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HomeMy WebLinkAbout5343-z FOR~I NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENt TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES COMPLETION OF THE WORK AUTHORIZED) UNTIL FULL N? 53 3 Z Permission is hereby granted to: ................ ~ :j.2-.- ~.,~ --~t~y.i~ ............. ..................... ~e3,c~.~ ......... ~ ....... ~ ................. to .... ~?~.~,:~L.~.~?L.~.~..~.~...~;~J,~...~..~'~.:LL':.,~2. .................... ~ .......................................................... at premises located at ............. ~.~.~..~. .......... [,Qt~.~.~...~?j~t~'~..~¢~ ................................. .......................................... .~).~ ;~m~.r...:,L~. ............ ~'.~::l, ............ ~.~;~,, ................................................ pursuan¢ to application dated ......................... ~.t~..~¢~ .......... :iQ .......... , 19.,~.'[., and approved by the Buildin~ Inspector. FO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's O~ice Southold, N. Y. Certificate Of Occupancy No.. zl+38.1 ..... Date ...... ..... aep~ ..... 1'3 ..... , THIS CERTIFIES that the building located at .. Delma~ .Dt~ve ......... Street Map No. Lau,. Cty. E~loek No .......... Lot No. ~]...... I~urel...l~,Y, ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ June .. lO · · . , 19 7~. pursuant to which Building Permit No.. ~ dated .......... J%llle ....lO , 19 7~., 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 ....... Pl~iua%o. one. family -dwelling The ceziificate is issued to . ~[nlancl. Homes. [[1t~. · Owll~l~.,· .ba.l~ld~l' ............. (owner, lessee or tenant) of the a~oresaid building. Suffolk County Department of Health Approval · ~ept';' '13' '1'9~1'' 'by' R.' ::Building Inspec[or ........... S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH TO WMOM IT MAY CONCERN: The sewage disposal facilitigs for a structure located / (Give deed location) have been inspected by this department and found to be satisfactory. TOWN CLERK'S OFFICE ali Approved " " , 197~/... Permit No....~(~..~(.~...~ Disapproved a/c ................ (Building Insl~ector) ' APPLICATION FOR BUILDING PEP-d~IT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ir)k and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relatibnship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn c~n the diagram which is part of this application. c. The work covered by this application may not be commenced befor~ issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue b Building f?ermit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progrej~s of the work. e. No building shall be occupied or used in whole or in part for any purpose whate~,er until a Certificate of Occupancy shall have been granted by the Building Inspector. : APPLICATION IS HEREBY MADE to the Building Department for the i~suance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New YSrk, and other applicable Laws, Ordinances or Regulations for the construction of buildings, additions or alterations, or f~r removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinan]es, building cad, e, housing code, ~nd regulations. (Signature of applicant, or name, if a corporation) ~ ....... : .,*., (Addre~ of applicant) ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is o corporate,, signature of duly authorized officer. ~ ~ ~/ ......... · ~ (Name and title of corporate officer) ~ ~ . I. Location of land on which proposed work w,'l be done. Map No.: ...r .~/~..! ............... ~ ........ Lot No.: ....~.~../. ............. Street and Number ................................................................................ /~ ~ ~ C-] ~'~) Municipality 2.State existing use and occupancy of premises and intended use ant occupancy of proposed construction: a. Existing use and occupancy ...... ~/..~?~-,..-~/?'......~; .................... .....~ ......................................................................... ,ntendeduseandoccupancy Z " ~..~/.~..'1 .................................................................... 3. Nature of work (check which applicable): New Building v' Addition Altera.tlon Repair .................. Removal ........,, ......... Demolition .................. Other Wor!.~ (Describe) ........................................ 4. Estimated Cost ....~..~...~..O...0.. .................................... 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 .....3~..~;...~.. ............. Depth ..~....~.: .............. Height ....~/.~ .......... Number of Stories ,.~-- 9. Size of lot: Front ...~/..~...q .............. Rear ...... Z.~...~... .................. Depth ...... ./....~.....