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Home My WebLink About467-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ~.~.....~O~'~..Roac~ .............................. Street Map No ........... ~,[~'~ ............Block No ........... .:X~F~-~ ............ ~-,~,.~ ..G.~een~...--.~[.e.~'o conforms substantially to the Application for Building Permit heretofore filed in this office dated .................... ~p.t ......... ~q9 ............ 19..~.., pursuant to which Building Permit No ..Z...~.~. .............. , dated ................... ~e.~; ....... .,~0. .............. 19..~.., 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 ............ ...................................................... PR I.V.A~i:E.. ~:~,LI~G .................................................................... This certificate is issued to ........ l~'~'"~hl~;..T.~ ..~tli'le~tal~ ......... : ................................................. [owner, tessee or ~enant) of the aforesaid building. Building Inspector FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 467 Z Dote ...... 8eT~tembe~......3.0. .................... 19.~.8... Permission is hereby granted to: John Chapmar~.... A/¢.....~oht~.. ~ar~n ................................ ............ gortl~-.l~ad. ........................................... ....................... O~etmpor'c.t....-.lt'.~.:~.,~ .................... to ...B~:l~..~n..~d~.t,,o~..on..~r~..e~t~n~...d~el-~Zng ........................................... : ........... at premises located at ~/8.....~l,.t,h...~Oe~C]..t ....................................................................................... .................................................. ~ree~I~c,r ~.t......N.v~.~ ........................................................................ pursuant to application dated ................... ~e~)f~ellllJ:)~' ......... '90 ........ 19..~.., and approved by the Building Inspector Fee $..~:,00 ............. Building Inspector / FOF~M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y.: Examined ........ ~...~..... 19......~..d'~ Approved ..................................... :..19....../..Permit No. Application No....~......~....Z ............ (Building Inspector) ! APPLICATION FOR BUILDING PERMIT Date .......... ~e,g~ ....... e,r....~..~ .............19 ............ INSTRUCTIONS a. This application must be com. pletely 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 coYered 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 o Certificate of Occupancy shall have been granted bV 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 $outhold, 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, ord inancesl a~d regulotions~ ,~.'''~ ~ ........ ......... Greenport, I~.Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · Mrs. John T, Haneman 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 ................ ;lll~.,,l~.:l~l~.tl.~.c~.d.~..~.r..~....a~.~..t'~...~..t.¥.t ...................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .............. .~,l~ .............................................................................................................. b. Intended use and occupancy ................... ~ ...................................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition ................... :Alteratlon .................... Repair .................... Removal .................... Demolition .................. ?Other Work (Describe) .................... 4. Estimated Cost ......... --~.~.~.e.. ......................................... Fee ...'......;; .............................................................. i ................ . · (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... J .................... 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.......~,.J~,* .......... Rear ..... ~ .......... ;.. Depth ....J~2..~w~. ............. Height .....2...0...~..~.: ............ Number of Stories ........ 2..~ ................................................................................................ Dimensions of same structure with alterations or additions: Front ............................... Rear ............................... Depth ~2t Height .............................. Number of Stones .,1, ............................ 8. Dimensions of entire new construction: Front.;....: ...................... Rear ......... ~.~ ............. Depth ...?. ...................... Height ......~.t. .................... Number of Stories ..... ~.. ................... 9. Size of lot: Front .......~...0...A?~.e~.. ..... Rear ............................ Depth ............................ 10. Dote of Purchase · ..................................... ~....;.....: ...... Name 'of Former Owner ........................................................ · 11. Zone or use district in which premises are situated ................................................................................................ 12. Does proposed cdnstructi0n~ violate any zoning Iow, ordinance or regulation? ........... :: ....................................... r ~ o. Jol:m To ~ res 13. Name of Owner of p em'se .~... ................................... Add s .....G.~...~...~-..~9..~..~l~e~e .......... Phone NO ..................... Name of Architect ........................................... : ...... ;.....Address .............................. ~ ............. Phone NO ..................... Name of Contractor.~.°...l~.....C...l~..~ .......................... Address .....;..~llJl~,..li,/Z,.....Phohe NO...1~..~.2. ............ PLOT, DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock 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. NO P~ T ~-, f~oAD STATE OF NEWr.-~YO~,J~,IJ ) S S ' /~~ (,.~r.,~i'z-~,,~ bein-dui sw'or-de-ose ands s that ~ is t' ' ' ................................. ~-...i ..................... ~..2~/::-.~..~.....,,..,,~ .... g Y . q, .P S ay ne ne applican~ (Name of(individual signing'ap'~'li~afionZ '-'~;.~r ' ' ' ' above named. He is the ............................................... ~~ ........................................................... ~'~:o~actor, agent, corporate officer, etc.) of said owner or owners, and is duly auth.orized to perform or have ,performed the said work and to make and file th~'application; that"all'statements'contained 'in this application ate trUe to the best rof his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before.methis ~ ~:-7 .......... AZ:"-~LO~ aOW~. ......... ..... day of .... ~tua~,,°-~ Yolk (Signature of applicant) Notary Public, ~.~ .......... ~;~#2x~:3e:Ti°~:n:~ ~