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Home My WebLink About66-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY TH(S CERTIFIES that the building lacated at ~$/.~ ........ ~,~;~%..,[~,,.~.~.~. ......................... Street Map No ...................................... Block No ..................................... , ~}.~f~o. ".T.t~;~%"'~'o~ ...... conforms substantially to the Application for Buildlng Permit heretofore flied in this office dated ............................. J~.zl,~,¢~.....~.....19.,~.~.., pursuant to which Building Permit No .....~..~ .............. , dated ........... A~l[~?~r~,~.....~ .......... 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 ............ ...................... ~..t ~Z.\.~A.~ ......... ~i~LZ~Lfl......~/..... e.,~ :~.~.~., t:~ k~¥~ .............................................. This certificate is issued to ............ ~tO~:~,~%~.,~/..,..~O]~., ~ ................................................................ (owner, {essee or tenant) of the aforesaid building. Building Inspector FOI~I NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Iq. Y. BUILD~4G PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WI~,.H, ONE SET OF A~PPR, OVED RLANS AND SPECIFICATIONS Ui31TIL FULL COMPLETION OF THE WORK AUTHORIZED) No. "'~9'"'~C~ ......... Dote ....................... A".,~,~,~...~. ~ ............. 19..~.. Permission is hereby granted to: Do~t~h~'" ~J ~...~.n~o~,%}~ ................................... ...... ~1.%...L~:ne; ................................................. ...... )~.~%...~, ~:~ .~ ~.¥~ ¥.....~ .,.~ ............................... to ....... .At¢.e~.. e~,~c~., .ex~ c~d...~ra~ e,. ¥ · · ~:~ ~,e:ehe~ -- <~.o- -.e~,~?e t..'~ i~ ........................................ at premises located at ..,~/~..~:~? ~,~,...;[,~;t.~¢~ ..(.~.~,~,~e ~c~,~..~%)...I~.¢,..*~.~Z*~ ~r~. l~ .~, pursuant to application dated ........................... /~,',~t~,.~%..-~.~ ................ 19~..., and approved by the Building Inspector. Fee $.~.00 ............. Building Inspector FOI~M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. x m ned .................. .~.,~. ................ 19 ........ Approved ........................... ~..~. .......... 19...i'....Permit No..~'...~.'..~ .............. Disapproved a/c ~ ....... (Building Inspector) Application No..:~..~...~ ......... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely fif(ed 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 detaUed 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 builizling shall be ocdupied 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 for removal or demolition, as herein described. The applicant agrees to comply with ali applicable laws, ordi~ipance~"'~7¢d~'reg~ations. (S gnature of apphcant, or ?am,~er~/c~., ~f <or~o~hon) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electricon, plumber or builder. (Name and title of corporate officer) 2. State existin9 use and occupancy of premieses ond intended use and occuRancy of proposed COnstructiOn: o. xist,ng use and occupancy ............ b. Intended use and occupancy ........................................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration.~ ................ Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cast V .................. Fee .~. ?~--~-' (to be paid on filing this application) FEES: I 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ....................~.......~.~..~.',~ ........................................................................................... 6. If business, commerical or mixed occupancy, specify nature and extent of each type of use .......... ~..~...-T~.~..'~.' ........ 7. Dimensions of existing sl'eac=.tttr~, iT any: Front .......... /..~ ............. Rear ...... /..~. ................. Depth ...../..~..~ ................. Height ............................ Number of Stories ...... ~:.~ .................................................................................. .. Dimensions of same structure with alterations or additions: Front ................................ Rear ..................... ? .......... Depth .............................. Height .............................. Number of Stories ................................ Front .......... ~¢- ............... Rear ............................ Depth D--,~ 8. Dimensions of entire new construction: ~ ~ o__, . ........................... Height ............................ Number of Stories ..6~.'..~.~ .......... 9. Size of lot: Front ........ ..~...~: .......... Rear ........ .~...5:.i~ .......... Depth ......./'.i.~.~.~ ....... 10. Zone or use district in which premises are s~tuated...../~. ......................................................................................... · ~ 1 ). ~oes proposed construction violate any zoning law, ordinance or regulahon ........... ~.. .................................... 12. Name of Owner of premises ........................................ Address ............................................ Phone NO ..................... Name of Architect ...................................................... Address ............................................ Phone NO ..................... Name of Contractor ......... .cO. ........................................ ~,,3~,,~'-~ ~ Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property Jines. Give street and block numbers or descri'~tion according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE~ YORK, ) ..... (Name of {n~viduQl sJflning/6~atJo~) named.. ,, the ........... ........................................................................................................ (Contractor, agent, corDorate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file thru application; that all statements contained in this application are true to the best of his knowledge and behef; and thae the work will De performed in tho manner see forth in the application filed therewith. Sworn to before me this ..... .~ .'~. ............. day of ........... ~ ........... 19,..~.../... Notary .............. County ~ '~$ingature of a~:.'~on~' FOI~[ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19.,.~.....~ Examined Approved ........................................ 19 ........ Permit No ................................. ~" -- Application No ............................ APPLICATION FOP,, BUILDING PERMIT INSTRUCTIONS a. Tills 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 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 whale or Jn 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 for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinCm~e~s--az~d regulations. ~ (Signatureo~op,plicont,~:~;;~~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general con~ractor, electrican, plumbe, r or builder. Name of owner of prem.ses.....~ i ................. ~ ............ ;'~'~' ........................................................................ If applicant is a corporate, signature of du~/ authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will,~e, done. Map No .................... ~ .............. Block .................................. ................................................................................... 2. State existing use end occupancy of premiesest~d intended use and occu~poncy of proposed construchon: a Ex stng use and occupancy ~.~.."~ ' ~ ~:..-~.,~-- b. Intended use and occupancy ~ .t ~ , , 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration...~.. Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ........ ~ ...... ...T....~..:...~.. ......................... Fee '~' ~'~-- (to be paid on filing this application) FEES: 1 ,5. If dwelling~ number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ............... ..~.....~..~...C~.~.~....~. ........................................................................................ 6. If business, commerical or mixed occupancy, specify nature and extent of each type of use ....... 'il ........ ~ ......... Rear ....~ ..................... Depth ............................ 7. Dimensions of existing uct,~ if any: Front ........... ./...~.. ......... (~ / ae'''~'' Height ............................ 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 ........ .(~'....~.. ......... Rear ....... .~..~. ............. Depth ../..~...~ .............. 10. Zone or use district in which premises are situated ........ .~...~ .......... ; ...................................................................... 11. Does proposed construction violate any zoning law, ordinance or regulation? ....... ~....~.. .............................. 12. Name of Owner of premises ........................................ Address ............................................ Phone NO ..................... Name of Architect ...................................................... Address ............................................ Phone NO ..................... Name of Contractor ....... ~.O.:k:~'..-=.~..z:...'m~... .............. Address ............................................ 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 numbers or description acco to deed, and show street names and indicate whether interior or corner lot. &"CC, ~ t c~ above named. He is the ......... '~z~..~ .................................................................................................................. ~ . (Contractor, agent, corporate officer, etc.) of said awner or owners, and is duly authorized to perform or have performed the said work and to make ond file this application; that ali statements contained in this app]JcatJon are true to ?he best of hi: k~owledge and belief; and that the work will be performed in the manner set forth in the application fi~ed therewith. Sworn to before me this Notory Public,~.Y..~ ........... County