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Home My WebLink About218-zFORI~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TO~VN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No . Z 101 Date ~ .1.3 ............ 19.~..~. THIS CERTIFIES that the building Iocated at .E/~.~...B~t~r...Vlew..A¥t{ ........................ Street Map No ..~).t.~..~..~.h...~..~...e.~ ....... Block No .......,--Y~ ..... , ~ ...C~..~..~.Q.~..~.~ .... N.~Yo conforms substantially to the Apphcat,on for 8uildlng Permit heretofore filed Jn this office doted ........................ ~.~UI~.¥ ..,~... 19 ~'6., pursuant to which I~uildmg Perm,t No ..... ~. 2~,.~ ........... , dated ................ F.e.~ .1~..~/'....,~ ....... 19...~.~..., was ,ssued, and conforms to all of the requirements of the cpphcable provisions of the law The occupancy for which this certificate is issued is ............ ................................... P~I~AT~. ~W~L.,~ ................................................ This certificate is issued to .~T~. He~¥...O.~el~....(.o~'lt~..) ............................................................... (owner, lessee or tenant) of 'the aforesaid bu,ld~ng FORM I~0. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES~I~I'.~iF~t-.~~ .~~~k.,A-'INI~IN,I~F~C-~I~it'~ UNTIL FULL C, OMPLg,T, ION OF THE WORK AUTHORIZED) \ Perm~ssion is hereby granted to {told~th ~.;~.,.. ~C .,'. lt~_t~r ~e$ ...... ............ ~.cAt~d .................................. to ..Btt~d. nn addSt:~ol~ to..e~st:L~..&~eZZ.~n~ .................................................. at premises located at .~.//~J ~r .~r~M- ~lf~.~...l?~t~er~l~ten .................... , ....... .......................................... G~.e~nt~or ~, .... t¢.~.. .............................................. pursuant to apphcatlan dated ........... ...L~I~]:III~..,~ ............... 19 ~.., and approved by the Building Inspector Fee $.~3...(~., ............. FO~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×om ned ......... Approved .................... (..'. ................. 19....~...~.Permit Disapproved a/c .................................................... (Building Inspector) Application r~o ........................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This opptication 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 descriptio~n of~Jayout of property must be drawn on the diagram which is part of this location. cl ~'h'he 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 o 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 applicant, or name, if a corporation) ...................... .................. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, eJeqtrican, plumber or builder. If applicant is a corporate, signature of duly authorized officer. ~t(Name and title of corporate o{fieer) Location of land on which proposed work will be done. Map No ................................... Block .................................. Street and Number ...~......~ ........ ~...~/~ ....... 4.~...,~/~......~ State existing use and occupancy of premieses and intended use and occupancy of proposed construction: a. Existing use and occupancy.....~,.,~.~ ............................. b. Intended use and occupancy ....... ...x~..~ ......... 3. Nature of work (check which applicable): New Building i ................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) ..~.~¢"~.....~,c~ 4. Estimated Cost ...............~....~.,2~...: .............................. Fee (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....,~u,~...../~c~r.~.~C...-: ........ Z-..~ ............................ ~ .................. 6. If business, commerical or m xed occupancy, specify nature and extent of each type of use ................................ Dimensions of existing 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 ............................Rear ............................ Depth ............................ Height ............. ~. ............. Number of Stories ............................ 9. Size of lot: Front ............................ Rear ............................ Depth ............................ · 10. Zone or use district in which premises are s~tuated ....... :.L .................................................................................... 11. Does proposed constructio~ violate any zoning law, ordinance or of premises..%~'../C~',~/......~'.='......Address ..,~,~'u~t~.a/,o ..................... Phone NO. 12. Name of Owner Name of Architect ...................................................... Address ............................................ Phone NO ..................... Name of Contractor.~.~,~'~../Z?L,4~b~,~ .................. Address .....,,~*~*~*~*~*~*~*~.r~.~a ..................... Phone NO. O~.-.~.~'Z.~. PLOT DIAGRAM Locate clearly and distinctly alt buildings, whether existing or proposed, and indicate oil 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 NE ' ....... ........................... be,rig duly swam, eposes and so s .that he the app,eant f individual signing application) above nome& 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 opplicotion~ that all statements contained in this application are true to the best of his knowledge and be~ief~ and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this (Singoture of applicant)