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Home My WebLink About530-zTOWN OF SOUTHOLD BUmLDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at~.~..t.~...~...~i~.~..~.iz~.e...TE'.e6..~o.~.cl.. Stree~t ' ~Utehogue~ N.Y, Map No~T&~U..~'~JJ~ck No ......... ~..~;~. ......... Lot No...~.~'. ............................................................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................ 0~C~:~...~ ..... 19...~8., pursuant to which Building Permit No..~...~.~(~ .............. dated .......................... .J~O.~efft~G.$~...~¥, 19..~., was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .............. ............................................ F~ i~:A.~ · · 0 ~J · · F.~ ~..L~'...DW.~; '~ '~ ................ ~ .................................. This certificate is issued to ..... A~.~1~11~',..~,S~9 ..O~t ............... f .................................................. (owner, lessee or tenant) of the aforesaid building. H~ARD M. TERROr FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 530 Z Permission is hereby granted to: Che~ter Or 1.o...~. ~.~L~,....., .~/..C......A..~ ~..h..u. ?....$.~ ~.~ .h ...................... .......... ~.u.t.o.h.o.g~.~e.,......~.,.~., ................................ to ...b.~$~d..:~.~...~...~Lo..%.t~.o.q...o~...~n...~.~.t~g....d~el.~.L.q~ ....................................................... at premises located at ..?..~...tj...!~.~...O,~...~..~rt.e,...~,~..~.~...~C~,C] .............................................................. ......................................... .1..o.~..;¢~. ~...~.~ ~:~...~. ~ ...................................................................... ..................................................... ~.e. ~.o..~.~.,.......;~:. ~.? ...................................................................... pursuant to application dated ................... ~~......i~.~.~..~,....19rj.~...., and approved by the Building inspector Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exa*ned ....... ...... Approved ............... '. ............... ~ ........ 19 ........ Permit No ............................... Disapproved a/c ......]"->'1 ........ '~ ............ : >'~"~ ............. [ .................................. ................................ .... ........... .............................. (Building lnspector~/ Application No.....~..~..~ ............ APPLICATION FOR BUILDING PERMIT Dote ...... ~.-~.....~c.. ............................ 19'..'?[.~ ..~..... 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 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 pui'pose whatever until .o 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 constructi9n of buildings, additions or a Iterations, or for removal or demolition, as herein described. The applicant agrees to cpmply with ali applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) ............. ........................... (,~dress of appficant) State wheth,er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. hlome of owner of prem,ses..O .L~..42~.~..~./....~.. ~... ~ ...................................................... If applicant is a corporate, signature of dul~authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map~lg//:~.~:~....:...~:fr:...?..~ ........ Lot No: .:.: ............ Street and Number '.~.,~....~ ....~... ~/..~-~...~.,'.~.~. ~..:.....~. ~....~.~.~5..~~ ~..~ ~ ~ Municipality ~! 2. State existing use and occupancy of pr.d~Fnises and intended use and occupancy of proposed construction: a. Existing use and occupancy.....Cr~...~ .......................................................................................................... b. Intended use and occuponcy.....~,~...~.'..~T~...~../ZT,~.~.....'m'~... .................. ~ ............................................ // 3. Nature of work (check which applicable): New Building .................... Addition ....~.~ .......... Alteration .................... Repair .................. ,~Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost......i~,~....(LTr/..::~ ................................... Fee ............... .S.i.~..:...c.~..~... ........................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ................................ 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 ....... ;.~..:U~... .......... Rear ..... i~..:..~... ............ Depth ...... .~...~./..../. .......... Height ....... L..c( ............... Number of Stories ............. .&.~..;~.' ................................................................................... Dimensions of same structure with alterations or additions: Front .......... .~...JL~... ............ Rear ...... .L~....~.. ................. Depth ........ ,,'~..O ............... Height ...,~:~.~...~... ........... Number of Stories ................................ 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ....../..~...~ ............ Rear ...... /./...3. ............ Depth~...~7:..~ .................. 10. Date of Purchase ...~. ZuZ~.,/.~...../...~'...~.~:r~.'.: .............. Name of Former Owner ../.~.~..~,..~!../.~....../.z.:./.~..~,..~ .............. 11. Zone or use district in which premises are situated .... .~,,~.d/~..~.~r~.~.~.~,.~.....~.~. .... ~..-~..~ . .~.':...~ ............... 12. Does proposed construction violate any zoning law, ordinance or regulation? ......... ~d{.~..;~. .............................. 13. Name of Owner of premlses./~.,~.b',..'..J.~,r¢;;~{..2...- ....... Address ..~x.~.~].~..'.'::.~:x.~..t./...L., .~..'..Phone NO Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor...~.~'J2,~¢~.~..~...Lz~. ~,z:SJ,4.~. ....... Address .. (,~..~.i'~.,~;'~..,,~..,. ~,... !/..:.. P ho n e N O J/:~' .¢...c/. ::~..;~ £: PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fram property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. 3, f P / STATE OF NEW_-. Y0~,K,~/r ) S S COU~ .NTY.,,OF ~'..'.,"C......) ' ..... .~....~.f...~ ................................ being duly sworn, deposes .and says that he is the applicant ~'~ (Nome of individual signing application) above named. He is the ............................. ~..~.;c.::...~..~:.~.'~ ....................................................................................... (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 fire this application; that all statements contained in this app. licotion are true to the best of his knowledge and belief; and that the work will be performed in the manner lii~_ ~in~i~lp~application filed therewith. ~.~... day of ~: ~ ~ ~x~ ~o (S,gnature of apphcant)