The URL can be used to link to this page

Home My WebLink About164-zNO. 4 TOWN O'F SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. CERTIFICATE OF OCCUPANCY . Main Rd. a Ke~.n ~1v6., Gree~or~. THIS CERTIFI{[$ that the bui~din,g located or .................................................................... ~treet Map No ......................... Block No ......................... Lot No ................................................................... conforms substantially to the A.uplicotion for Building Permit heretofore filed in this office dated ...~.. ..................... ..N..O..,%~...~..E...,,4.,...., 19...~..?.., pursu,a'nt to which Building Permit No. Z 164 d.. November 4 .,. 57 area ...................................................... I¥ ........, WaS issued, and conforms to oil of the requirements of the applicable provisions of the Iow. The occupa.ncy for which this certificate is issued is ................ I~I~S~/NESS BUILD2]NG This certificate is issued to .................. ]~y.,,~,;~.c.$.~......~...~.e..~. ......................................................... (owne. r, lessee or tenant) of the aforesaid, building~ Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN Ct.[RK'$ OFFICE SOUTHOLD, N. Y. BUiLDIHG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES V~kT~ic~[j~l~. ~V,~I~6*~*~I~r.T~E~I'~[~t~IS~!JNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No....Z...i~ ......... Permission is hereby granted ~o. Date .............. Bovember-... ~..-.' .............. 19%~... · l~y~o~..~iae&a ............... : ............................. .............. Main...Re~cl...(.~te~.te...2.~.) .................. .................... ~er~po~.~.~..,...~,~,._v.~ ..................... to ..... ~Bu~L~¢I.. n~.. l~u~l~e s.s .. l~u~.Zelin~. ..................................................................................... at premises located at ..E/~..Iv~tt~..~oa~l,r..R~t. te...2~...&..Ke~,~i~..t~].~t.i~ ............................ ......................................... Greenpam.l~t...l~ol~o ......................... .......................................................... pursuant to application dated .................... ~o.V.e~e~,...~.i ................... 19..~.~.., and approved by the Building Inspector. Fee $..~.0.,..0.0. ........... Building Inspector FORi~I NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ×omned ....... ......... l . '. Perm't ....... Discpproved c/c ................... ~::..,~ ....... ~.~ ..................... ;~..~,;~. ....................... (Building tnspector) Application No ........./.....~'... ~ ....... APPLICATION FOR BUILDING PERMIT 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 granied 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, agar, general contractor, electrican, plumber or builder. prem ses .... ....~....: ~..~...~ ~ ............................................ Name of owner of ~ ....................... 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,~,Mop~,/ /~ _J) '"~;~ __N° ............... ~ ................... Block ... ~, , Street and Number ......~.. ~..,...~,....~.::..'.~.. ........ .(~......./.~,.~..~.....~,.~....~....~..~/~,.~.~.f',.';~/~:q(i,?:~': State existing use and occupancy of premieses and inten~Jed use and occupancy of proposed construction: b. Intended use and occupancy.../.~..~...~...~....~.......~..........~.....?~.........~. .............................................. ~...:... 3. Nature of work (check which applif:able): New Building ....... .../...'~.........Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... /~\ ~_~---- 4. Estimated Cost .../.~ ......................................................Fee ..f..'<....."'"'" ........................................................................ (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 bus ness, commer cai or mixed occupancy, spec fy nature and extent of each type of use ............. property lines. Give street and block numbers or description whether interior or 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 enti~ new construction: Front ......... ........... Rear ...... ............... Depth Height ........ ...'~...O. ............. '~ Number of Stories ..~ .......... 9. Size of lot: Front ! O O Rear /O O Depth /'3~; ]0. Zone or use district in which premises ore stuated ............................................................................................ 11. Does proposed construction violate any zoning law, ordinance or re§ulotion? ................................................... 12. Name of Owner of p ..... ~ ................................ ~ ............... Phone NO. Name of Architect ..................................................... Address ............................................ Phone NO ..................... Name of Contractor....~..'.~~ ........... .('~....~'.. ............ Address ...~.:' ' ................. Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from =ording to deed, and show street names and indicate STATE OF NEW YORK, ' ) SS ~U~ITY OF~.....~[ " ~..;..~,.~fZ~.~?....:.~.(.-~-.'~..~rff.. ............. .. ............... being duly sworn, deposes and says that he is the applicant i ~j (Name of inaividual 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 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 c"7'L~ ' 19....'~...Z.. Notary Public,~ .... ...J~... ~.~~ ........... County ELOISE BOWDEfl I~ota;y Pubhc, State of New York Resi(fing in Suffolk County No. 52-03~57800 MY Commission Expkes ~,'~arch .30, ~.9~/~ (Singoture of applicant)