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HomeMy WebLinkAbout5416-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy THIS CERTIFIES that the building located at . Delmar. Dx'.tv® ............ Street Map No. I~tl~e].. 13ou~l~ll~l~l~t~tes ...... Lot No .... I~ ..... Laurel...!~ oI[.,. ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ J'~l.,Y .... .9 19.7.i. pursuant to which Building Permit No..~'~1~. dated ......... .J..u.~. y. .... .l~. -, 19.7.1., was issued, and conforms to all of the require- ments of the applicable provisions ~f the law. The occupancy for which this certificate is t~oded is pl'i.~a.t~ ..~.e f~!.l, lr..~.~.~.~.l.i.ng ...................................... ertificate is issued to . .~l~a~ud. tiomea .Inc ...... 0wr~er ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Dee. 8.19.7.l.. bt~ .R°. ¥.illa ........ liouse ~ 1 ~0 .... / ............ Building Inspect br FOII~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMI$1~$ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5416 Z Permission is hereby granted to: · . ..Z.~..~..~.ft...~.e.m~,~.....~.~ .................... .............. .~$2.....tf&~l~...C~tm~...lll~ ........ ................ ~.e3.~ ......... .~*.%* ............ ~ ................. to ~Z~.~e~ e~e ~..Z~....&.~..e..z..z..~ ........................ .............................................. · ............................................................................................... ~t premises locoted <~t ........ ~ ................. ~. .............. ; ...................................................... ~ .................. b.e3~a:~..,t)~.i.v~ ......... Z,a~e& ..................................................... pursuant to application dated ....... ~?*~.......lk~. ...... h ·., 19..~..~.., and approved by the Building Inspector. Building nspector ~k S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a (Give deed locatio~) structure located ~'-&7' A-~T~-'-~ )-.4..u~L . /D. ¢ / / have been inspected by this department and found to be satisfactory. OEO 8 Chief of General Emglneertn~ Servlce~ 197f /c ia" Approved ........................................ , Disapproved a/c .......................................................... ......................... ~.~.....:./~ ................................. ~uu, ,a,ng ,nspTrJ APPLICATION FOR BUi~LDING PERMIT TOWN OF SOUTHOLD BUILDING DEPARTMENT ' ~TQWN CLERK S OFFICE SOUTHOLD, H. 19 ....... Pemit .............. ........ 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 premi'ses, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty 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, ordi nances, building cede, housing code, and regulations. .................................... : (Signature of applicant, or name, if a corporation) / (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............. .~.~.,....~....~...~..~.~.~.~.~.>: ....................................................................................................................... If applicant is~ corporate,/.~gnature of duly authorized officer. {Name~Sd Htle of corporate officer> ~. c~ot~on o* ~a o~ ~ pr~ose~ wo~k ~i, bo ~on~. ~p ~o.~.~.~...~.ZL. ~t ~o. Street and ~umber ...~..~.~...~. ......... ~ ............. ~.~ j. ..... ............ ~ .......... ~ / ~ ~ ~ ' Municipali~ ......... 2. State existing use and ~cupancy of premises and intended use and ~cupancy of pr~osed construction: a. Exisiting use and occupancy ................................................................................................................................. b. Intended use and occupancy ......... ~/~?~/~/~.~(~/~ ................................................ 3. Natb~6'of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ....... ~..'~,..~....~..~.....~.'~.. ......................... Fee /0. ~ / (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 .................................................................................. j ................................................. ~ ........ 16. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ Dimensions of existing structures, Jf any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of slame structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ..................... ~.~Jq~ber of Stories ............................... 8. Dimensior~ (~6 entire new construct on Front ~ .~..~. . Rear ..~..-~..:.....~'.. ........... Depth ....'~..~.' ............. Height ................... J ~hgFlber of Stories ......7.~,~..D ...................................................................................................... 9. Size of lot: Front ............. .7/.4/.~./ Rear .................................... Depth ....../.5'......~.. .............. 10. Date of Purchase ........................................................ Nome of Former Owner .~.~...~....'~....~.....~.~.~...T..~.~...~.....~...~..~..Z..¢;.~ ...... 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction y~9~a, te, 9~y ~qlr~r~ Jew, ordinance or regu at on:~ ~ ~;:~' · "~-"-'" ~ e*u-~- ~ ~ ~ z~ ,~ ~,~ .~'- ~'"'~;,'"~:~T~f ................................ 13. Name of Owner of premises ...... /~, ................... Address ............................. Phone Ne7..~...Z.Z..~../..Z.?.:.. Name of Architect ................... ~,~ .............................. Address ...................... -. ..................... Phone No. 6 ,, 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. Id0 STATJ~ ~NEW I~,_ ~ ~c c ~ ....... I.~.'....~C....~.........~l~.;....~-I~.~..~ ..................................... being duly ~m, d~o~s and says t~t he is the applicant (Name of individual si~ing application) above named. He is the .............................. ~ .............'""'""'"'"'"~;~'[' ~;;;, ............. a;~t, ~;;orat;':f~';j'~;~ ...... of said owner or owners, and is duly authorized to perform or have peffo~ed the said work and to ~.ke and file this application; that all statements cantoned in this application am t~ to the best of his knowledge and belief; and thar the work will be per~rmed in the manner ~r fo~h n the ~plicati~ filed ther~ith Swo~fore me this [JMI~EL A. G[IGEL , ~ ' ' ...... ..... ........ ..... ............................