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HomeMy WebLinkAbout4182-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy �! i NO- .7..34678. . . . Date . . . . . . . . . .Deo�,. . . . . . . . . ]�J`.69. THIS CERTIFIES that the building located at JA,,,l,q .B0:L0seau ,Ave. . . . . . . . Street Map No. . . . . . . . Block No. . . . . . . .Lot No. ;X . . . SQta thcj.d s• N«Y . . . . conforms substantially to the Application for Building Permit heretofore filed in this offic6\ . 1 dated . . . . . . . . .Feb. . . . . . .3, 19. . 69 pursuant to which Building Permit No. 418p- .Z Z. dated . . . . . . . . . .Feb. . . . .3. . . ., 19. (..�9, 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 . . . ' 1 �c�easory. .�b�.s•3:��ss• •btt�.•1c1.3:xY�i• • . . . . . . . . . . . . . . . . . . . . � •.� ��� The certificate is issued to lauxa.'Caxey. & Ano. . . . . . . . . .Omar.s. . . . . . . . . . . • • • (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . . . . 11*R,.. . . . . . . . . . . . . . . . . . . . . . . . . . . i Building Inspector Rouse # 205 r f FORM NO. 2 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) N0 4182 Z Date ........................febw=v.......3..., 19...619 Permission is hereby granted to: .............. ........................ ................... . ....................................... ................................................................................. to ......ftild..aM..addition--Gift­a -.6XIStinS--&te*&SWy'..b»irld-I ;g........................ ................................................................................................................................................................ atpremises located at ...............W fir.... 01-808 iu.-AT-0. .................................................................. ....................................................tsouthom. .........A-0y„. ............................................................. ................................................................................................................................................................ pursuant to application dated ...........................F0b.........:3.............. 19.... and approved by the Building Inspector. .Fee s.....5, 00......... . . .. . ....... ::. .......... .. . . ..... .. .. .... Building Inspector iFO.RM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT < TOWN .CLERK'S OFFICE' SOUTHOLD, N. Y, Examined . . . . . . . . . . ., 19. . g •? �,I Application No. . I . Approved . . . . . . . . . . . . . . ... . . .. 19 . . . . Permit No. . . .... . . ... Z� Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . .... . . . . . . . . . . (Buil(diing Inspec or) APPLICATION FOR BUILDING PERMIT 3 19 69 Date . . . . . . . .... . . . . . Feburary. . . . . . . . . . . . . . . . . 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 premise's or public streets or areas, and giving a detailed description of layout of property 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 In specter 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 Sautho Id, Suffolk County,New York, and other applicable Laws, Ordinances or Regulations, for the construction -of buildings, additions or alterations, !or for removal or demo- lition, as .herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. Wes . Bednoski Jr . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Signature ;of.applicant, or,name if a corporation) . . Southold. . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . .. . . . (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or Contractor builder . . . . . . . .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . .. . . .. . . . . .. . . . . . . . Name of -owner of premises . .Laura Carey & Ano. . • • . • • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . If applicant is .a corporate, signature of duly authorize d -officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) 1. Location ,of land on which proposed work will be done. Map No. . .� . . . . . . . . . . . Lot No. .:= .... . . . . . Street and Number .'.WAS Boisseau Ave Southold . . . . . . . . . . . .: . . . . Municipality 2. State existing use and ,occupancy iof premises and intended use and occupancy of proposed construction. a. Existing use and occupancy . . . AGoessory. building. . . . . . . . .. . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .b. Intended use and ;occupancy . . . . .same• with •an ,addit qTX , • , , , , , , 3 A_/�� 3. Nature of work (check which applicable): New Building . . . . . . . . Addition . . . Alteration Repair ... . . . . . . Removal . . . . . . Demolition Other Work (Describe) . . . . . . . . . . . . . . . . . . . . . . 4. Estimated Cost . .800.p�M. . . . . . . . . . . . :`Fee 00. .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling, number .of dwelling units Number of dwelling units on each floor . . . . . . . . . . . . . . Ifgarage, number .of cars . . . . . . . .... . . . . ... . . . . . . . . . . . . . . e. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . G.. . If business, commercial or mixed occupancy, spec ify nature and extent ibf 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 Hof entire .new construction: Front . . .21y. . . . . . . . . . . . Rear . . . .�i+. . . . . . . . Depth ... . . . Height . . . . . . . . . . . . Number -of Stories . cme. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . 9. Size of lot: Front . . . .... . . . . . . . . . Rear . . : : Depth . . . . . . . . . . . . . . . 10. Date of Purchase . . .... . . . . . . . . . . . . . . . . . . . . . . . . .Name oaf Former Owner . . . . . . . .... . . . . . . . . . . . . . . . . . . 11. Zone:or use district in which premises are situated. . . . . ��B" d1st . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation? . . ...M . . . . . . . . . . . . . . . . . . . 13.. Name,of Owner•of premises T,.417.r.A .QArey. A. AX10lddress . . . SQ1AbP.1d, . . . . , , Phone No. . . . .... . . . . Name of Architect .Address . . . . . . . . . . . . . . . . . . . . . . Phone No. . . . .... . . . . Name !of Contractor . .W.. .Bednoski .Jr. . .Address_ . . . . . .S.outhold . . . . . Phone No. . . . .... . . . . PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street.and block number !or de scription according to deed, and show street names and indicate whether interior or corner lot. . -7j U. STATE, OF NEW f o K )S.S. COUNTY OF . . . . . . . . . . . . . .) . . . . we5ley. Be 2=5X� . Jr. . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the appli- (Name of individual signing application) cant above named. He is the . . . . . . .Contractor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) of said owner ior.iowners, and is duly authorized to perfo rm 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 that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this . . . . . . . . . . . . .3. . day of . . . . . . .Fed r. ... . . . . 19. . . . . . . . . . . . . . . . . . Notary Public, (Z. (Signture of ap c t) MARION A. REGENT NOTARY PUBLIC, State of New York No. 52=3233120 Suffolk County Term Expires March 30, 19 A 9