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Home My WebLink About414-zFOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ......... X..P-J~... Date ............................ THIS CERTIFIES that the building located at ...... l~/.J~....,,~-{~l~.,~¢]. .......................... Street Map No ..................................... Block No ..................................... , Lot No...~.~...~..~.~.t'.~.~.~.L.,,~.,'..~..° conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................... Al~i,g. us.t.....'i.8 .......... 19..~'~.., pursuant to which Building Permit No ......~....4¢...]t.~. ............ , dated ............................. ~'1~.1~.~...~..... 19.~.~i..., 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 ............ ............................................ P. RI.VATF,.....DWF.,LLING ........................................................................... This certificate is issued to ..... P. aul.,l a helor .......... ...................................................... (owner, lessee or tenant) of the aforesaid building. FORM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ................... J~..~.....~..~. .............. 19..~.0.. Permission is hereby granted to: ~tanl~ ~.~ .....&(..~..... P. m~.. ~c~;~.r. ..................... ...~mm~t..Av~ ...................................................... ................ ~lat~t~uc~.....~,X, .......................... to ...... jt~.l~.. ~z~ ..aSd.~.t .~.. ~ ..s~ ..~.:~r~ .. dYe.t 1~.~ ................................................... at premises located at ...~:l~...,~,~,~...~l~.t,t,~.~l~..jf~F~..j~l~F. ty. .............................................. .............................................. 8~h~...~o~ ....................................................................................... ........................................................ ~a f,t~.%u~k ~.....~, ~;,. ................................................................. pursuant to application d~ted ................................................................ ]9 ........, and approved by She Building inspector ......... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. I( - Approved ........................................ 19 ........ Permit No ........... (Building Inspector) 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 adioining 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 he occupied or used in whole or in part for any pui'pose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuanoe of a Building Permit pursuant to the Building Zone Ordinance of the Town of So~thold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or o Iterations, 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, electrician, plumber or builder. ...................................... .............................................................................................................. Name of owner of premises ..................................................................................................................... If applicant is a corporate, 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: ...~....../. ......... Street and Number ...~..~ ....... ~'"~'""~"~'?"'"'~Municipality ............ [~~~~"~"~'""~'~' ........ 2. State existing use and occul:~ncy of pr~r~ses and intend~:l use and occupancy of prpp~ed construction: o. Existir~j u~ and occu~ncy .......................................... ~ ........................................................ b. Intended use and occupancy ....................................................................... ~ ........................................................ ~ Nature of work (check which applicable): New ~utl~i~i~h;.-: ............... Addition .................... Alteration .................... ,; Repair .................... Removal ................... J~' '~Kt...'r.~..:.t ~,~yOther Work (Describe) .................... 4. Estimated Cost ....... ~ ........................ ~ ................... Rle2,~..D~-' .............................................................................. .... - (to be paid on filing this application) S. If dwelling, number of dwelling units ......................... ;.,..~.Nfl~r of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify .neture and exten~ bf' each type of use....j ...... i .................. Height ............................ Number of Stories .......... ~ .............................................................................. DImen~'ions of same structure with alterations or additions: Front ..... ~....~.. ................. Rear ....~...-.~.. .................. 8. Dimensions of entire new construction: Front ......... ~ ........... ~,..R~ar .......... ~ .......... Depth ~..~..,.L..,~ ........... Height ............................ Number of Stories ...... L~...- 12.' Does proposed construction :~,ioiate 'orly' ;~O~iing law, ordinance or regulation.> ......... ~ .................................. ~ Name of Architect...; .................................................... Address ............................................ Phone NO ..................... Name of Contic~tor.~.~., ......................... Address ...i..~.~2./. ...... phone NO ...... 7? .......... .... ~ · ;" PEaT DIAGP-~M' ..~ate ctearly and distinctly eH b~iJdings, proped~/ lines'. Give street qrld b[~ ~ n ~urn~e~ r~. ,or dmcr. iptlon acco~i.ng to a~ee~,., .a~.a.~ snp~. st,r~,.., na~e~, and JJndlcate STATE OF NE"~_Y,I;~.,.. ~' ) S S ~" ' "" ' ' cou~P~ 0~~....~..~~ ~ ...~~- · ... : .... : - .. . ..~..:. ........ ...... .,. ,, ' (Na~'~~'*~~ ...... - .... ' ~ '~ a~ve na~, ~ ~s ~ .................... ~, ........ ~~~?~;~tF~;'~;f'"' ......... '~'-:~ .................... of mid ~er or owne~, and is duly aut~riz~ to.~ ,r ~'--"''"" ~'"~'~'~e .i"--"~;~.~ ~.~ ~il~ and ~at ~e work will be ~r~rmed In t~ ~nner set to~n m me ~pucaT~ ~1 ~ ~ . .