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HomeMy WebLinkAbout8713-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . .~,l~..V.~! .I~.~0~ .1~..o.a.d. ....... Street Map No. ~ .......... Block No. ,~ ....... Lot No, ~... ~ghOld.. ~.*.~* .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. J~. al., i9 .~6. pursuant ~ which B~ilding Permit dated ............ ~..a~..t', 1976., was issued, ~d confo~s to ~1 o~ the requ~e- ments of the applicable provisions of the law. The occupancy for which this ce6tificate is issued is .P~$Ya~O. ~. ~.~!$~ .~!!~g.~i!h. a~i~l~n ...................... The certificate is issued to ' . .t~I'~'~.. 3.eil~elll:lt~ ....... 0trla®x'. ........................ (owner, lessee or tenant) of the aforesaid building: Suffolk County Department of Health Approval Ii,R,, UNDERWRITERS CEi~TIFICATE No..1}~llililqg ................................... HOUSE NUMBER .//.t.87~ ....... Street ...Ca~.v.O$. ~.e.¢k. ~d ....... l~ovi;llQld:... ~uilding ns~/oemr FORB! NO. ~B TOWN ~OF SOUTHOLD BUll.DING Dr~ARTMENT TOWN CLERK~ OFFICE SOUTHOLD, I~. Y. BUILDINg PERMIT (THIS PF.I~AIT MUST BE KEPT tGTq THE PREMISES UNTIL FULL COMPLETION~ THE WORK AblTHORIZED) N? 8713 Z Permission is hereby granted to: ~o~%hold to .......... ; ................ : ................................... ~; .............~ ....................................................................... at premises located at ~/~ ao~thold N.Y. pursuant to application dated ............................. ..~...~....e...~.~ .......... , 19...?..6., and clpl~roved by the Building Impector. Building ~ ! FO~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ormit ~o ..................................... Examined ........ Approved .,...~ Application No...~..~..d,./..,~ .............. ~'~ (Building Inspector) / APPLICATION FOR BUILDING PER/~IT D June 21, 19 ............ '~'~ ate ................................................. 76 INSTRUCTIONS a. This application must be completely filled in by typewriter o~ in ir~k and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. 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 o 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 Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, o~ for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. Robert L. Hyatt Ina (Signature of applicant, or name, if o corporation) ............. S~u~ho~Ld .................................................................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. builder . . Harry Schwendt Name of owner or premises .................................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officeX) Builder's License No ........ /..~..:...JT....J..~..:....~7. .......... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: .......... ~ ...................... Lot No .......... ;~ ........ Street and Number ....~.../.~...g..~..'.J...~..e..~..~.~.O.~....i~.°..~.....~.O.]~.~.~P.~,~ ....................................................................... Municipality State existing use and occupancy of premises and in.*ended use and occupancy of proposed construction: a. Exisiting use and occupancy ......ct:~.?.~.].:,z.~ ........................................................................................................ b. Intended use and occupancy .......... .~.~.~.,e...,~,~..~..~....~..~,~..~.~..~,,o,~. ........................................................................... 3. Nature of work (check which applicable): New Building .................. Addition .....~..%.. .........Alteration .~.~:.,...~,' Repair .................. Removal .................. Demolitiar, .................... Other Work .................................................. (Description) l ,oo 4. Estimated Cost ............................................................ Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling~ number of dwelling units ............. .O..1~..~.. ........ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occupancy, specify noture and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Fron~ ............................ Rear ................................Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Deptb ................................Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories .................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................Name of Former Owner ........................................................ uA" ~ist 1 1. Zone or use district in which premises are situated .................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~.O.. ............................................. 13. Will lot be regraded .......... .~,.,O. ............. Will excess fill be removed from premises: ( ) Yes ( ) No 14. Nome of Owner of premises ..... .~.......S..q..~3f.~)2.c]-...~ .................... Address ...S..o.~.h..,o.,]..~ ........... Phone No ....................... Name of Architect .............................................................. Address ................................Phone No ....................... Nome of Contractor .~.*..~....}.~z.a,..~..~...Z...~..9 ............................ Address .....S..o.,,~.~.o..]_.,~ ......... Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions property lines. Give street and block number or description according to deed, and show street names and indic'ate *hether interior or corner IoL _qA~[: OF NEW '~1¢,~,~, ........................... .].~.O...b..~..:...~.~.fkt~..~ .......................................... being duly sworn, deposes and says that he is the applic~m (Name of individual signing contract) above named. He is the ...................................... ~&~¢.~ .......................................................................................................................... (Contractor, ~gent, corporate officer, afc.) of said owner or owners, end is duly authorized to perform or have performed the said work and to make ~nd file this application; that all statements contained in Ihis applicction are true to the best of his knowledge and belief; ik, af the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this Notary Public,. .................. ~PZ~"" .......... ~oup~ ............................. ~;~'~'~;;';;';¥';~'z:'-~v-'"' ......................