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Home My WebLink About393-zFORM NO. 4 TOWN OF SOUTHOI. D BUILDING DEPARTMENT TOWN CLEP~K'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY Oaklawn Avenue THIS CERTIFIES that the building located at ............... S.~fb~.M~...E.,.i.~.~...N.~Z.~ ..... Stree~t Map No.. ........................ Block No ......................... Lot No ...... ?..~ ....................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. ~.]'..~.....~..~. .......................... , 19..~.~.., pursuant to which Building P~ermit No.~..,~.~ ................. dated ............................. ~[ ' ' ~1~ ........ , 19..,~...8.,, wes issued, end conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .............. PRIVATE DWELLING This certificate is issued to ..... ~.~!!.~.?...0..~..~'~..?.~?. .................................................................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector r~~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, No Y. BUILDING PEP. MIT (THIS P'ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 393 Z Date ........................ ~3,~.. · ~,~,,. ~C) ~L.. 19 ........ Permission is hereby granted to: e, eor~e ~P~lt~ml~o..--. A/~.-.-. ~-~oee...E:e.~ .......................... -...~.~7. ~... ~:~.e~;~.~ .. ~, L: ............................................. ......... · ~'~e[to ~e.~,..-.-~.-D ~..f --...-;,~. ¥ ~. ................ to ......... B~t~} ..~e'~..~et.t~ ........................................................................................................ at premises located at '~'/~"O~¢~t~--A~e-'.~ea¢.~o~ ............................................................... pursuant to application dated ............................ D~'~'?'"'i~'~' ................. 19.~... and approved by the Building Inspector Fee Building Inspector FOP~I~I NO. 1 TOWIq OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD~ lq. Y. Approved...~:.?!........!./. .......... i../.....19 ........ Permit 'l~' ~, ~ ~ ~ No.../~.....~ ...'..::~ .......... ........................ i~'~'il'~i'~'~"i:sT~T~';;'~i ............. 't ............... ^ppl,cotion Ne. ^PPUC*T,ON FOR EU"DING PERMIT Date ......,.~ ....... ..~..'~... .......................... 19..~...~..i. INSTRUCTIONS a. This ~ppHcation must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing Ioc~tion o~ lot ~nd of buildings on premises, relationship to ~dioini~g premises or public s~re.e~s or ~re~s, ~na giving ~ detailed description of I~you~ o~ property must be drown on the diagram which is p~rt o~ this Ioc~tion. c. The ~orl< covered by this ~pplic~tion m~y ~ot be commenced before issuance o~ Building Permit. d. Upon ~pprov~l of this application, the Buildin~ Inspector will issue ~ Building Permit to the ~pplic~nt. Such permit sh~ll be kept on the premises ~wil~ble ~or inspection throughout the progress of the work. e. No building sh~ll be occupied or used in whole or in p~rt for ~ny purpose whatever until .a Certificate of Occupancy sh~ll h~ve been gmnted by the Building Inspector. APPLICATIO~ IS HEREBY MADE to the Building Dep~rtment for the issuonae of ~ Building Permff pursuant to the Building Zone Ordinance o~ the Town of Southold, Suffolk County, Ne~ York, ~nd other applicable Laws, Ordinances or Regulations, for the construction of buildings, ~dditions or ~ Iterations, or for removal or demolition, ~s herein described. The applicant ~grees to comply ~ith . .~..~K. ~.~2~ .... ~: ...................................... / (Sigffature of applicant, or name, if a corporation) State whet~h,er applicant is owner, lessee, agent, architect, engineer, general contractor, electriCian, plumber or builder. ................................................................................................................... Name of owner of premises ................ - .... .~ .~...C. ...... . .......................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which prop, osed work will be done. Map No: ............................................ Lot No: .................... Street and Number ...~.'.: -~.,'./.~....f~;;.~...t:....Z.~.L ' ~/..,x.;¢:.~. ~ .~....t~'.~..~.. ......... Mufiicipality / / 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... .~...~.-~Y:.e.~-.%.; ........ ~: ......................................................................................... ' ' 3. Nature of work (check which applicable): New Building....~'......AddltJon .................... Alteration .................... Repair .................... Remova~ .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ...................................... Fee .......................................................................................... (to be paid on filing this application) 5. if dwelling, number oF dwelling units .........4 ..................... 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 ....... ~'~r~ ...... 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 ...,~,.~4'.'. ................. Depth ..~..::.% .................. Height ..../...~.. ................. Number of Stories ..... .~. .................... 9. Size of lot: Front .... ./o ~" Rear ..,/..~'.~.~L.~ ................ Depth /...~i:..~...'. .......... 10. Date of Purchase ..../..~..~¢..~....~- ..................................... Name of Former Owner J~..~f4.~.er:'~~ ............... 