HomeMy WebLinkAbout5751-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificnte Of Occupnncy
No. Z~;92 ...... Date ...... .OCto.b. er. ~t ........ , 19
THIS CERTIFIES that the building located at .~/esi;.vJ.e¥. D.r~,¥Z. .......... Street
Map No... Hason ... Block No..X~(. ...... Lot No ......... Ha.t.~.~;~.e.k. ..............
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ........ Feb...25~..., 19.73 pursuant to which Building Permit No..
dated ........ ~eb,..2~, ..... , 1973., 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 .... Accessory..bldgo. (atorag®~ .......................................
The certificate is issued to ..... ~ttl:l.US. ~/llttne~. ..................................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval . N.,R, ..............................
UNDERWRITERS CERTIFICATE No... ~lolt, .....................................
HOUSE NUMBER .. 2Olt~ ....... Street ...... ]de$1~rie¥. D.r:~v~. ..................
................................................. 1/atti.tucl~ ....................
Building Inspector
FOF~ 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)
5751 Z
Date ........................................................ , 19.....~..
Permission is hereby granted to:
............ ~tm..J~tt~e~. ...............................
................. We s~eview.../)~, ....................................
........................ MR.ttittm3~ .................................
to ....... ~lA..~n..acees~o~...(~s.tora~,e ~..h~Lld~z~, .........................................................
....................... ~....~.v.e.~..~...~ ...A..u~.~. 1~.). ..........................................................................
at premises located at .............. ~III...~I~IIe~...D~L~II ...................................................................
~attituek M.~[.
pursu~n¢ to opplication dated ............................... ~.~ ............... .~.~ 19....~...., and approved by the
Building Inspector.
Fee $....~.~.e.(~. ........
FOBM NO. 1 ~
TOWN OF $OUTHOLD
BUILDING DEPARTMENT.
TOWN CLERK'S OFFICE
^pp,co.on No. /
SOUTHOLD, N. Y.
Examined
Approved .... ~ .~.......(....~. ............ , 19..~....~.. Pemit No.~....'~.....~...!..~ ........
' o/c . .... ,L.,
Disapproved
...~..._..._.._.._.._..__.._.._....._............... ..............
I/~t/~ q ~ /0~)~ (Building Inspector)~ ...............................
~ ~ ~
19 ............
/L~^ ~~ uate .................................................
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 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 perm t
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.
i APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Perm t pursuant to the
~-. -~'uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lcmvs, 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 oil applicable laws, ordinances, building code, housing code, end regulations.
........ ........
W~tview Drive g045~ Na~ituok
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
0~ner
Name of owner of premises ................... s~l~,~]$~..~g.t41~e.~. ..
If applicant is o corporate, signature of duly authorized officer. ~
(Name and title of corporate officer)
Location of land on which proposed work will be done. Map No.: ...~...s..o..n. ............................. Lot No .........................
Street and Number Westvte~ Drive ~045 ~ttitua]c
Municipality
Stcte existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exisiting use and occupancy Residence
b. Intended use and occupancy Aooeseory Bldg. General Btorage,~arden E~uipment
3. Nature of work (check which applicable): ~ Building .~.q.w...~].~g.* Adclition ..' ...... .~.... Alteration ..................
Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................
4, Estimated Cost ...~..°..~.~..?....8.~....E~....d.~.e.~....~..~.3:.~.~.?....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. Dirnensions of existing structures, if any: Front ......5~..~ ............... :.. Rear ....5..0..; ....................... Depth ~.5..; ..............
Height ........................ Number of. Stories ............................................... ~ .................................................................
Dimensions of same structure with alterations or additions: Front .................................... Rear ............................
Depth ................................ Height ............................ Numb~ of St6ries ................................
8. Dimensions of entire new construction: Front ...... :.;.....-..:~ .................. Rear ..... .9.~ ................... Dept~h .l.~ ..................
Height .................... Number of Stories ..............!...?...t.°...~.~. .........................................................................................
9. Size of lot: Front ....... .6..0....~..t... ......... Rear .......... .l.~.0...~t.... ............ Depth ...~.0.O...~.t..*..J.~9..x)
10. Date of Purchase ._.?...6..5......., .................................... Name of Former Owner ..~.o.~.m..~.~.t. ........................................
11. Zone or use district in which premises ore situated .....................................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation.;> ............................................................
Julius Juttner ~estview Drive
13. Name of Owner of premises ........................................ Address ............................................ Phone No. ~9.@..~.9...8.~....
Name of Architect ...................................................... Address ............................................ Phone No .....................
Name of Contractor .................O~.e.~ ............ : ............. Address ............................................ Phone No .....................
PLOT DIAGRAM
Locote 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 nomes and indicate
whether Interior or comer lot.
Survey enclosed
Building to be constructed of same material ~s residence
Appearance to conform to residence
Location "A# Desired
Location "B" Alternate
STATE OF NEW_YORK,
COUNTY OF ...~..~...%..o..z.'.~. ............... ~=.~
Julius Juttner
................................................................ '.. ............................... being du¥ sworn, deposes end soys that he is the applicant
(Name of individual signing application)
above named. He is the .....................1~R-.9% ...........................................................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perforr~ or have performed the said work and to make end file
this application; that all statements contained ir~ this. appJi~cation are true to the best of his knowledge and belief; and
that the work will be performed in the manner set forth in the application filed therewith.
Swam to, before me this
,9
/