~ t,.~... ~.~.~g.~. ........................................................................................ The certificate is issued to .......RXch~'cl. F.,...D:z:ake.~...cr~tl~,r ...................................................... (owner, lessee or tenant) of the aforesaid buildmg. FORM 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? 3378 Z Permission is hereby granted to: ...... .~.:...~,..~....c..o...a. ~..t..r......~...C....~..h.~..~_d....~T.~.e .............. ~...~.....o..~...~ .............................. ................ ~,.t& 0:~.~ ..~. ,.~.... ........................... to ~.~..a....~...~.....~..~..a.~...~.a..~.a..~?.~.(~!~..~.~.~.¥..a..t..~.....a..~ ~.,e.~.~.o.~..~.z.~ ...................... Cuteho~ue ~ l~.~. pursuan,t to application dated ....................... ~,?~:......?:.0.. ................. , 19.~.?....., ond approved by the Building Inspector. Fee I'OR~I NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ........... D~sapFroved a/c ................................... ~_.. .. .................................................................... 'Z"'7 ........................ :: ............... .................. .......... ................................... (Building lnspectd() Application No. ~ ~ ~ ~- APPLICATION FOR BUILDING PERMIT ........ ....... .&...o... ............... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted m duplicate to the Buildit Inspector. b Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giwng a detailed description of layout of propertymust be drawn on the d~agram which is part of this applicatio c The work covered by this apphcat~on may not be commenced before ~ssuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Su, permit shall be kept on the premises available for inspection throughout the progress of the work. e No budding shall be occupied or used in whole or m part ~or any purpose whatever unhl a Cert~f,cate of Occupan. shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the ~ssuonce of a Building Permit pursuant to tl Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances Regulations, for the censtruction of buildings, additions or alterct~c~s, or for removal or demolihon, as herein describe The apphcant agrees to comply with all apphcable laws, ordman , building code an regulations. 'T\- ';'f'~; i ..... \ _.... ,.,~..-- ....... .';:Z'~'"':"i~a'~;;'~i:'a"~'~i','~nt"T ........ " .......... State whether appli.~ont is own~r~ lessee, agent, architect, engineer, general contractor, elJectrician, plumber or buildc ............................. ~...e.n.~.~.~....~.. ....... ..Oe....o...~..!~..¢..~..~ ................................................................................... Name of ow,er of premises ....... ~..'.'..C...6.~...~..0 ............ .~T...,.....~....~../<.C-- .......................................................... If applicant ~s 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: ~..~...~ ....~.......s~.~.~ Street and Number ......... ../.~...~..~.(?....~....~......z~.......~.~..~...~...~..~¢ .................................................. Municipality 2. State ex~sting use and occupancy of premises and intended use and occupancy of proposed construction: e an n ................................... .~..,..~.~ .,'~...~. "..'"~7..' ......................... °/a-~a~//' ~ o Existing us d occupa cy ,~,.. ,~ :~. b. ,nt,ended use and occupancy . ..-~..... ...... ...~....~..,:.F.~...~...'/...~. ......... ..~.~,~..i..~....0..~?..~....~....~.~..~...~.~:%,' .................... 3. Nature of work (check which applicable): New Building .................. Addmon, :./~.. ............ Alteration .................. Repair .................... Repgoval .................... Demolition .................... Other Work (Describe) ...................................... tZ.v 4. Est,mated Cost ............. ./,~..~...a. ................................. Fee ............... .~..:....c5'....~, ........................................................... (to be paid on filing this apphcation) 5. If dwelhng, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars .......................................................................................................................................... 6 If busmess, commercial or mixed occupancy, specify nature and extent of each type of use ................................ 7. D~mens~ons of existmg structures, if any' Front ..........................Rear .......................... Depth ............................ Hmght ............................ Number of Stones .............................................................................................................. D~mens~ons of same structure w~th alterations or addmons. Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stones ........................................ "~'! ......... '~.......~..,.,.~.... Depth ,~.. 52- ~ 8. Dimensions of entire new construction' Front ........ ~...(,,~¢'.i ....... Rear ............................ Height ........................... Number of Stories ............................ 9. S~ze of lot' Front ............................ Rear ............................ Depth ................................ 10 Date of Purchase ........................................................ Name of Former Ortner ....................................................... 11. Zone or use district in which premises are s~tuated ..............................,(."/'J .............................................................. 12 Does proposed c°nstru~°c'a;__-'r"P,_ _vi°late any zoning law, ordmance___. ,, __ ~/_,ar regulation? ..................................................... 13. Name of Owner of prem'i~,es .J,~..~;t./(~' ...................... Address .-'~...~...~...c../..x'.....~....°..~'.~......~..:.../5...~ r:~n~-r~e No .................... Name of Architect ...................................................... Address ............................................ Phone No .................... Nome of Contractor ~.x(-~:.~.f2~.~..`~C/~cc.~.!~ddress~/...~..~.~.~.~.~.'w~.`~.~...~.'~ Phone No.."~....(~...~....'ZZ. PLOT DIAGRAM ' f Locate clearly and distinctly all buildings, whether ex~sting or proposed, and indicate all set-back dimensions fron property lines. Give street and block numbers or description according to deed, and show street names and ind~cah whether interior or corner lot. STATE OF NEW Y~I~RK, ?. COUNTY OF ...... .~:.~....17.~...(.~(~../ SS. (--'} /] ~Z ..'.2'.._ ~ ,.~. [~r ...... being duly sworn, deposes and says that he s the app ca, ................ --~'¢~''' ~"~ .............. t'U ..... ~". ..................... above no' med. He is the ......... <"r~'-', ......... ~ ......................................................................................................................... (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 fl th~s applicahon, that oil statements contained in this application are true to the best of his knowledge and belie and that the work wdl be performed in the manner set forth ~n th~application filed therewith. Sworn to before me this (/ ......... ~<...(~ ..... day o.f ...... q~...~ .............. , 19./.,-~ "~_ ~/~') ~.-- Notary PuN,c, :..,..~,~~~.,4~._°;.~..~.,,#~.,, Cgunt~"'"'Y/~f ...... 7'":'"'ig'i'~'~'~'r;~" ......................