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HomeMy WebLinkAbout4985-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Occupnncy No. z!+2032[ .... Date ...........At--il...22 ...... ,19..~.1 THIS CERTIFIES that the building located at . ~S/S. J.oeke~ .Ck. Dr~.v® ... Street Map No... 3~X ...... Block No ....XX ....Lot No .... XXX ....~e. uthol5.. I~.,¥. ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...........0ct' ' '~ .... , 19 70 pursuant to which Building Permit No...1+98~ dated ............Oct- - - · 3' '" 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 .. Pr&Fate .&ecessoz-j .bu.$1dSng ....................................... The certificate is issued to ... S..,I.¢ea~&d3r ..... 9waer ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .... 5.R o ........................... // House 1.~80 ......... ........... TOWN OF SOUTHOLD BUILDING DEPARTMEN'r ~: TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISE~ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4985 Z Permission is hereby gronted to: ~' ......... ~..,,'.~.q.e~.~. .......................... ................. · ........ ~.e~O~...~. ~ ........................ : ................. .............. 8.~2~t ............. ~ ............... ., .............. to ;~.~.~...~.e.~..a~.~.e~.ao~.~.:....(~.~.~r~ge.. ~)...i'. ......... ,.~....~.~ ..................................... at premises located at ..................... .~.it~..,.,~O.~ '~-..~,~ ............ :.~ .....~.. .............. ; ............... pursuon¢ to application dated ................................; ............... , 19 .... an approv e Building Inspector. ' ¢ Bu~(d~ng inspector ~NO, I 'TOWN OF soUTHOLD BUILDING DEPARTMENT ~ TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. Examlm~:l ........................................ o . . ~pproved ........................................ , 19 ........ Pe~it No. .. Di~pp~ed a/c .............................................................................................. APPLICATION FOR BUILDING PERMIT Amlication No. C('/~.~'~ Date ................. Oc.t;ol~e;~.....,.~. ................ , 19....7.0,.... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, r~lationship to adjoining premim or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which It part of thio 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 o Building Permit to the applicant. Such permi 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 pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lay4, Ordinances or Regulations:. for the construction of buildings, additions or alterations, or for removal or demolition, el herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. S. J. Conrady (Signature cf applicant, or name, if o carl:rotation) ........... · T~ckair..Ek.D~.i.va ....... ~%outhc~].d. ....................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..~.A~T.P.(~.9,B~'9,~. ....................................................................................................................... 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.: ....4~f- ............................... Lot No.: ~ ................... Street and Number ......... ~/.$.....~D.~:~....~:..~' ..........$.Q'~l.thp'l~ ...................................................................... ]~/-- /,.~ ~ ~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ~.e...~..];..~..~.$. ....................................................................................................... b. Intended use and occupan? . ............ .s,..a.~.e...~...~...a.9.~.~,~.l~.9.~..Z..~.t~,T.~g.~,..)?.]~e:R ............................. 3, Nature of walk (check which applicable): New Building Z3I:Z~[ Addition Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) ................................... 4. Estimated Cost .................. .1..0.(~....+. .............................. Fee .........~.~..~. ................................................................. (to be paid on fi'.ing this application) 5. If dwelling, number of dwelling units ........ ~i.Q~ .......... 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 8,..~..~...e.~..$..o...z~. ...... 7. Dimensions of existing s~ructures, if any: Front, ........................... Rear ................................Depth ......... Height ........................ Number of Stories ........................................................................................... Dimensions of some structure with alterations or additions: Front .................................... Rear ......................... Depth ................................ Height ...........................Number of Stories ................................ 8. Dimensions of entire new construction: Front ............. ~ .................... Rear ...........~ .............. Depth ...... *~0 ............. Height .................... Number of Stories ........... ~l~ ................................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ....................................................... # 1 ]. Zone or use district in which premises are situated ..... r~...C~J. 8~ .............................................................................. 12. Does proposed constructlon violate any zoning law, ordinance or regulation? ............. Zl~ .......................................... 13. Name of Owner of premises ~,rT.~J~tt~'~,~. ............. Address ............ ~O~l.f,,J/O~,Cl. ............. Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No .................... Name of Contractor ..... .8...a;.;[i...e. ..................................... Address ............................................ Phone No .................... PLOT DIAGRAM Locate clearly and distinctly oll buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block number or description according to deed, and show street names and indicm'e ~hether interior or corner lot. STATE OF NEW YORK, t S.S COUNTY OF ..~.fo~ k ............ $ · ................................................................................................. being duly sworn, deposes and says that he is le appJicant (Name of individual signing application) above named. He is the ................ Ock'Z~:~ .................................................................... ......................................................... (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 this application; that all statements contained in this application are true to the best of his knowledge and belief: and ti,ar the work will be performed in the manner set forth in the application filed therewith. Swam to before me this ..................... day of .................. ............... , j'/) .... ~ ... ELIZABETH ~NN NEVILLE ~ ~ v NOTARY PUBLIC, State of New ¥~rk No. 52-J]25850. Suffolk Coun. Jy_ Term Expires Mm*ch 30, 19_,~