~.. .............. 10. Date of Purchase ..........~':tl~'.~. ................................ Name of Former Owner . .~...~..~..~...~.r....~.-.~.)..~.~..'~...~.~f. ........ ! 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed constructibn violate any zoning law, ordinance or regulation? ....~..0.. ................................................ 13. Name of Owner of premises Z/I~],../~..~.0..~..~F'~. ......... Acldress'r~,.l~....~.....r~...] .................... Phone No.'/.~..~.?...I~...~Z. 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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~,c e COUNTY OF ................................ ....................................... beino duly sworn, deposes and soys that he is the oppIicant (Nome of individual signing application) abow~ named. He is the .............................. ~~__,~ ............................................................................................ (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 that ~he work will be perfor,~ed in the manner set forth in the opplic~tion,~filed th)~re~'~'h. Swpr~ to I~efore me this 1] ,-v, Notary ~rt. flledw~th~l.~., · k, .CA Examined ............ ~ ......... ; ................ , 19 ........ TOWN OF SOUTHOLD ~U~LDING DEPARTMENT TOWN CLERJ('S OFFICE $OUTHOLD, N. Y. Approved ........................................ ~ 19 ........ Permit No. Disapproved a/c .,. ,;5.;>, '~.,.,~..~ ~,~ , ....... , ........ ~.,.A..:...,~.,..~;.~ .............................., ........................ (Buildin~ Inspector) Application No .... APPLICATION FOR BUILDING PERMIT Date .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buiiding inspector. b. Plot plan showing location of lot and of buildings on premises, relcJtlohship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn or~ the diagram which is port 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 throughou~ the progtes~ 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 issbance of a Building Permit pursuant to the Building Zone Ordinance of the Town'of $outhold, Suffolk County, New Yoj'k, and other applicable Laws, Ordigances or Regulations, for the construction of buildings, additions or alterations, or fo~ removal or demolition, as herein aescribed. The applicant agrees to comply with all applicable laws, ordinanges, building cod~, housing code, ~nd regulations. · ' ......... ............. ......... ......... .... State whether applicant is owner, lessee, agent, architect, engineer, general ~ontractor, electrician, plumber or builder. Name of owner of premises ~-~ .; .... tf opp$icant is o corpara, t,e~ signature of duly authorized officer. ...~.~¢~,~...~'~.>,:~/~.~... ...........................~,..-~ ~. , (Nome and title of corporate officer) 1. Location of land on which proposed work will be done. MapNo.: .~' ~/~.. :..~.~..:. ........... (.' Lot No.: ..%.~. .............. Street and Number ...~¢:...~Y.f..~.~....x~......~:..~....:~....~,.¢~.,,~..-¢~.. ....................................................................... Municipality 2. State existing use and occupancy of premises and intended use and 6ccupancy Of proposed construction: a. Ex~stlna use and occupancy ...... b. Intended use and occupancy ...... /...~ ~(~(~,' / · ' ' ............... ~ .................................................... .... ,, wo~k (check which applicable): i,,,w Building ........ ~ ........ Addition .................. /\liera.tion .................. Repair .................. Removal ......... ; ......... Demolition .................. Other Work (Describe) ........................................ O ............................................ ¢ o~ ' ..,. Fe /~2 4. Estimated Cost ....~....;I e ....................................................................... ! (to be paid on filing this application) 5. If dwelling, number of dwelHng 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 ....J.~.. .......... Number of Stories ........... :.,.......~, ......................................... ¥.~ .................................................... Size of lot: Front ...~/..~.Lq .............. Rear ...... /.*~..'.~.~.. .................. Depth ...... ./...'.~.. ................... , - 9' Date of Purchase ..........~..,~,.r. ................................ Nome of Former Owner..~...~.~..~...~'.r....~.~.~?..l:~.~.',~.~.'.'~f. ........ 10. 11, Zone or use district Jn which~' premises are situated ................................................................................................ '"'"'" """' 12. Does proposed constructibn violate any zoning law, ordinance or regulation? ..../~....~ .............................. : ................. 