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Home My WebLink About178-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY conforms substantially to the Application for Building Permit heretofore filed ~n th{~' office dated dated ........ ~'~e~ ~.~ ........ 19.~..., was ~ssued, and conforms to all of the !equ~rements of the applicable prows~ons of the law The occupancy for which this certificate ~s ~ssu¢d is ~ .......... (owner, lessee or tenant) of the aforesaid budding · .l...: ..'n....~ ........................................... ~ .............. BuildIng Inspector FORFf NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES ~T~~T,~ ~~~.~.~P~C~I~ UNTIL FUEL COMPLETION OF THE WORK AUTHORIZED) Permission ~s hereby granted to Harold R. Reeves & ~ons · .A/C · .Rt~h~d. ~ je~kins .................. ~t¢i~e~t.. ~.,Y~ .............. to ...~oVe..e~i~ing.. ~elli~g ..t~ mew.. l~¢a~i~rt..same, premlses...a~_~4 ................. ..... ~u.lld .am.,addi~ion. ~ s*__~e~ .............................................................. at premises located at '~Z~V&t,e '~ ~ "~:~_~"~e~"~b'rte ............................ ......................................... P~eont¢.,.. ~. Y.., ................................................................. pursuant to applicahon dated ............. ~O¥,el~l'' ~.(} .......... 19~'~.., and approved by the Budding Inspector Fee $10..00.. FOEI~ I~0. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19 ........ Permit No ............................... Disapproved a/c .............................................................................................. Apphcotion No .......... : ............ (Building Inspector) APPLICATION FOR I~UILDING PERMIT D ~ November 20 ate ...................................................... 1 INSTRUCTIONS a This opphcation must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildi Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stre, or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this Iocotk c. The work covered by this application may not be commenced before issuance of Budding Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Su 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 Occupan shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuanc.e of o Building Permit pursuant to t Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or a Iterations, or for removal or demohtion, as herein describe The applicant agrees to comply with all applicable laws, ordinances and regulotLons. (Signature' of applicant, or name, if a corporation) ,/' ,,, 6/ , ,: /? q/ (Address of applicant) , State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build.- o~ers Name of owner of premises~`~?..b`~..`~`e.~`~.~`~..z~.~.~;.~.~?`.e.~...~-'§z~§~...~..~,e. .................................................. If applicant is a corporate, signature of duly authorized 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 ............ ~.~.~;.%.~..~.~...q~.e..e.~.~.~.~..e~.`..~'e...~...Tv..e..~`~.e.~..?...e.9.9~'~.9.~..~.~.~.~...~.~ .................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................... ~.~.~.e..tT..e..e.. ............................................................................................ b. Int?nded use and occupancy ................... .'9..e...c)..~.°..°..m...~,,~.~n ......................................................................... 3. {q~¢ure of work (check which appllcable) New Building .................... Addition .,..~.. .............. Alteratbn ..........~. ...... Repair ................... Removal .................... Demolition ................... Other Work (Describe) .................... 4 Estimated Cost ........ $35.0.0.,.0.0 ...................................... Fee ....................................................................................... (to be paid on fd~ng this application) 5 If dwelling, number of dwelling units ............................... Number of dwelhng umts on each floor ........................... If garage, number of cars .......................................................................................................................................... 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use ............................ 7 D~mensions of existing structures, if any' Front.....~.6.~. .................. Rear ............................ Depth .../+..0..~. ................... Height ............................ Number of Stories ........ Q~e. ............................................................................................ Dimensions of same structure with alterations or additions. Front ........ ..Z..8.~ .................. Rear ...... ..2.~.~..8.[ .............. Depth ............................. Height .............................. Number of Stories ........ .0.~e. .................. 8 Dimensions of entire new construchon: Front ........ .~.8..~. ............. Rear .......................... Depth ..2.~.~..8.!~. ............... Height ........................... Number of Stories .... .0...~..e ................. 9 Size of lot' Front .... 2..0..0.]. ................ Rear .......... .2.0..0..~. ........... Depth ........ ~5.0..~. ............ 10 Date of Purchase ....... ~.~ ..................................... Name of Former Owner ...~.~..~,e..~.?~.~. ?.,.e.~.¢,..~...~.o.} 11 Zone or use distr~ct in which premises are situated ......... ~..A.~~. .............................................................................. 12 Does proposed construction ~ol~t~z,c~r~, z~nj~gz~O~: ordinan~j~c~zraz~e~lUeloa~io~mi~.....~.°. ..................... 13 Name of Owner of premises ...................... ~.e~-~s...Address 2.~J.a~..~.,~Z .................. Phone NO...653~ ....... Name of Architect ........................................................ Address ............................................ Phone NO Name of Contractor..~?...~..~.D...~.'...~.~...&.....~..~....Address ....~.._~?~..~....C~.--.~..:.~..:. ............. Phone NO ..~;2~¢ ....... PLOT DIAGRAM Locate clearly and d~stmctly all buildings, whether ex~stmg or proposed, and indicate all set-back dimensions fro~ property lines. Give street and block numbers or description according to deed, and show street names and indicai whether interior or corner lot. STATE OF NEW/'Y~P-,~,~'" , ) S S COUNTY OF ~'.,..,U.~/..,..[:./t.:;...~ ' ................ ................ be,ng du¥ sworn, deposes ond so s that he ,s the app,,c, (Name of individual sifting application) above named. He is the ................... ~...~..;..: ........ Z ................................................................................................................ (Contractor, agent, corporate officer, etc.) of~-s~+d~.vc.~ac~e~rs~- and is duly authorized to perform or have performed the said work and to make and this application, that all statements contained in th,s application are true to the best of his knowledge and and that the work will be performed in the mqnr~r.~s~J~.~J~}ff_ ~q~ ~ch~,application filed therev/i~r) Sworn to bef~e me this ~ ~ ....... t4 i / z ~// I1 ...... .~,~ ............ day of, ..J~.~..~ ........ ~....~ ............. T~.~J¢~.~¢, u~ a0, Z~' [51gnat~re/~ gpphcant) )~A~ROLD JEN~I~ R£ALTY ¢onP.