The URL can be used to link to this page

Home My WebLink About230-zFORM TOWN OF SOUTHOLD BUILDING DEPARTMENT ~'OWN CLERK'S OFFICE SOUTHOLD. N. Y. CERTIFICATE OF OCCUPANCY No. .. Z...9~...O.... Date ~X'~/' 18 19. 7I-I!S CER~F~S that tAe building located at B~&~ .~.~., ~~ ...... Street ....... .... Map conforms ~ubslan~ially lo ~he Application for Buildin~ Pe~it heretofore filed in ~his office da~ed ....... ~~ ..~. , 19 ~. pursua~l to ~,hich Buildin~ Permil No ..... .~.. dated .......... ~ 7_ · .. , 19..~., was issued, and conforms to all of the require- ments of the applicabl~ provisions of the law. The occupancy for which this ce~icate is This ce~icate is issued to ...gg~ ~...L~..~9~...~ar ................................ (owner, lessee or tenant) of the aforesaid building. Building Inspector FO~,M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. N.o BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 230 Z Perr~lssion is hereby gronted to: ~om~ ~u.r~..~...,~...,...~...C.....:r.p...~....~...7~r~.... ~1~ ....... ~.~.,....~:~ ......................................................... ................. ...m...~...~.~.,. ..... .~.,.L, .... 1t.,.:~ ........ to .... ~i~:~...~.'....~~ .......................................................................................................... at pr~mi,~ ~otea at .... ..I~......t~.~..~.~.V.~ ......................................................................... ...............' i .......... .(..~...~...~. L~.~.....~...~.~..~;.~.~.,t ............................................................... ', ll~tti~ekt ,~/,'~', ........................ pursuant ~o application dated ....................... ~~.......~. .............. 19...~.~, and approved by the Bu. dding t~spector Fee $..~...0.~.1~ .......... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .............. Approved ........................................ I9 ........ Permit No ............................... Disapproved a/c .......~ .................. .~.. .................. .~.~ ........... L~ ........ ................. ( B~'= "' ~ -,','i'l~'i~,' 'J ~ ;~'-:;~:,~ ;.{- ~-u .-~-~--~-. ......... r' ..................... Application No ...... ..~'~.... ~.~ .......... APPLICATION FOR BUILDING PERMIT 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 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 namer a corporation) Route 25A, ~/t. Sinai, ~:ew ~or~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......... ................................................ remise Jo~r~ a:~d Lona Name of owner of p s ..................................................................................................................................................... If applicant is a corpora,te~,.signatuJCe of cJqly authorized officer. ................... (Name and title of corporate officer) / 1. Location of land on which proposed work will be done. Map No: ..... ..]..~?..'.4. ............................. Lot No: ...g. ................ Street and Number ....... Municipality 2. State existing use and occupancy of pr,emises o~nd intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................................................................................... one £'amily t~ome b. Intended use and occupancy ................................. = .............................................................................................. 3. Nature of work (check which applicable): New Building....~ ............. Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ..o..n..~. .................. Number of dwelling units on each f[oor....O~ ................. If garage, number of cars ........ (3g~ ............................................................................................................................. 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 ............................ 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 ....... 6.Q! ............... Rear ...... 6~J.t ............... Depth ......24,! ................ Height 16t Number of Stories one 9. Size of lot: Front 112,85~ ........ Rear .~.QQ.~D .............Depth 10. F r r Dawn Estate . Date of Purchase ........................................................ Name of ofme Owne ............................. .~...]g.9 ............. !1. Zone or use district in which premises are situated .......... ~ ............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ..... z~o .......................................... Flushing, N. z, Name of Architect ........................................................ Address ............................................ Phone NO ..................... Rou~e, . ................... New ~o~k PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give strt~et and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. OF NEW-'W~OR~[, _OR ) S S. ,~.~.~ ...................................................................................... being duly sworn, deposes and says that he is the applicant =~.~ (Name of individual~ sig/~ing application) ~ //~ ,. ~ d'~ (Cont~ctor, agent, corporate officer, etc.) o~:sai~=''<~'d owner or owners, and is duly authorized to perf~'rm or have performed the said work and to ~ake 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 fi~_d therewith. :, Sworn~efore__ dayme this ~ ///',,~_~/~-i~/'/~-~-~ Notary Public,. ...... /'... ,~,_,~;.~c..T~.~-~.~. ~ ~¢~'.; ~'G ....... County