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Home My WebLink About469-zFOE~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ~ 65g Date ........................................................ , 19.. THIS CERTIFIES that the. building located at .~B&~'...~}~O~..i~Ct~.~...~?.~IC~D~. ..... Street MPe~ontc ~ay ~m~es ap ~o ......................... ~ock No. e~ Lot No. 6~ conforms substantially to the Application for Building Permit heretofore filed in this office dated Oc~o]oc~ ! IQ ~I~I pursu.ant to which Building Permit No. ~ *¢6D dated ................. OC~,O~:IU~..flL ............... 19.....~wa.s issued, and conforms to all of the requirements of the applicable provisions of the law. The occupa, ncy for which this certificate Js issued is ................ This certificate is issued to ..[D.~..~t~D.,,..~.~>~ ........................................................... .' ........... (owner, lessee or tenant) of the aforesaid, building. Building Inspector FORM NO. R 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° 469 Z Dote .........0.91.9.k4'r.......11...................... 193A.. Permission is hereby granted to: Baker d Fiakeiasen•••.•AAC.....Mliz..BUta............................... .....Bouthc 1d r..A.Y.......................................... ................................................................................. to ..... ..4Y.0111.1t................................................................... ................................................................................ ................................................................................ at premises located at ...ty..s.bQTe RQ9d,I... 111Q„Ba]!„E8t8t!! . v ...................................................fteenl=tq.....d..10........................................................................ ................................................................................................................................................................. pursuant to application dated ...............0AACIOX......I.......................1915,8..... and approved by the Building Inspector Fee $..5-t!?q............ . .... ...................... ..... Building Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CL~:RK'S OFFICE SOUTHOLD, N. Y. Examined ....... .......... Approved ........................................ 19 ........ Permit No .............................. Disapproved o/c .......................................... ~~~~ .................................. ~,~..~.~ ................. ....................... (Building Inspector) Application No ........?~.~.~../.. ........ INSTRUCTIONS o. 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, relotionshlp 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 port 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 port for any purpose whatever until a Certificate of Occupancy shotl hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuonae of a Building Permit pursuant to the Building Zone Ordinance of the Town of Sou'thold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with ail 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. .Nome of owner of premises .............................................................................................. If applican~t~ 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: .~.?......2~.. ......... Street and Number Municipality 2. State existing use and occupancy of premises and~intended use and occupancy of proposed construction: a. Existing use and occupancy ........ . ./......~......~ ~~. ................................................ b. Intended use and c p cy ................................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition '/~" ~' Alteration Repair ..................... Removal .................... Demolition .................... Other Work (Describe)~ 4. Est,mated Cost...;, ........................................................ Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........... .Z~'.. ................. Number of dwelling units on each floor ........ ./' ................. If garage, number of cars ............................................................................................................................................ 6. [f business, commercial or mixed occupancy, specify nature and extent of each type of use .............................. 7. Dimensions of existing structures, if any: Front......~...~....~ ........... Rear ....'~....d...../ ............... Depth ....~:....?...~ .............. J 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 ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ]]. Zone or use district in which premises are situated .............. ./...~....~.~. .............................................................. ]2. Does proposed construction violate any zoning law, ordinance or regulation? .... ~ .......................................... Name of Architect ................................. ,, 2 ~ //~_~7'~"'"",Address ........................................... ~~.~z~ Phone NO ..................... Name of Contractor~..~.... '.,~..~dress ..... ~.~.... ....... Phone NO. PLOT DIAGRAM Locate clearly and distinctly aH 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 NEWc~OR~x~, ,~/,. ) S S COUNT~ OF ..;...-.-~r~'...,~..~....) ' ~"/"-'~' J~-'*~--' be n" deposes and says that he is the applicant · ,~.~ .~..../~.~ ....................................... u duly sworn, (Name of individual si.a~ing application) above named. He is the .......... ~..,............---.....~:... .......................................................................................................... (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 set forth Jn the application filed therewith. Sworn to before me this ~l~,,. ,~0~ ~ow .z"~,--,/, , ~,~.'_ Notary .................. P~hc,:'"~ ~.:~ ~' ?i!,: ...................... ~'r ~e ~ :i.,..~] ,,,I,~ .-/"'~ ..-b it~~~a~u~ .t . of ~1~- app icant)