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Home My WebLink About194-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ~J~.lJ~...J~O.~.([t....CHP~..t~uTL~.O~l~.~.)Street Map No..'~/.~,.}J,ttJ~t .............Block No .......~ ..................., ]J~J(]Jbl~ ...... ~1~t,~o~1,c1~......~,.~o conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................... ]~2.~11~.~e.~.....~.J~...19..~J'., pursuant to which Building Permit No ...~...'[:~.I.~ ............. , dated ....................... ,g.,~.~.~.~...~.?....~.0. ...... 19..~.~.., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ............ ..................................................... P. B. ZT~t.~'.TE.... ~¥LF...L-L Z.~G ................................................................... This certificate is issued to ...Ji~,~,~.~:Z'...~.,...~.t~.t,J ........ ~O.'~'l.e~,) ..................................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector FOltl~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES ~t~.~I~.~,~F A~P~C~/~m[~I~I~9~[~w~ljD~x~ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No .Z 1~ .... Date Dec~.mbez... 20 ..... 195~... Permission ,s hereby granted to Robert Hya.tt... A/~ WaI.ter..F_,... ~.a.tt .................. ..... Pt..irate.. R~....~£..Wa~, ..... ~ound...Vlew Ave, ................ ~o~thald,... ff..Y, . to .... ~uild new ~well. ir~ ......................................................................... at premises located at ~/~ p~:l,~rat~ ~ ~f W~r .N/~. ~O~lld. V.iew A.~I~ ....... ................................ Southuld,..N. ~. .............................................................. pursuant to app[icatlon dated .... ~e~o~4~: ~.C~ . .. 19 ~ , and approved by the Budding Inspector Fee $,.~O,,,OO .pa.,~d Budding Inspector \ FO~M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19 ........ Permit No ................................. Disopproved a/c ..... ;:~ .... .... ............................ 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 o detailed description of layout of property must be drawn on the diagram which is part 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 ~ntil a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southotd, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations· (Signature of applicant, or name, i~ a corporation) "* (Address of applicant) / // State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, pJumb~ or builder· Name of owner of premises ...... ~...~.i...~.?. .... ~-..~. .... · ............................................................................ If applicant is a corporate, signature of duly authorized of~er. (Name and title of corporate officer) 1. Locat'on o land on wh'ch~o~osed work will be done. Map No ................................... Block .................................. Street and Number ...~.~.~j.~.......~.....~:~.......~........`.~.d~.....(.~..`~f-4~......~....~j~...~ ......... State existing use and occupancy of~premieses ar~ i ntef~/(~ed use~nd occupancy of proposed construction: a. Existing use and occupancy ................ ~ ............................................................................. b. Intended use and occupancy .......... ~...~....~.~. .............................................................. Nature of work (check which a~plicable): New Building ..... ~ ........Addition .................... Alteration .................... Repair .................... R. et,~oval .................... Demolition .................... Other W,~,rk (Describe) .................... · '~-Zf-~ F ~, ~:~-0 4. Estimated Cost .~..~ ................................................. ee ................ /. ....................................................................... (to be paid on filing this application) FEES: If dwelling, number of dwelling units..O.....~. ...............Number of dwelling units on each floor ............................ If garage, number of cars .................. ~.....//L.L'~_ .................................................................................................... If business, commerical or mixed occupancy, specify nature and extent of each type of use ................... r ........... Dimensions of existing str~uctures, if any: Front ....... .,~.....~.. ........... Rear ...~. .................... Depth ...~,~.... .............. Height ........ rl~......~...&.,../..: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 ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ..... ~.....~..~ear ............................ Depth ............................ 10. 7one or use district in which premises are s~tuoted .......................................................................................... 1 ]. Does proposed construction violote ony zoning Iow, ordinance~or regulotion? .......... ~ ............................... 12. Name of Owner of premises~.Z...~"',~/.~Addres~.'.~.~.~..~./~..~.~. ~[ ~0 7' Name of Architect ....... ~ .................. ~ .................. Address .......................... ~.~.~hone NO .................... Name of Contractor...~:~:~.~~ress ...~~Phone ~IAG~M ~ Locate clearly and distinctly all buildings, whether existing or praised, and indicate all set-back dimensions from property lines. Give street and bl~ers or description according to deed, and show street names and indicate whether interior or corner lot. . 4~ ~- / ,/ - ~ /v , STATE OF NEW YORK, ~ , ' ,~ S S)~/ COUNTY OF~~ ...... ) // ........................ ,,om, i, (No~e of individual si~nin~ oppli~otion) i, ..................................................................................................... (Contractor, o~ent, cor~rote officer, etc.) o{ soid owner or owners, ond is duly outhorized to perform or have performed the soid work ond to moke ond file this opplicotion~ thor oll stotomonts contoined in this ~ppl[c~tion ore true to the best o{ his knowled~ and ond thor the work will be performed in the monnor sot {orth in the opplicotion filod th*rewith. Sworn to before me this ...... ~..~. .......... day of ..Z/-.~-f..',.~.....' ..................... 19.~.~..'... Public,. ...... --~ .~q-~..g~..~Z~:-~2~..~~ Notary £LOISE BOWD£N N~tarY. ~ubli~, Ste e of New York (Singature of applicant)~/