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Home My WebLink About436-zF,OR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. CERTIFICATE OF OCCUPANCY No....~...7.17 ........ Date ............................. ,Ylll,~r...l~ ............. 19(~.0. - THIS CERTIFIES that the building located af P.l~e..~eg]~...R~l,-r...gO~h~.~.~ ........... Street _Map No ........ ~,., ....... Block No ......~, .......Lot N~ ........................................................................... conforms substantially to the Application for Building Permit heretofore filed in this office, dated ............. .~.~?..~.e._l~...~.~.....9. ...... 19...5..~... pursuant to which Building Permi~c qated ............. .~..e.p..~.9.1~..~....9......., 19..~l~., ~vas issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......................... PI~-~VA~.-ONI~' '.P~I'~¥'' l~I/I~ ................................................................................ This certificale is issued to ............~l,~,~%..&...~l~l~...~4,...~o~]~e&llgl.~...~e~s ..................... (owner, lessee or tenant) of the aforesaid building. Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S SOUTHOLD, N. Y. Examined ....... ......... Approved ........................................ ]9 ........ Permit No ............................... Disapproved o/c ...................... ~¢ ........... ~ .............. ~ ............ .............................. ....... (Buildin~ Inspector) App,cot,on 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 krept 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 lows, ordinanc, e,~ ao.d reg~uulatio~_s. ,, ~ ................................... (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. ...... : ................................................................................................................................................................... ~ame of owner of premise ..... · · · If applicant is a corporate, signature of duly autkorlzed 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 :) .( r~' .~.~.. :: 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exist lng use and occupancy....r~,x,(~ ,'.~-~.zc~' '~k'~'~x~'c '- ~' ·: ........................................................................ b. Intended use and occupanc~ 3. Nature of work (check which applicable): New Building .................... Ad n ..Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. -'stimated Cost .......... /..;-2..-. ............................................ Fee .~'.. ...................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... ..O..i~ .......... Number of dwelling units on each floor ............................ If garage, number of cars.m-..:.n...~... ............................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use..7.¥.-.T~..T. TT..~... ......... 7, Dimensions of existing structures, if any: Front....~.L~..~, ........ Rear ...~..~..k.~..: ........ Depth .....'..-~......t_~........~.:. Height ...~-~..Q...~....~:.....Number of Stories .~,,._..~?.'x,) .................................................................................. Dimensions of same structure with alterations or additions: Front ....~,~..~....~.% ......... Rear ........ .~..~...~....~, .... Depth .......~.'.L~D.....~.~i.~... Height ..... ~.L'ql...~i..~:....Number of Stories ..~....'~..~,,-t:~..~.x.~. ...... 8. Dimensions of entire new construction: Front.....-~..b...~....~., .... Rear ..... ~.~....~.....~..~..:.. Depth ..... Height ....... .~......~:...~,. .... Number of Stories .~'...N...'~.(,3_.~ ..... 9. Size of lot: Front ..%..~.%;,....~-..~.N..:... Rear ..... %..O..9.'~....~.~.-,. Depth ..... ..~......'~..'~.....~--, 10. Date of Purchase ..... '.h.C)..~..N..~...~..~-:~L, ...................... Name of Former Owne~rX.~,."5....'~(r'~%z..:~?~k~.~%.~%.~._~. ..... 11. Zone or use district in which premises are situated ........... /~..~.: ................................................................... 12. Does proposed construction vi~a~e any zoning law, ordinance or regulation? ...~(b .................................... 13. Name of Owner of premises.~..`~.~%`x~`:;t~x1~.g/x`~Address~\~.[~`q~&.~..~..~*~.%.~`~'Ph~ne 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 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...YOp, K,, ~ ) S . (N~me of Mdividu~l slgnin~ ~pplic~tion) ~bove n~med. He is t~e ............................................ ~ .................................................................................. (Contractor, ~gent, corporate officer, etc.) of so~d owner or owners, and is duly authodze~ 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; andswornthatto beforethe workmeWillth 'she performed 'm the manner~set ~or~h, ,~Ol~l" ~o~v" in the application~ ~.filed ~therewith" ~ ~ .~ .X . Note~ Pub ~c, ~...~~......~u~y