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HomeMy WebLinkAbout8002-zTOWlq OF $OUTHOLD B~.DI~G DEPARTlt~.NT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z7338 Date ~ov 1 19..7.6. THIS CERTIFIES that the building located at . ~¢~4~.t.o.~...R.o. aS. .......... Street Map No. l~ee.tfleld Block No ........... Lot No, . ~. .... G~.e$~.o.~ ............... conforms substantially to the Application for Building Permit heretofore filed in thl, office dated .......... J..1~..e....~.6, 19.7,$'. pursuant to which Bugdi,g Permit No..8..0Q2..Z.. dated ............J~...16.., 19.?~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is ~-,~sued is . .?.r~.v.a..t.e..a.c..c.e.s.s.o..~3,..C.a?.a.~e. ......................................... certificate is issued to ...A~..t.o.n.q..V.o.1..l_D~s.k.:Jt. ..... ~.wn. q~' .......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ]q,]~, .................. UNDERWRITERS CERTIFICATE No. Ii. I~ · HOUSE NUMBER ..... ?~. .....Street .. F~c~clel.t~n. ~o.&4 ....................... Building Tn.pector FORM 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) No. 8002 Z Date ........................... ~.mae......~6 .......... 19.2.5... ~Permission is hereby granted to: .... An~tm~ ...V. olzLnsk £ ..J~. ................................ ........... [q~.cld e ~1 ~;.oz~. ]loa{L ......... Olt. ee~tp.az..t... to ..blLtJ.d..lae~...l~..v~a.. gaI'age ................................................................................................ at premises located ct ....L.o.t..~...5....~.l.e.e.t~;t.elcl ........................................................................... ........................................................... l~iddelton..l~oad ....... ~rae~po~.t ................................ ~..~... pursuant to application dated .................. ~u~e......1.6 .................. , 19..~.~., and approved by the Building Inspector. Fee $...1.0~*.00. ......... Building Inspector FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Examined ....... ~..(¢. .......... 19. Approved ...W. ,~,,. ......../;~. .......... , 19.Z?.. Permit No. Z.~....~,..~..~ ........ Application No ............ Disapproved a/c ....... [.~.[~~ ............... ~ INSTRUCTIONS a. This application must be completely filled in by typewriter o~ in ink 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 show~'ng ocat'on of at and of buildings on premises relationship to adjoining ........premises or public streets az 0reos, and ~iving a detailed description of layout ofproperty must be drawn on the d~agram which ~s part at th~s app,cot~on. c. The work covered by this application may not be commenced before issuance of Building Permit. of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit d. Upon approval 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 S HEREBY MADE to the Building Deportment for the issuance of a Building Permit pursuant to the~' Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other appl cable Laws, Ordinances or~/ removal or demolition, as herein described. Regulations, for the construction of buildings, additions or alterations, or for code, housing code, and regulations, and to The applicant agrees to comply with all applicable laws, ordinances, building admit authorized inspectors on premises and in, buildings for necessary inspections. ................. ........ (Signature of applicant, or narn~/if a c po 'o .Mid..delton ,t.~q.a.d .G..r..e...e...n.p...o.~.t.. .......... (Address of applicant) .................. ii~i~'~ and title of corporate officer) o~tr~e r Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner -...b..u..~.~,.~.e.~ ..................................................................................................................... Name of owner of premises Antone Volinski ............................... If applicant is a corporate, signature of duiy authorized officer. Other Trade's License No ............................................... ~,~/;~s¥ l_o c , 1. Location of land on which proposed wo~k will be done. Mop No.: ...~.~.~.~. ............ Lot No....~ ................... Street and Number .~.~.~.~g~..~a~ ....... g.[~.9.~PQ~.~ .............................................................. Municipali~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...~g .......................................................................................................... b. Intended use and occupancy same with detached rivate ~ara~e 3. Nature of work (check which applicable): New Building......:~... .......... Addition .................. Alteration ................ Repair .................. Removal .................. Demolitior, ....................Other Work .................................................... (Description) )%000' + 1,0.00 4. Estimated Cost ................................ .-'. .......................... Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............. .o...~..e. ........ Nunqber 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 ....~-~-~1' ................... Depth ........................ 22-8 Height .................... Number of Stories .... .Q~.~ .......................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................~ ............. 10. Date of Purchase ........................................................Nome of Former Owne;.~.:...~.....',?.,Z;K~.../..z~.....~.~7... ....... ,: ............... 11. Zone or use district in which premises are situated ...!)~!)...clj. 8.t .............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .... .~.i.©. ............................................... 13. Will lot be regraded .....~...O. ................... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ..~.k3,.~.o..,'Ct..e.....~..o..~.~.~.~.~.~....,rT..r. ....... Address ....q.Z'...e..e..~.:q,o. ,~.~ ........ Phono No ....................... Name of Architect .............................................................. Address ................................Phono No ....................... Nome of Contractor .......... .s...a.~.t.e. ......................................... Address ................................Phone No ....................... PLOT DIAGRAM Locote clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensidr~ property lines. Give street and block number or description according to deed, and show street names whether interior or corner lot. STATE , COUNT ........................... ~.~.~..~....~...o.~.i...~.~..~.~....Z.~. .......................... ,being duly sworn, deposes and says that he is the applicam (Name of individual signing contract) above named. owner -builder 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 tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this , ~ ................. .1..~... day of .................... ~..V~....e ............... , 19.~,.~... /~ /] ~ / /)' t ~ · ~.~ ~. / ~ (Signature of appJic~rnt)