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Home My WebLink About208-zFORM NO. 4 TOWN OF SOUTHOI. D BUILDING DEPARTMENT TOWN CI,ERK'S OFFICE SOUTHOLD, Iq. Y. CERTIFICATE OF OCCUPANCY Street ~~~~..~,o~o ......... ~ .~ ........... ,~o, ~o~...~ ~,~. conforms substantially to the Application for Building Permit heretofore filed in this office dated ~.~..~.19 ..~..., p~rs~an~ to which Build,ng Perm,t No dottel .~.~~~.~.~~/ ...19.~, was issa~ The oc~pancy f~d~dh ~;~r;;~;;L ~ ................. ~~ ..... Th~s cert~{icate is ~ssued to , ......... f ................... (owner, lessee or ~enont) ...... ....... ........ Buildin~ Inspector FOI~I~I NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No ....~ '~.0~ ...... Date Permission ~s hereby granted to ........ 'P,6.~' ~ ...................... ................................... t~ke-(}ro~e '"L":~ .... to ........ b~l. td..ne~ .dwel. l~:~g ............................................................................. ...................... ~ S~®, Hoad" '~East. '~de .... l~econi~ B~'- E~s~ates .... at prem,ses located at .... ~Ot ~ ' ' GX~I~II~O~I~ N.~j~. ............................. pursuant to application dated .. *~'1.' ~1~I~ ........................ 19...~,~, and approved by the Building Inspector Fee $ .'l.~)i~ ............ Building Inspector Howard ~erry FORi~ NO. 3 TOWN OF SOUTHOLD BUlL. DING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL ~,~e No ...... 5...?.~ ..................................... Dot, ..................... 5~.q~r'.z....~. ..... ~ 9..~.~... ~.~.~ .e.~:~.o ~.~..:[~T~.~.. ~ ......................... PLEASE 'FAKE NOTICE that your apphcat~on doted .......................................... 19 ........ for permit to construct ..~,.~e...]:..]-.~z'q-L~. ................. at the prem,ses located at .e./..s~.~.e.....~..~...,~.~..o..~.e R.~a,:I.~..~z'~.fl~p~z'..~.t, .~e~r..~zt~ ........ Street Map. ~** Block *** Lot *~' is ~¢~[~,~¢~'~'~'~ d~sapproved on the foliowi ng grounds .~,~..r..~.Jr..~.~.e......~.~.~.~...~..e..c..~.J:.o..~...~..0...~.. · ~..e..~...~.~.e.~ m.~p..~..~.e.. 3.~...t'~....o~..~.~.e.~..~&~..e..e..~...~.~...~ ..0. o~..~.em .~.~..~.: ..................... Building Inspector FOI~M NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19..~.....~.Perm.t N o ~..~.....'.)T'....~ .CZ .......... Disapproved a/c /~ /- ............. ....... ........ .... .................. ..................... (Building Inspector) / 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 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 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 alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of aF~plicant, or name, if a corporation) ..... ~ .: .9..:....3..o.x.....z..z..,... ~.a. ?....~..o.v..e.. ,... ~ :..z.. :..~ .~ .e?....Z..o.t..t:: (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. ..................................................... ~$ ~.~.e. Z ....-....D...e. ,s...i.g ~.e..r. .................................................................................. Name of owner of prem ses ........ .].;.:...~.a..m.~.~..]f..e...n..d.~`~..~.D:~..`A..d..e...l..e.....F~.~t....H...e.'n.'d...r.~..~..b:.i..?..~?.(.i..f..9 ............................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. ?econic Bay Location of land on which proposed work will be done. Mop No....~.~..t.{~.t...e..s. ............... d~ec--k .L.q.t...'~...7..~ .............. Street and Number E/Side Bax Shore Road, Greenpoint, ~Te~,.r York State existing use and occupancy of premieses and intended use and occupancy of prOposed construction: a. Existing use and occupancy .......................................................................................................................... b. Intended use and Residence .... One (1) Story Frar~e occupancy ....................................................................................................................... 3. Nature of work (check which applicable): New Building ..... ..~. ............ Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Ot,hsr Work (Describe) .................... 4. Estimated Cost .....~...~....~J~... ......................................... Fee ...... (~.~ ............................................................................. (to be paid on filing this application) FEES: 5. If dwelling, number of dwelling units......0.~,e. ................ Number of dwelling units on each floor ............................ c-~ No Garage If garage, number of a .............................................................................................................. 6. If business, commericol or mixed occupancy, specify nature and extent of each type of use...-..-..-...-..-..-...-..-...-..-...-..-... 7. Dimensions o~ng structures, if any: Front....~....¢~....~...~ ....... Rear ............................ Depth 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 ........................... .~ear ............................ Depth ~'~'" Height ...... ~.? ................ Number of Stories ....~t' .................... 9. Size of lot: Front ....~.......~..~..~ ......... Rear ....... ~..,;~'[~ ............ Depth ...../...~...~ ............. 10. Zone or use district in which premises are situated.......~......". ................................................... 11. Does proposed constructio~ vioate any Ton ng aw, ordnance or regu at on~ 4~ ........... .................. 12. Name of Owner of premise .s":~....~.~?....~'...~....'¢~'.....~....... Address .~..~..~....4~....~...~..~..~....~..~.....Phone NO ..................... Name of Architect ..................................................... Address ............................................ Phone NO ..................... Name of Contractor...4~...~.~.../...~..~...~/...,~l~..~ .............. Address ..~..P...~...~./~....~...~.~...~...~.Phone NO.~..~....~..'...47..2....~', 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. ,~',4/~,~..~' /~0/~, STAT oF COUNTY OF~4~..~'k:¢~ ....... ) S S.' ~/-' ............. ~..~....~....~..~....~./..~....~...~...~.. ............ being duly sworn, deposes and soys that he is the applicant (Name of individual signing application) above named. He is the ................. ...~.....'~.....~.....~'....~.~ ................................................................. (Conffbctor, 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 applicatio~ filed therewith. Swam to before me this .... ~,..~.......~..... day of ........... ..~..~..: .......... 19 (Singature of applicant) Notary Public,. ~.~.~.... ............. County ~,~'ot~ry P,:]::. St:'c ~Jt i'tew Yod~