11. Zone or use district in which premises are situated ................................................................................................ ' 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... :¢.¢..z.~...~,~.~,.,,,~.'.~.~.~,v,/. ..... 13. Name of Owner of prffmise,sa.~'~-~..~.~.......Address,, ------ --"/-- ~--~ ../.4.Z~'~'-v,~¢ '~---~-Z.~:x~.z~fnoneNo.x"/ '~"~ ..............- ~.~i...'. ..... Name of Architect~.(..~.-__________________~4~.z2 .............. .~ ....... Address~ -- ~;~q'~ ......... Phone NO ..................... Name of Contractbr.,~c,Z-~-.~.(~.Z'~'.~.~,.-~.-z~..~? ......Address ~'.~.Zr.'~'~r~..~o'...,~Z.../..'......Phone NO. ~.'./~.0~..~.'~...~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate ali 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'Y.J;~,/2.,( ) S S COUNTY OF Y.L~~,~...) ' above named. He is the....~.~~g~:~..~ ...................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du[y 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 fi[~d therewi~-3 ~ / Sworn to before me this / ~ ~ ~~~ ............ dav of , ,, 19 ~ , - (~ature of apphc~t~N~ ~ ~ . TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ' E×om ned ........ 9.Y?e?- , ,, , . ...... Approved ........ !..~.. ........................... 19 ........ Permit No. ...... .......... (Building Inspector) Application No ....... .~'~....?. i'..?.. ........ APPLICATION FOR BUILDING PERMIT Date ........................................ 1 9. . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and su6mitted 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 pu?pose whatever until .a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION 1S HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southotd, 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. .......... : ....... ~ ........ : ........................ ~ .................. ~ .............. 7"[~,gn~ of appl,cant, or name, ,f a corporat,on) (Address of ~pplic~nt) ~ State wheth,er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ' ' " ............................ Nome of owner of premises ...................................................................................................... If applicant is a corporate, signature of duly authorized officer. · /. ,.~.z. ~.~,~,.. ........................................... (Name and title of corporate officer) I Location of land on which p,r~oposed work will be done. Map,No: .................................... ........ Lot No: .................... Street and Number ...¢.'~.~..'-.L~~..' '~~h~. ./~...~j.: ..../..'~..~.~,./.'. ......... Municipality / ! 2. State existing use and occupancy of pr, emises and intended use and occupancy of proposed construction: o. Existing 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 Cos.¢~...~.J .~.~..~.,.,.~.<.,:'..~.: ..................... Fee ............ i~';"l~;";',~'i'h"~;";F'i'l'i'~";~i~";';'~'li'~i;~i ................... 5. If dwelling, number of dwelling units .........~ .................... Number of dwelling units on each floor ............................ If garage, number oF cars ...... ~ ................................................................................................................................. 6. If bus,ness, commercial or mixed occupancy, specify nature and extent of each type of use .............................. 7. Dimensions of existing structures, Jf any: Front......~ ..... Rear ............................ Depth ............................ Height ............................ Number of Stories ............ ~ ................................................................................................ Dimensions of same structure with alterations or additions: Front ...... ~.:.:.:~.~ ................. Rear ................................ Depth .............................. Height .............................. Number of Storie~ ................................ 8. Dimensions of entire new construction: Front.....~'. .............. Rear ...~; ................Depth ...:,~.~. ...... ' .......... Height ...~.~. .............. Number of Stories ....... ~ ................... 9. S,ze of lot: Front ...... ,,~,,/~'~"~ ......... Rear ...... ~.~..~(. ......... Depth .....~.~...~.;....~.. 10. Date of Purchase ...(.~.~..d.... ................................... Name of Former Owner .~~~~ 11. Zone or use district in which premises are situated ....... ~.. ..................................................... 4// ................................ 12. Does proposed construction violate 9PY zoning law, ordinance or regulation? ...... :~.~.,~.....,.....~.,.~ ....... 13. Name of Owner of pre~i~.~..~~...Address ~,~~Z~.Phone ~..~.~.¢~Z Name of Arch,tect~~~.~ddress ............................................ Phone NO ....................... Name of Contractor.~Zf.i~~....Address~:2~.~.~:.~g)one PLOT DIAGRAM Lecate clearly and distinctly afl 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. , ~ ¢~I<~-At/~t ~.~ ' STATE OF N~YORK,_. :,,~__ ) SS · ..................... ............................. swo,n, e.o.e.a.d he ,, ,h. (~me of ff~dividual signingCapplica~iog) above named. He is the ........~.~:¢~.~ .................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, ~nd 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 th~ . Qualified in Suffelk County Commission Exolrei Mer~BO. 1959