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Home My WebLink About212-zFOI~M NO. 4, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the budding located at ..~/S K.~,/'t~.r,..~lF~ .......... Street Map No Pe~o~e' B~fr E$'I;&~k No .... ~-'~,~'.:~'c]~ .... , ~ ' I~e~/',por~;i'"'NMY. conforms substant,al/y to the Apphcat~on for Building Permit heretofore filed ,n th~s office dated .............................. ~'~1~."28" ' ' 19..~, pursuant to which Building Permit No ....... '~'"2' ']~ ........ ' dated ............. J~D,. '~.8 ............. 19..~., was issued, and conforms to all of the requirements of the applicable prov,s~ons of the law The occupancy for which this certificate ~s ~ssued is ............ ............................................. ~R lr~AT~ D~,~J;Y~'~.~ .............................................................. Th,s cert,ficate is ,ssued to .... [~']:e~rC]"~il~'~'ee~ o~L~ ......................................... of the aforesaid budding Budding Inspector FOItM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST 13E KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No . ~..23.~. · · Dat~ .J~n~m:~... ,19~ ............ 19 ........ Permission ~s hereby granted to .......... ~aha.x,d... ~rao~k~. ............... ..................... :L,,~. ~,.. ,16,cid3.e .lle~k ~ ...... .......................... t]~ea:t... Il. eoT,- ....~1 Y.. to ... mid.. x,'eem.~e ear. J.et,-~. p~i.'~e,~e d.wett~..s~ .......( e:a.~.z,ge..px, eae~,,~..~,ao-,) ............... at premises {oct:ted at ........ ~t~ .~].~'~. .......... ~'Z~l~)O~'~ .................................................. pursuant to apphcat~on dated ..... ~ ~T~m~...~r ............ 19..~ , and approved by the Building Inspector. Fee $ ..... j.~ ....... Budding inspector ~ FO/~M NO. I TOWN OF SOUTHOLD · BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........................................ 19 ........ Approved ........................................ 19 ........ Permit No ............................... Disapproved a/c .............................................................................................. Application No ............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ............ i~...c~r.<~...~,. ~. ................. 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 ~lhole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the BuildJ~ h~spector. ~ APPLICATION IS HEREB~ MADE to the Building Department for the issuanoe 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply~ith all applicable laws, ordinances and regulations., (Signature of applicant, or ~r~ne, if o corporation) (Address of applicant) State wheth,er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Gen. Contractor .... ~o~ Richard Knoeckel Name of owner of ~ .............................................................................................................................................................. If applicdnt 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: .................... Kerwin Blvd., Greenport,N.Y. 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 .......... Fa,-~10~..DwelZ~ng ............................................................................................ 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 .............. .~.1..8...0~..., .................................... Fee ............ ,~.~.0..0. .................................................................... (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.....~..;~..~.?. ............. Rear ...$.&~,e .................. DeptH ............................ Height ............................ Number of Stories ........ ;~ .................................................................................................. Dimensions of same structure with alterations or additions: Front Z~O~6n /~0~ ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ...........I .................... 8. Dimensions of entire new construction: Front ....... ~ ................. Rear ..~.t ...................... Dept~'~t ........................... Height 8~ Number of Stories 1 9. Size of lot: Front ......i-'/~A .............. Rear '17~.~ ..................... Depth ....]~.~ .................. 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ !1. Zone or use district ih' which premises are situated ....... A. ...................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ~o 13. Name of Owner of premises..3{.~ba~d..~3~Jr~....Address T~50.~e~D;tctle..Neck..Rd,..Phone NO ..................... Great Neck, I~.Y. p .................... Name of Architect ........................................................ Address ............................................ hone NO. Name of Contractor...~e.G=a~3t,..C~az~. .................. Address~Z~.ee~po~r..No~' ............... Phone N{~ ..................... 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. Street 1 STATE OF NE~ ) S S COUNTY/~ ~/ ~ ~/OF ......................... ) · ............... ..~?....~..~~...' .............. ,...,.....being duly sw, orn, deposes and says that he is the applicant (Name of individual~signing application) above named. He is the .........~ii ....................................................................................................................... (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; end that the work will be performed in the manner set forth in the application.filed therewith. Sworn to before me ........................ o .............. Nota~ Public, ~..