The URL can be used to link to this page

Home My WebLink About391-zFO~I~f NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY Z ' November No ...... 22,~: ........... Dote .................................................................... THIS CiRTIF:[ES that the building located et .~/.~.....~'~..e..lff..~..~...f..~?..]?....A...V.?.' ................. Street Map /No ......... :....~,~.~.Z~ ............. Bloc[< No...~Sf.,XX]~ ................... , ................ ~ l~Ia. tt, it~lok:s conforms substohtiolly to the Application for Building Permit heretofore filed in this office dated ........................ ,~.I12~. ....... 2~, .......... 19.~..., pursuant to which Building Permit No .....~.....~.~..1. ............ dated ...'~ .................... ~1'tt],~.....2~ ............. 19.....~., was issued, and conforms to all of the requirements of the a'pp(icab{e provisions of the I(~w. The occupancy for which this certificate is issued is ............ ............. ~ ....................... Businea~...btlil.d.$~g .................................................................................. This ce~ificote is issued to ..~O~.g..~;l..g.~O.!¢......-Ik~.~: ..~.~..~...~.0..~. ........................................................ · (owner, lessee or tenant) of th~ qloresa~d building. Building Inspector FO~R/I NO. 2 TOWN OF SOUTHOLD BUILDING DEPAP~TMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMrSES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 391, Z Date .......................... J~l~..~;TL ~ ............. I~. .... Permission is hereby granted to: · ~ti.tuck..~ir...D~$~...~c~ ......................... ................. ~e~;..~:.~Z~.~I~... Ave ........................... ......................... .................... to ........ to" 'btti i'd" 2-~dd~i'o~s" ~n" 'an' ' 'exi's ti'~ g" '~usi~e's s' - .bu-~tc}ing ..................... at premises located at ..$~.~q...t~e,4..Duil. fo.l~..£~e. ............................................................................ .............................................................. ~.ttit~ak,......N..:~ ~ ............................................................ pursuant to application dated ........................ ~T..~ly--,2,t- ....................... 19..~.., and approved by the Building Inspector Fee $.~'...00 ............. Building Inspector M A T T I T U C K 9-8330 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ............ L~. ~.'..~....'~...'k .'~'...1 ....... l C)..?...~.. Approved ........................................ 19 ........ Perm t No. Disapproved a/c ........... ./...~. ........ :,,:~. ........ ;,~. ......... ~ ................................. ..................................... [ .......... : ............................ T. ......... .x,,~..¢c ......... ........... ..................... (Building Inspector) Application No ....... ?..~..L ............ APPLICATION FOR BUILDING PERMIT Date ....................... ~ ........ ¢-..T.'. .............. 19 : .... INSTRUCTIONS o. This application must be completely filled Jn 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 part of this location. c. The work cowered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Bu~ildlng Inspector will issue o 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 p art for any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuonoe 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 re]ulations. ............ ........ (Signature of applicant, or name, if a corporation) ............... ............ (Address o{ opplicont) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applic~a~ is a~orporate, signature of duly authorized officer. /..__ ........ ...... .................. ......................... / / (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ....... ~ .................. ~ .................. Lot No: ...:......Z ........ Street and Number .~Z~....Z~.~(~: ....... ~ ........... ~.~?.~.....~:~ ~ [ Municipa~lity 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: o. [xistin~ uso ond occuponcy ....................................................... ~ .......................... b. Intendod uso ond occuponcy ............................. ~..~ .............................................................................. 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost...~..;~.!}..~. ...... ...~....~.i.~.?....?.. .................. Fee ~....:~ ........................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ................................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................ 6. If business, commercial 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 ..... ................ · l~" Number of Stories ~ ............................... 8. Dimensions of entire new construction: Front......T... ..................Rear ........ .~. ................. Depth .../..~ .................... Height ............................ Number of Stories ..... ~... 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ........................................................ Name of. Former Owner ........................................................ 1 1. Zone or use district in which premises are situated ' - 12. Does proposed construction vioJate..al~y~zor~ing lawL ordinance or regulation? ...,._~.'.O.. ................................. 13. Name of Owner of premises..~/~.'..~..~..-~...'Tz.f..~..rV..0~eress ...... ..~.:..-~..'~.....Phone NO ..................... Name of Architect ........................................................ Address .................................. '1 ...... Phone NO ..................... Name of Contractord../.~:...~..'O..~..~.~....~..~..~%..Address ...... ~.f': .~..:~...~':..Phone NO. PLOT DIAGRAM Locate c[earty and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fram 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 NE~/~YO~I~, ~)~. ~ S S COUNTY OF ....................................................................be ng duly sworn, deposes ~nd soys that he is the applicant (Name of individual signing applicatio~ above named. He is the ...................................... ~.X...'~T .............................................................................. (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 s~t,,,,f._orth in the application filed therewith. Sworn to before me this i~ I~ I¢~ ~_ ~ow~)~:. , ..~...J...~.. day of ........... ~ ~.~)_9~.~?ol/m,~lo~ ~ (S,gna~Jure 9f apphcant) Notary Pubhc, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFPlCE SOUTHOLD, N. Y. Approved...h<. .............. Disapproved a/c ..,, ....... .......................... .......... .".~..;~ ........................ (Building Inspector) / Application No....~.../...! ................ Date ............ ~'~:~"1%t ....... 'c~' '"'/' .......... ,9..:~..~.. 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 l~ept 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and re]ulations. ......... ...... (Si~noture of ~pplicont, or nomo, if o corporotion) ............... ............ (Address o{ .ppl~c~nt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................... ..................................................................................................... Name of owner of premises...~. ~ .~1 ',~*~. ....... ...... /~.t ........................................ If applic.q.~ is a ~orporate, signature of duly authorized officer. ....... ........................ ~'?" / (~o~e ~nd title of corporote officer) 1. kocotion of Iond on whlch proposed_work wdl be done. Mop No: ............................................ .kot No: .................... Street and Number .~ ....... ~.~ ...................... , ............................................. // / Municipality 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: ~. Existing use ~nd occup~n6y ................................................................... ~ ....................................... ~ ..................... b. Intended use ~nd occupancy ............................. ~¢..;?.%~:; ............................................................................... 3. Nature of work (check which applicable): New Building .................... Addition ~' Alteration Repair .................... Removal ..... :; ............. Demolition .................. .._Other Work (Describe) .................... 4. Estimated Cost..~..:.~....0.~.~...Z...~-...~..?..~,....~'.. .................. Fee~....!~. ........................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ................................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.....¢.~. ............... 7. Dimensions of existing structures, if any: Front ........... '"-'~ -~.~......./~..'.... Rear ............ ..~...'..~..i ..... Depth ....~.....~.. ................. Height ............................ Number of Stories ........ ~..~ ................................................................................ Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height ................... ../y~Lz..Number of Stories ~ .................. 8. Dimensions of entire new construction: Front......'~ ..................... Rear ........ ?. ................. Depth ............................ Height ............................ Number of Stories 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ........................................................ Name of, Former.Owner .............. ~. ....................................... 11. Zone or use district in which premises are situo,~'ed...../~.....¢~'.~.P~...l ...... ~.../...b/....~.....C~......../.~.-..: ................... 12. ,D. oes pro, p~osed con, struction v~9~3t~k~,~,j~zo~:i~.~,'%-Ia.~,~ ~Ji~nance ~,),~g,u~,~:;~...~...'...~.. ................................. 13. ~Name or uwner or premises...,LY. ..........'.'....'....~.:J...i;.....;~ddress .................. ~ ......................... Phone NO ..................... Name of Architect ...... ~. .......................... ¢, .................. Address ................... 'M'/J'~L'"Ph°ne NO ..................... Name of Contractor.'.,.- ................................................. Address .........-.......f.~:%~..Y. .................. 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 according to deed, and show street names and indicate whether interior or corner lot. STATE! OF NEV~'Og.~,,.PJ("..,~S S COUNTY OF ....'~,.T(..I.~...~..Tt:./~),,/ /?' / /~,/ ......................................... ~ .................................................... ' g duly sworn, deposes .and says that he is the applicant (Name of individual signing applicati~~~ above named. He is the ....................................... ~,~m.~ ................................................................. -- ~ .......................................... (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 Jn the manner set forth in the application filed therewith. Sworn. to bebe me this [~ ~ ~4~ ' ~'. ............. day of ..........~.~ ~ ~ 1 g~. ~ ~'~ of ~ /~ignatuJe of~pplicant) ....... m~l~ ~ '~ ~ .~