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HomeMy WebLinkAbout7548-zTOWN OF SOUTHOLD BUILDING DEPARTI~NT Town Cl~k's ~ Soathold, N. Y. Certificate Of Occul ncy No.Z].~2..0 ....... Date ......0et,..20 .............. ,19.76. THIS CI~TWIES that the building located at .. :~2u~ans. P~th.., ......... Street Map No. ~Y ........ Block No .... xx ..... Lot No, .xx..I,. I/arian ................ conforms substantially to the AppUcation for Buildln~ Permit heretofore filed in this office dated .............Sep.t..2~ 19..~ pursuant to which Building Permit No. ?~SZ.. dated .............Sep.t..23., 19.71~., was issued, and conforms to all o! the require- ments of the applicable provisions of the' law. The occupancy for which t_hi~ certificate is issued is . .Prl.v.~..~ne. fi~l~y..4velling .w£th. ~a~age. t. sto~age ............ The certificate is issued to.. ,P.a~r, lck. ~xemo.~.~_ .... Qw~er .......................... (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval . .Ii :~: .............................. UNDERWRITERS CERTIFICATE No.. llerl~lir~g .................................. HOUSE NUMBER ..... 127/~ ....Street..Truman. P~th ..... E,. btario~ ........... ..... ...... I~OP~ NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N? 7548 Z Permission is hereby granted to: Fa.~r ~;k..-~-r~er. tt~t~ .-~....w~.~'e ......................... · .~?.~ ....... 98s~.."'~s~o~'~a' ............................. to b.~,J,~C~,. ~e~ .,~ J..v.a.~e ,.4;aY~ g~ .. &., ~,~.~.~ g~.-~d~. ............................................................ at premises located at ,.~f/,~...~::r~'~.,$~.a.~}! ...................................................................................... ............................................... ~.%..~-~$(>n ......... ~.r~J'.. .......... : ......................................................... pursuant to application dated ..................... ~e?~ ......... :.~..~ .......... t ]9~7~..., and approved by the Building Inspector. Fee $~.~, O.Q .............. TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE o SOUTHOLD, N. ¥. ,, ,, 75'Y/ Disapproved o/c ................................. .................. :,spector'"""-'-'"'"j .............................. APPLICATION FOR BUILDING PERMIT Date Sept 23 19....7.~. % INSTRUCTIONS o. This application must be completely fill~:l in by htpewriter o~ in ink end submitted in trlplicate to the Building .Inspector, with 3 set, of pkm% accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot end of buildings on premises, relationship to odio n no oremises or nuhl v ~tr~*~ ~,, areas, d gwmg o deto I~:1 descnphon of layout ofproperht must be drown on the diagram which is l~rt of this appllcofion. c. The work covered by this aPPlication may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Soathold, Suffo k County, New York, end other opp icoble Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable laws, ordinances, building code, housing code, end regulations, end to admit authorized inspectors on premises end in buildings for necessary inspections. ~S~gnature o$/opplicont, or frame, if a corpomhon) ...... ~.1.7.~. ....... .2...8..s, ,t., Astoria (Address of applicant) (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No. ................................................ Electrician's License No ............................................. Other Trade's License No ............................................... 1. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................... own.~r Name of owner of prem ses ~.~,.~..~.¢~ ~., .E..~enn.a.,n If applicant is a corporate, signature of duly authorized officer. location of land on which proposed work will be done. /¢~ap No.: ................... ~ ................ Lot No.....x.~.. .................. Street and Number .... ,~.?....¥~l....a...D....S...?...~..~...h. ......... ..~..a...s..~....}.4.~..~..fi:..o...~. ....... ..~.....~..... ............................................................. Municipality 2. State existing use and occupancy of premises and intended use end occupancy of proposed construction: a. Exisiting use and occupancy ...~..¥..e.~.~..~...~.~. ........................................................................................................... sa~e with garage & storage b. Intended use and occupancy ..................................... 3. 'NatUre of work (check which applicable) New Building'~'. ........ Addition .................. Alteration .............. Repair ................. Removal .................. Demolition .................... Other Work .................................................... (Description) 4. Estimated Cost ................... J. ~2CII~...~ ........................ 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 c~ rs ....l!.:.q..~.~'....~..L~..~.9..~,.B'..g.e...~.i .................................................................................................. 6. If business, commercial or mixed occupar~y, specify nature and extent of each type of use ............................ 7, Dimens,ons of existing structures, Jf 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 ~ntire n~w construction: Front ........ ~ ..................i.... Rear .....1.~. ................... Depth ..... ~,~ ............. Height ..................... Number of~ Stories .~,I3~. ............................................................................................................. 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................Nome of Former Owner ........................................................ 11 Zone or use district in which premises are situated ....".A.."...~'I ~.1~..; ........................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... .Zl....O. ............................ ; .............. 13. Will lot be regraded ........ ~ ............... Will excess fill be remove~ from premises: ( ) Yes (Z) No 14~ Name of Owner of premises .p~6~AeA..~&l~.~..~.:l..~e~ddress ....As.~.~,~,iL.~ ....... Phone No ....................... Nome of Architect .............................................................. Address ................................ Phone No. Nome of Contractor ....... .O.~t~. ......................................... Address ................................ Phone No. PLOT DIAGRAM Locate clear'Iv and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and blocl~ n?~n.~be, o~-~c~rJ~.i~n according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YO.I~(..- .. lS5 COUN~ ....... .......................(Name~":~'~'"~o' individu., signing ..................................... contrac~ being duly ~rn. deposes and soys t.t he isthe above name. He is the ~e~ -~[~e~ (Contractor, agent, cogorote officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke and file this application; t~t all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set fodh in the application filed therewith. Sworn to before me this .................. ......... ....................