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Home My WebLink About202-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .... Bt, W~'~I~"P'].~OO' 'C~'~rt'l:~ol't,' Street Map No ................................. Block No ............................ , Lot No ................................. conforms substantially to the Apphcat~on for Building Permit heretofore filed m this office dated ............... ~~.~ ................ 19¥~., pursuant to which Budding Permtt No ~....~. ............ , dated ....... ~~ ~ ....................... 19.~.., was ~ssued, and conforms to all of the requirements o~ the applicable prowsions of the law. The occupancy for which th~s certificate ~s ~ssued ~s ............ .............. en~loze~. ~eh. ~.. ~..h~ ......... (.. e~z.~. ~1.~. } .............. Th,s cert,ficate ,s ,ssued to ............ ~..~e~r[ lessee or tenant) of the aforesaid build~ng FOP~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (~T~rf~EI~/~t't~MUST BE KEPT ON THE PREMISES ~l-f~l:~NE*Sli~ ¢¢¢[OV[[~I~bAN$,~4~Pt[~K~A~46*UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission ~s hereby granted to Charles Bumble .... ;~/C. Wa..~n~y ............. Fourth Ave. .......... g~?~o~ ............................. to ...... .................................................... at premises located at ~'~L~ stez'].i?~ .]?.~..8:.g.e ........................................ ........................................... ..... ~ ,r....:.Zip. q ?.~e~ ..... ~,l ,.,-z ........ ................................................................ pursuant to application dated ..... ~.a.g..~.a~z..)+}.~.. ........19 ..~.~.., and approved by the Building Inspector Fee $. ~....,..0...0. ............ Budding Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................ t. ............... 19.'J ...... Permit No ................................. ............... ................. (Building Inspector) Application No......~....?....~ ...... APPLICATION FOR BUILDING PERMIT Dote..-.~.......¢~..(.. ......... 19...'~.....~.... 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, 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 port for any purpose whatever until a Certificate of Occupancy shall hove 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 SouthoJd, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable Jaws, ordinances and regulations. (Signature of applicant, or name, if a corporation) State wheth~ee, agent, arch tect, engineer, general contractor, electrican, plumber or builder. Name of owner of premises ....... ~.~ ........ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) q. LocatiOn of land on which proposed work will be done. Map No ................................... Block .................................. Street and Number ......... ,~..1....~.. ............ 2. State existing use and occupancy of premieses and inter'dad use and occupancy of proposed construction: o. Existing use end occuponcy .............. .~ ............. : ..................................................................... b. Intended use and occupancy ............. ..~..~ .~,~.~, ............................................................... 3. Nature of work (check which aDplicable): New Building .................... Addition .................... Alteration....~ ....... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ..~......~......~.....'..~ ............................... Fee .................. ..~.~Z.....~... ......................................................... (to be paid on filing this application) FEES: ) / .5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................................................ 6. If business, commerical or mixed occupancy, specify nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front ......... ~....,~.. ......... Rear ..... ~.~... ............ Depth .....-~...~. .............. Height ....~2 .................. Number of Stories ........ ."~,~c...: .............................................................................................. 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. Zone or use district in which premises are situated ........... ~ ......... ~ ................................................ 1 1. Does proposed constructi~ violate any zoning law, ordinance or regu at on? ..... ;~ ............................... 12. Name of Owner of premises...~...t../...~.~..Address-- --- ..... ~'~..~..~...~]0.~sr~ NO~-- .................... Name of Architect....:...~.~TL, fl~.....: ............ ~.;......Address ........... :.,~j///. ........................ Phone NO ..................... Nome of Contractor.~....~.....Address ~/..~....~.. ...... ~...,~~ne NO...~.,..~..~..~..7.. 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. STATE OF NEW YORK, ) cou w OF ............................ ) ..... ~ ....... ~..~ ................................... being duly sworn, deposes and says that he is the oppl[cant (Name of individual signing 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 in the application filed therewith. Sworn to b.~efore me this/ NOTARY PUBLIC, State of New No. §2-20~~'700 Suffolk Term Expires March ~30, 195g