13. Name of Owner of premises 2.//2)~..~..~.~..~..~!..~.~. ......... Address ~,=-~,.~....~.~.....r~...] .................... Phone No.'/.~..Z'..Z...~...~.~. Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indica{-e all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner Jot. /V STATE OF NEW YORK, ~ ¢ e COUNTY OF ........................... .... .~.~:.~J,,.¢~..(~.~,,,,~ ................................... 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 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 Ihat lite work will he ~erformed in the manner set forth irt the apI)liq¢LtiOn filed ilTare~th. / - ,~A~Y ~l)Ll~, q, ~ , / ~ ~ ...... ~ ......... g ..................... : ............................... Nlotar~, Public ~Z~'-~o&S~'~3~S~ ~/~.~.. County' (Signature of apphcant) " ' '' .......... ~;/~tlt{ii i.'~'~' Z'Z .... FOltM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.. ,T~38.,I ..... Date ........... aep'~ ..... t3 ..... , 19'~'"1 THIS CERTIFIES that the building located at .. De~ .Dr~ve ........... Street Map No. La~l.. Cry. g~lock No ........... Lot No. ~l ..... L~®i · .l/o~. ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ Jul~ .. lO... , 19.7¶. pursuant to which Building Permit No.. ~ dated .......... J~ln® .... 10.., 19 ~l, was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ....... ~r~v&te- ~e. £1~y- dwelling ................................. The certificate is issued to . Xlkl. an~ .iii®re. Ye.. O~el,.o. t~[ld®l, .............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · 8®pt' · '¶3' -l~)?¶. · 'by' 1~ 'Via:l:&' · · Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Bldg. Perm$C No. TO b~HOM IT MAY CONCERN: The sewase disposal facilities for a structure located (Give deed location) have been inspected by this department and found to be satisfactory. ~h~.ef of G~eral Engineering Servlc~$ Disapproved a/c ................ ~ APPLICATION FOR BUILDING 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 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. NoJ~uilding shell be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall hdve 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 gf 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 cod~e, housing code, ~nd regulations. (Signature of applicant, or name, if a corporation) (Addre~ of applicant) ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....... ~.~..~.~.~. .......................................................................... If appJicant is a corporate_ signature of duly au~thorized officer. · - .. · .......... (Name and title of corporate officer) on we: wi,, · Street and Number ...~..~..i.~ ............................ : ........................................ /~ .~ / Municipahty 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~..~4,w~n~...:/.:~_ ............................ i ......................................................................... 3. Nature of work (check which applicable): New Building ........... Addition .................. Alteration .................. Repair .................. Removal ....... .~ ......... Demolition .................. Other Work (Describe)'. ....................................... 4. Estimated Cost ....~,~.~.i....~...O...D.. .................................... 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 .....~r...?.. .................. Rear ......~...:..~.. ............. Depth ..~...~.:. ............. Height ...../.~ .......... Number of Stories ,~__1 Size of lot: Front ...~/..~...q .............. Rear ...... /.~..~.. .................. Depth ......./....~.....~.. .............. .- 9. Date of Purchase ......... -- ~ ................................ N~me of Former Owner . .~....~...~...~......~...~..~r....~..?..~.5~.~. ........ 10. 11. Zone or use district in which"' premises are situated ..................................................................................................... 12. Does proposed constructibn violate any zoning law, ordinance or regulation? .....~.....~. ................................................ 13. Name of Owner of premises J~/J~),../l..~.l~..~..~..~.....~ ......... Address ~l~.l~....i~.....r~...; .................... Phone No.7.3.~T...'~...~..7.. 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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW' YORK, COUNTY OF ................................ .... .~/~.~ .................................... 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 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 that the work will be perfor, Rned in the manner set forth in the appliggtion,~filed thj~re~"j~n. Swp~ to I~efore me this { J ,-~. _ ..........................