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HomeMy WebLinkAbout8273-zFOR~I NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Soutbold, N, Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ,.. ~,0~,.~oE/~ .(}rar~d. A.~e.. Street Map No...x.X ........ Biock No ..... .~.... ,~,ot No .... , .~.,,,, .~..t.~.~.~..~.~ ............ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ 0.e~.. 30.., 19 .~.~. pursuant to which Building Permit No.. dated .......... .0.~.. 20 .... , 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 issued is . .P. ?.~.~.~.~.e..o.~..e..~.a.~.l~..(.l .w.e~.].~~n.g..w.i.~h.. g.~.e.e..n.h.o)4.~e..a.d..d.:L.~.t.? .~ ........ The certificate is issued to . ~.Xy.i.a.. p.af.e.~y~.. ...... o'..,~, e..~ .......................... owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..... N.*.R.: .......................... UNDERWRITERS CERTIFICATE No..N.; .~; ....................................... HOUSE NUMBER .... J.~20 ...... Street .. Ore, nd, A.v.e... }{~i~uok ............... Building Inspector 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) 8273 Z Date .............................. .Qc..~.o.b~.~2.....3~, ] 9.~..~.. Permission is hereby granted to: ..................... [J~az~d.. J~.v~ .............. ~:~.t t ~,t~!¢. i,LL~.~..'~. &z~ E ~r;~hO'Um;, d .... ~ ~ '~ ' ' d.~:¢'"'-'~~r;' to ...................... (,., ~. ............... ~..~.)....a ... z;L~.;L~.~t...~ Z~...~¢;L~ .d,~ ,~ ........ ~4.~. ,~ ~. .................................. at premises located at .-~-G*~.*..~,~/~*...G;¢~>;~..,~.~;e' ' ~ ~ ........................................................................... ........................................................... l~k~.ti.l,~ek ................................................................................ pursuant to application dated ............................ .Q~.t,......~O. .......... , lC~..~'...., and approved by the Building Inspector. Fee $,,.t.~.(.)..©. .......... "' Sylvia Pafenyk Box 1040 ~attituek, NY 11952 Howard Terry Building Inspecto~ Ssuthold, NY Jan. 24, 1977 Dear ~ro Terry, Reqardinq your notification of certificate of occupancy On oermtt ~ 8273Z: Norm noilly obtained a certificate of occupancy'for the house so that I could get my bank mortgage, a~d ~he lean-to greenhouse addition ~as inspected by ¢ffm~df you~; repreaentatives, who said it was fine, and nothing further aesd be done regarding paper ~o~k with you~ office on it. trust this clears un any question on the matte~. TOWN OF OUT'OLD BUILDING DEPARTME~T~ TOWN CLERK'S OFFICE ~UTHOLD, N. Y- Disapproved a/c "~~i'"'"]~ ................ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No ................................. ate ..................................... 7. ......... , 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 o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is port 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 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'--r-. 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 f6r remora or demolition, as herein described. The applicant agrees to comply with ail appli.cable laws, ordinances, bui!dirJg code, hou~s~n code, and regulations, and to admit authorized inspectors on premises and ,n buildings for necessary//~nspect, ions....~../~.. ~..~... ............................ /(Signafte of applicant/ r namer a corporation) ...................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ....... ....... .......... ................................................................ Name of owner of premises ~ .~.].~T~ ~-D,.~el~.i~c ................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... [~;~.¢.).~ ............................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trode's License No ............................................... Location of land on which proposed work will be done. Map No.: ......... ~..~. .......................... Lot No ......... ~.~. ........... Street and Number ....... [L,.Q.,.'~.,.....~kL/.~Z..I~'~.~L..~%~z....J:~.:gJ~.~L¢.~ ............................................................... Municipality State existing use and occupancy of premises and intended use and occupancy Of proposed construction: a. Exisiting use and occupancy .....~..~,;{~.Z..~L..~:z...z~ ................................. ~ ........................................................................ b. Intended use and occupancy ...... ..s.~1.~.....¥]~..~.!'.1...~,[~;'.(.~?.?.:.~..5.~.~..8....c1:!~;.].';~ ........................................... i ....... property ~Jnes. Give street and block number or description according to whether interior or corner lot. 3. Nature of wcJrk' (~h6ck which applicable): New Building .................. Addition .......~..x.. ....... Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) 4. Estimated Cost ...................... ~O.O.....~ ........................ Fee ...J.~..t..O..0.. .......................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... ..o..n..e. .............. 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. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of some structure with alterations or additions: Front ....................................Rear ............................ Depth ....... .......................... Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ....1.0. ............................ Rear ...J..0. .................... Depth ....1.3. ................ Height .................... Number of Stories ...... .o...n...e. ........................................................................................................ 9. Size of lot: Front ....g..q~.~.~.g~. .................................... Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 1. Zone or use district in which premises ore situated ..... .t).&]!...(.~J..~.~. ............................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation'. ...... BO ............................................. 13. Will lot be regraded ......rt.o. ................. Will excess fill be removed from premises: ( ) Yes ( ) No 14. Na me of Owner of premises ....~r.l.~.t.a...P. ft,f. fl t&~ .............. Address .......1';~.~ ~'b~.~'.P.'.1)..O..k..... P hah e N o ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Nome of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from deec and show street names and indicate STATE OF NEW, Y©RI(~ .........."--~J~ame'" '" '"'" "" ~"/~'~/t"'""'""'"'"'""'~"'7~"J~'~)'"'~/3"Jof '",ndJv,dual'~' slgmn0' . c~)~t j~.). .................. ................. .... being' duly sworn, deposes and says that he ',s the opphcom' above named. ~ Owzte r .......................................................................... etc.) of said owner or owners, and is duly authorized to perform ar 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 that the work will be performed in the manner set forth in the application filed therewi Sworn to before me ................................................... this · Suff olk .......... Z ............ ELIZABETH ANN ~IOTARY PUBLIC, State of-New ¥orl( No. 52.8125850, Su~ol~ County Term E~pires I~tarch