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HomeMy WebLinkAboutZ-1092 ~os~ x~o. a TOWN OF SOUTHOLD BUILDING DEPARTMENT R`OWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No..`L..1G92............ Date August..... 2..........., 19.b1 THIS CERTIFIES that the building located at _Alatssi©z~••Hpuse T1g...•. Street Map tio..xX Block No......aG7E.............i,ot No..XSC.....,j~.~hei.~...~sland.................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................P1oYembeP...S3.., 19..f.~ pursuant to which Building Permit No..~i..X..~,..8. dated ....................~VTOV@~~@.T........, 19...b.0, 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 .......Priv:at~ . one...family. d1rel.ling This certificate is issued to .TlI3.a1x.3At..I~1IPy8a...8~..a1~.,~Q_ .....................Q?AX1.@x.&........ (owner, lessee or tenant) of the aforesaid building. 4~ ~"-^.1` . Building Inspector FO$M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ,~(nn r Exomined.....1.Y.!~:~. 5 ..............19..... ~ A lication No..... Approved ..............~.`...............,.....19.~~.....Permit No. .......1..................... PP Disc .............J.•:°.."......~~....-.~.=,1- ~-.2~c;d-e.~`'.`.:~.~..... CS . ~6:~.~-:::~-~........... (Building Inspe APPLICATION FOR BUILDING PERMIT Date......I-.'.../VG~ ...................................19...(? 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 of property must be drawn on the diagram which is port of this location. 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 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, 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, or f removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and ti ns. (Signature of applica , or name, if a corporation) (Address of applicant) State whether applicant is owner, less e, agent, architect, engineer, general contractor, electrician, plumber or builder. ......g~ ~ ~r..a.1.....~:~r~.~:r..a.~:~~.r Name of owner of premises If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) x{ ~j t u6 L-.- Lot No: 1. Location of land on which proposedw/ofrk will be don//e. Mop No:/./....~..s.K.~ Street and Number .......~.~~.../.:l.~Yl<,G/7...~7.!~~la:°....1~.!.~~~ Municipality 2. State existing use and occupancy of (p'nemises a/nd intended use and occupancy of proposed construction: a. Existin use and occu anc ~ .1.:.~... ~1/d r~ ~ ~~'~~F~G.,_-,r 9 P Y....../•1. ,J..~...~.~........~ / b. Intended use and occupancy..!a/..1........~...~~~.. ~~~......(.~~1...~°.~t'-..'..?°. 3. Nature of work (check which applicable): New Building ....................Addition ....................Alteration Repair ....................Removal ....................Demolition....................Other Work (Describe) 4. Estimated Cost....~r.~l".-._.L~..~\..i....-.^ 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..........-- . ~i~f..S"j,: f%%.a %i 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.....l.`:~~fliT~'!.lZ~.~r... 7. Dimensions of existing structures, if any: Front.....,~~ Rear ....,h..c7',.............. Depth ....~~~.Cr.................. c i Height .......t.!~ .................Number of Stories ....Z.......................................................... Dimensions of same structure with alterations or additions: Front Rear 1 ~ Depth ....1'~.~% 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 ....1.~J..<....~.~.,[...f~~~ .............NameffJJof Former Owner ..,/..°.l.C.//S'l..v~.f'.................... 17. Zone or use district in which premises are situated_.....j.?~,S ••.,....~7Pf.1..-...~.A./.7.X?7F.r!Z(..~T. 12. Does proposed construction violate ,(any zoning law, ordinance orLr/egulation/? 13. Name of Owner of premises..~r.G.,l.%CS.,.~4~~~°c~.Address .~r'C'.F/.,'~./.~".r.~7../.fr~.:f.-.i........Phone NO.~(~..~:-.4~.~~ Name of Architect Address .~..-.;..../...`-.`......j.......j........./....Phone NO..............q...... Name of Contractor.~A.~F1.....Ll1r7d~i.17.~~r?...Address 1.:t5.~!~'f.S...,,,G..S/~7.f.7.d....Phone NO....~:~./...... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. _ - _ - - 4- I I I • - - -1 Su~~.~,' ~ ~h~s ~ rro~~~~fi ~ h~nt-mz f- STATE OF NEW YORK, ) S S. COUNTY OF ~ ~ ~ } i .....f~~.~~c-'..(-.1.......~!~!.:~.~.~A.h.S~.~c~/.~ ..........................being duly sworn, deposes and says that he is the applicant (Name of individual signing appli ation) above named. He is the..... ~.~~~~,rJ..<::-~~!.r (Contractor, agent, corporate officer, etc.) >f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file his application; that all statements contained in this application are true to the hest of his knowledge and belief; ind that the work will be performed in the manner set forth in the application filed therewith, 'worn to before me this yr ~ ~ day of Y ~ i~ ( ~ 19 n r of lotary Publicf "G~` ~0 ~~f ~~`",_„L.. County pp --"C~~+-TyLL~ t~ s -cs~LC:L