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Home My WebLink About112-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .~./.~......~:~.~.~.~..~.~.......~..~..~. ..................... Street Map No...~{,-'~)f~ ........................ Block No ........](ZC~ii'X ................... , ~..~.Q.~O.~-.d.~......~.,.~'~ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................. ~.ep.t~elg~t~...~,09...~.~., pursuant to which Building Permit No ......... ~...~.~ ....... , dated ................... .~...e.]~.t¢.e.~.~..°...~.....~..O.. ....... 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 ............ ....................................... PRII~AT.~;.. DWEL. T~I[~6 .................................................................................. This certificate is issued to ..... 1~....C~...~,t-~ ................................................................................ (owner, lessee or tenant) of the aforesaid building. I Bui ding Inspector FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES '4t/~T..~¢Q,N,~T,~,B,~ .~.~B(~:~,~,..~fit.~J~&¢.~j[l~C.~.~ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No....Z..,.. ~..1.~ ....... Date .................. ~ep%eLEt,~e~.....~O ........19_ ~.~. Permission is hereby granted to: Roy O...~.~'~l.in .............................................................. ............. ][~:~.~s~,~....~,. ................................. .................... ~o. ut, hold.,.....~h ~ ......................... to .. D.u il~...n~-~., dwell ~..~ .............................................................................................................. at premises located at ..~.....~.~t~.....A~,~ ............................................................................ ....................................................... ~,.. ~O1~.,.....~,,,.~,~ ...................................................................... pursuant to application dated ~)~h~.....~O ................... 19.~..., and a~,proved by the Building Inspector. Fee $ .~ .0.. O.O ............ FOI~M NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OI~:FICE SOUTHOLD, N. Y. E×amined ....... Disapproved a/c · ' ......... ........... INSTRUCTIONS o. 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 publio 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 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 all applicable laws, ordinances and regulations· (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electricon, plumber or builder. .................... .~. :.~.~ ~.~:...~.. ;...~z:.. .............................................................. Name of owner of ~-_m~-e .................. If applicant is a corporate, signature af duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No ................................... 13lock .................................. Street and Numbe~./..~.....~!~<~.~./../...~.: ...... ,~.¢....~.'~ .......................................................................................... 2. State existing use and occupancy of premieses and intended use and occupancy of proposed constructiOn: a. Existing use and occupancy ....... !../:.;':.'~ ...... b. Intended use and occupancy ........................... 3. Nature of work (check which applicable): New Building ...... X .......... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition. ................... Other Work (Describe) ......... ~ .......... 4. Estimated Cost ...... ~'...(.,~.~.~2. .................................... Fee / 6 ~ ........................... (to be paid on filing this application) FEES: If dwelling, number of dwelling units ............ ~. .............. Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................................................ property lines. Give street and block numbers or desc~ whether interLqr or corner lot. v 6. If business, commerical or mixed occupancy, specify nature and extent of each type of use ................................ 7. Dimensions of existing structures, Jf any: Front ............................ Rear ~ Depth ............................ ............................ Number of Stories~ , Height ~'~ Dimensions of same structure with alterations or additions: Front ......... ~.T.~ ................... Rear ....L-.: ........................ Depth .............................. Number of Stories .............................. Height ................................ 8. Dimensions of entire new construction: Front .......... ..~'.~...,¢..~'~,.... Rear .... ~./.'f'?..~.,~ .......... Depth .......~,.f/....~.~, ......... Height ...... ./..~.....'~...f....~./.*.~./~. ~lumber of Stories ...... =..~.;,~/~ ....... ~7,5 .~ Rea ... ,/. ~./.~.../.~./'.,. ...... 9. Size of lot: Front ...................... :.t... r ..~ ........ Depth s tuated. 10. Zone or use district in which premises are .............................. ~. ............................................. 1 1. Does proposed construction violate any zoning law, ordinance or regulation? ...... ...~...~. ....................................... 12. Name of Owner of premises./.[~...(..../.~.]Z.A.!.F/. ......... Address .~./~..~.~..'.O.~:!~ .................. Phone NO ..................... Name of ' ~ . ........................................... Phone NO ..................... Architect ....................... Z/' ~,~['~, __ ,~ .......................... Address Name of NOi Co nt rac to r. ~ .~.. · .¢.~?..'~. ~ ................ Address ............................................ Phone PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from ption..according to deed, a~cJ sh.ow street names and indicate STATE OF NEW YORK, ) S OF ~/~,~ ~......) S COUNTY -- (Name of indi~duol signing opplication) above named. He is the ........................... ~ ............................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work ond to moke and file this application; that all statements contoined in this application ore 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 therewfth. Sworn to before me this ...... .~..'. fl.....~..~.. .... day of ......... ~...~ .............. 19...~.i~.. Notary Public,.....~..~..[:..~ff.. r~-,..~ ~ M.~ ........... Count~T- 'ELOIS£ BOWDEN ~lel~R Public, State o[ New ¥o~ esidin~ in Suftolk CouDty No. 52-0367800 My Comrn~ssol F'p:lPs March 30, I9 ~ (Singature of applicant) FOI~I NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...... ...'~.....~¢._... ................ 19 ........ ^ .... pproved ........................................ 19 ........ Permit Disapproved a/c ........... ~ .............. .............. -- (Building Inspector) Application No / / APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. 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 drown 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 ~)remises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in port for any purpose whatever until a Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o 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, ordinances and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electricon, plumber or builder. Name of owner of premises ................................................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work will be done. Map No ................................... Block .................................. Street and Number 0,~-~ ,-. State existing use and occupancy of premieses and i ntended/-,gse ai~d occupancy of proposed construction: .... b ntended use and occupancy 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... Estimated Cost ../i..~.~....O...'~._..~.. ................................... Fee ../.....U......~..~....' ................................................................... 4. (to be paid on filing this application) FEES: If dwelling, number of dwelling units ............................ Number of dwelling units on eoch floor ............................ If gorage, number of cors ........................................................................................................................................ 6. If business, commerical or mixed occupancy, specify nature and extent of 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 of entire new.construction:. Front ........... ..~.....~.. ....... Rear ..... ..~(.....0. .............. Depth .~ Height ......... /..~.. T/~....~..:~ Number of Stories ..... /. ..................... 9. Size of lot: Front ...... Z..~.... ......... Rear ......... .~....~.... ........ Depth .../....~...'...0.. ......... 10. Zone or use district in which premises are situated ...... ~..........~...c~.~..~... ....... ~ .............................. 11. Does proposed construction violate any zoning Iow, ordinance or regulation? .......... ~ ................................ 12. Name of Owner of premises...~ ..... ~: ..~..~ddress ...~.~i'..~...~.../....~. ............ Phone NO ..................... Name of Architect...j.~,~v/ ............................................ Address ............................................ Phone NO Name of Contractor..~...~ ............... Address ............................................ Phone NO .................... PLOT DIAGRAM Locate glearly and distinctly all buildings, whether existing or proposed, and indicate all set-back 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. ~ ............ STATE OF NEW .,O 5., C.,) S S COUNTY OF~T...) " ~,....../.~..~/:...Q,~......~'~/~..4~..~ ............................................. being duly sworn, deposes and says thai' he is the applicant ~Name of i~div'~ual signing application) above named. He is the .............................. ~~ ......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform 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 h;s 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 .... ~,.~...~....~:~/) ' ///~ ~day of .... .~.~.. .................. ~ Notary Public,'~.~~ ........ County [[OIIE BOWDEI't ~'~ PUbilo State of ~ew York II dll~t In Suff~ k County No. 52-0367800 ~ ~mtt~io, Expires March 30. ~.~. (~