Loading...
HomeMy WebLinkAbout5107-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupnncy No. Z~3~.3 ...... Date .............. AtlgUSt. 25, 19 7~[ THIS CERTIFIES that the building located at .. Jackson .St .... Street Map No. X~. ...... Block No.. ~ ..... Lot No. XXX .NeW 8uff. olk lf,Y, .... conforms substantially to the Application for Building Permit heretofore fried in this office dated ....... No.~ . 2~. , 19 70 pursuant to which Building Permit No. ~IQTZ.. dated ............ D.ec 21 , 19..~.0, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is. Private garage .(accassor~r) bullc%ln~ ............................ The certificate is issued to .. James. ]4a.nv~:~ng & Wife 0wn~s .............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . .,~,t~, ....................... Ho~se 1370 Building InspectorI TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLI:-flON OF THE WORK AUTHORIZED) -N? 5107 Z ~ Permission is hereby gr~nted to: ............ ea~et~e .............................................. to ....... ~..i~.~~-.~~.-g~aSe ................................................................... at premises located at ......... ~J'"~ll~l~!~"~ ................................................................................. .............................................................. i~mr .,~~ ...:...l~X.~. ...................................................... pursuant to application dated ............................ ~ ....... ~ ............ , ]9~.., and approved by the Buikting Inspector. ~J~li~ J~ Jill AJ~JlilIJ~Ij D~JJ 'j~j~JJlJ ~:~ ~....F,Oe ........... ~, Building I~'spector J FOR.Bi NO, J. 'I'~WN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No....~'.,~..~..~. ............ ~ ,, ~"/o ?~__._ Approved ....... ..~........'~...! ........... , 19 ........ Permit No ............................. Disapproved o/c ...... Z~..?...c~...~.....~.,~...~. ..... ~.,.~..~..~ ...... ~ '~' '~-~- ~' ~ ~ d~F ~ -J ~ ............. ...... ......... .......................... ................ ................................. APPLICATION FOR BUILDING PERMIT ate ......... ...... ......................... , INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted irt d~plicate to the Bulldin Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining p~emises or public streets, areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this applicatio, c. The work covered by this application may not be commenced bsfore issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such perm 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 Occupan, 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 t~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, on.d other applicable Laws, Ordinances · Regulations, for the construction of buildings, additions or alterations, or for r~,~r~al or demolition, as herein describe The applicon, agrees ,o comply with ell applicable lows, ordinan~,s, buildin~a~,,~ho,using code, and regulations. ......... ..................... (Addre~ ~ appllcant) ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build= ~-, r. ~, ,-'.,'-' \ ' Norne of owner of premises :~~:~:~..,.,~,~ ........................................ If applicant is a corporate, i (Name and title 'of corporate officer) 1 Location of land on which proposed work will be done Map No.' ...... ~ ........................... Lot No,: ,,.,"~, ............... Street and Number ....~/~.5:.~~,..~" ....... )~.~..,~.....~.,.,~.";~,., ............................................ U q ~ Municipality 2. State existing use a,nd occupancy of premises and intended,use and occupancy of proposed construction: a. Existing use end occupancy .... ~ .(..~.?, · ,'~.,., ~ ~::~./. ·..../..~.?..~. ,~ ..................................... ~ .............. '~i ..... b Intended use and occur.an ............... ~.~,v .................. ?~ ........................................ ...~..... ..... property lines. Give street ant whether interior or corner lot. block number or descnpt~on according to deed, Repair .................. Rems,vol .................. Demolition .................. Other Work (Describe) ......................... 4 Est mated Cost ................. ~...4?Zf~. ............................ Fee ...................... ,~ ................................................. (to be pa~d on filing th~s apphcat~on) 5. If dwelling, number of dwelling units ............................ Number of dwelling umts 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 exist,ng structures, if any: Fronf ...... ..~....~-~'... .......... Rear .... ..~....~ ............... Depth .,~ ......... Height ........ ~....~..f ....... Number of Stories ......... ~!::..~.....~.. .................................. ~, ................................. ~ ........ Dimensions of same structure with alterations or add,tions. Front .... ----..L~._~... .................... Rear ...~...'~" . ......... / Depth ...... ..~..,.~...?. ............ Height ,../..~(. .................Number of Stories ...... ~ ............. 8. Dimensions of enhre new construchon: Front .................................... Rear ............................ Depth .. Height .................... Number of Stories ......................... } ......................................................................... 9. Size of lot: Front ...... //...~ ............ Rear ........ /......(~... ............... Depth ...................~ ......... 10 Date of Purchase ....~.~...' ...... ./..?...7../... ~..~,.~.. ..... Name of Former Owner .../..~.:Z.:..~.-~~,~ ......... ! 1. Zone or use district in which premises are situated ................. '.~, .......... : ................................................................. 12 Does proposed construct,on ~olate any zoning Iow, ordinance or regulahon:~ ..}~tz.....Z-TT]~...~..-~.......-'.. ..................... 13 Name of Owner of premzses ..~ Address one No Name of Architect .............. .~ .................................... Address ..................................... Phone No ............... Name of Contractor ~.~.~.'. ............. Address ...~..~.:~,T.,.~.:y.:. Phone No .............. PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether ex~sting or proposed, and ind,cate all set-back d~menslons fro nd show street names and ind~ca STATE OF NE'¢~ Y/~RI~,~ 1... ~ 6-f~; ........ C COUN~ OF~ ........ '~~T .... ~'' ~' (Name of individual s,gning appl~.. ~ . above named He ~s the ........................... ~.:.~~~ ........................................................................................ (Contractor, agent, corporate officer, ~tc.) of sa~d owner or owners, and is duly authorized to perform or haw performed the sa~d work and to make and this application; that ~11 statements contained m th~s apphcahon are true to th~best of his k~wl~ge and belie~, a tF,~t the work will b~ performed in the manner set fo~h ,n the applic~ fiJe~h Swomtobeforemethis ', ~~ ~~. .... ....... .......... , ....... ..........