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Home My WebLink About129-zFOI~i~ NO. ~ TOWN OF $OUTHOLD BUII. D~NG DEPARTMENT TOWN CL[£K'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No... ~..~.7. ............ Date ............... ~o.v. embe~..... 23. ............. 19...~.2.. THIS CERTJFIF$ that the building located at ...F/8...Sm~..th..~J..v.e...8ou~l~ ............ Street Map No...G..Q.O.~.e....N.e. ck..E.s..t,,.BIo~XKI~, ..................................... , Lot No. 6~-~-'"'.8ou'~ho'l'~}'~" N.Y, conforms substantially to the Application for Building Permit heretofore filed in this office dated .......................... O.~.O.b~.~...~. ........ 19...~.., pursuant to which Building Permit No ...Z..3~f). ............ , dated ............. .0. f~.t~.e~...2 ..................... 1 9..~.~.., 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 ............ ...................................... ~.z. ~...~.E~.~ .z..~ .................................................................................... This certificate is issued to ....D~.~-.~...~:].~, ....... .(~.~e~'.) ....................................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTFIOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES VPI~*-*S"~:'t~)P* ,~,f~;~gga~,~,~,f,~c~A~,~ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: Oeo. ........ Main..Road ........................... : ...................... .......... S~u.thold.,......N, .Z, .................................. to ....~uL~d..and...addi.tio~l...to...ex~s.~2~..d.~e.1..~B& ......................................................... at premises located at ..~/.tB,..s~JL:~'L.~:Lt/;e.,.~Ol~t;h ........................................... lI~o~.~...~I~.~1¢ ............................................................................................. .................................................. ~o.~.~h~ ~.~.~ ......t..~... ~.z.... .......................................................................... pursuant to application dated .................... 0.~'l;l~bel:'.. ~ ....... 19. ~.~.., and approved by the Building Inspector. Fee $. ~:..0...0. ............. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×amned ....... ........ App ovecl ........................................ 19 ........ Pen'mt o ................................. Disapproved a/c ................. ?..... ................ (Building Inspector) Application No...../..?:...?. ........... APPLICATION FOR BUILDING PERMIT Date ~ ~'~..~..' ~ 19~..i~ ...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 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. Zhe applicant agrees to comply with all applicable laws, ordinances and regulations. (Si~ure ~Fplic~nt, or n~me, if ~ corporation) ....... ..................... (Address of ~ppHcont) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. Name of owner of premises....~~:..~..........~~ .............................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I.Location of land on which proposed work will be done. Map~No. ~.~.~,!~.~..,.:....~..,.~.~.,~, ................ Street and Number ~.~..~....:~ ......................................................................... 2. State existing use and occupancy of premieses and intended use and occupancy of proposed constructiOn: a. Existing use and occupancy ................ ~..~-,,~-.. ....... ' ...... i ........................................................................... b. Intended use and occupancy ........... ~ ................................................................................................. Nature of work (check which applicable): New Building .................... Addition .....~. ......... Alteration .................... ' Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ....... /......~...~ .................................... Feerr~ (to be paid on filing this application) FEES: 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 ................................ Height ....... ./,,~.. .............. Number of Stories .......... ~ .................................................................................... Dimensions of same structure with alterations or additions: Front ..... ~....~ .................. Rear ....,.~.....~. .................. ~ L .... ./.~...f ................ Number of Stor~es ...... ~ ........... 8. Dimensions of entire new construction: Front ........ /;..~ ........... Rear ....,Z'.~....~... ............. Depth ...../....~. .................. 10. Zone or use district in which premises are situated ......................................................... 1 1. Does proposed construction violate any zoning law, ordinance or regulation? ....... ~ ...................................... 12. Name of Owner of premises.~.~, ddress ............. Phone NO ..................... Name of Architect ............................... ~, ..................... Address ...~..._~; ......... Phone NO. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or property lines. Give street and block numbers or description accord~.g whether interior or corner lot. STATE OF NEW YORK ) " ............. ~.~.-.: ..................... being (Name of individual signing application) and indicate all set-back dimensions from and show street names and indicate duly sworn, deposes and says that he is the applicant 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 ali statements contained in this application are true to the best of his knowtedge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworr, to berore me this ~)~ ~ ........ ~ ........... day of ............. ..~,....~...,' ................ 19.~....~.... c~/~''''-~ ~ ~ (Singature of applicant) Notary ~L~ ,1~~ ................................... Y l, lo~tY P~b ¢ State at N~ york Residing in Suffolk County No. 52-0367800 ~y Commission Expires M~rch 30, 19 FOI~N[ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. " ' ................. Approved ........................................ 19 ........ Perm ~ Disapproved a/c ................. ,.~ ............ (Building Inspector) Application No ................. ~. ......... APPLICATION FOR BUILDING PERMIT Dote.....0..~.. ~ ................................ 19~...~.. .... 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 drawn on the diagram which is part of this location. c. The work covered by this appllcation 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 ap,plicont, or nome, if a corporation) (Address of opplico~t) State whether applicant is owner, Jessee, agent, architect, engineer, general contractor, electrican, plumber or builder. Name of owner of premises....~..~.....~~~ .................................................................. If applicant is a corporate, s~nature of duly authorized officer. (Name and tfftle of corporate officer) 1. Locat'on o and on wh ch propooed war< w be done. ~v~ap Nc>: ............ ~..C,.,,./'('. ....... E~ ...~...,.~=,. ....................... Street and Number~~....../.~.. .............................................................................. 2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction: a. Existing use ond 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 Cost ..... ./~ ...................................... Fee (to be paid on filing this application) FEES: 5. If dwelling, number of dwelling units ...... ~....Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................................................ 6. If business, commerica[ or mixed occupancy, specify nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front ....... ...~.....o. ............ 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 .../....~ .............. Depth ...../....~.. ................. Height ........ ./...."~.-../. ......... Number of Stories ......~ .......... 9. Size of lot: Front .../....~ ............Rear .....~..~ ............. Depth .....~...~ ............. I0. Zone or use district in which premises are situated ....... ./..~................................. .................................................. 1 1. Does proposed construction violate any zoning law, ordlnanc¢ or regulation?.........~_..: ...................................... 12. Name of Owner of premls Address ... ........... Phone NO ..................... Name of Architect......, .......... '~'"'%7~.~ ....................... Address .....~ ........... ¢ ....................... Phone NO ..................... Name of Contractop~..~..<.~...~.~Address~.~..~...: ...... Phone NO. ~...~'...~...~. PLOT DIAGRAM whether and dimensions Locate clearly and distinctly all buildings, existing or proposed, indicate all set-back from pr°perry lines' Give street and bl°ck numbers °r descripti° n~acc°rding %C,~,x~/~/.j ~,~~ to deed, and show~t,r~et names and indicate whether interior or corner lot. STATE OF NEW YORK, ) ................. ~..~ ............................ belng duly sworn, deposes end soys that he is the applicant (r',lome of individual 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 his ]~nowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. // Sworn to before me this ,~/- -/'/ // ./ ...... 2, .............. day of .......... dL .. ................... (Singature of applicant) Notory Public,.-.~....~ ................................ County ELOISE BOWDEN Notary Public, State of New york IMsJding in Suffolk Coun~ ,o. 52-0367800 ..~ ~ My Commission Expires March 30. 19