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Home My WebLink About246-zFOI~M NO. ¢ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ....]~....~.~..a..t,...e....~...o..a...~. ................................... Street Map No. ~?.....W..~..~.O...~....?..~.~p.. Block No .................. ...3~... ............. , ~ .....I~....t~...~......~..:..~..,.... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................ ~.¢~....~,.~..19..5~.., pursuant to which Buildir~j Permit No ....... ~.~.~..~.. ........... , dated .................... ~9~3h.. ,1,~ ................. 19.~1.., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ............ .................................................... . .~... ~ ~ ~.~.. ~.~ ~.~.~:[ ~.~ ...................................................................... This certificate is issued to ...~.{I~...~Q~/~....OD.~ ....... ~,O.~rl~.~ ............................................................. (owner, lessee or tenant) of the aforesaid building. FOI~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 246 Z Date .................. 'lJ.J'i~ '1.'9 ........... '~ 9'5'8'" Permission is hereby granted to: ~e~er 12t, l~,J["'" '~" '"~/g · ll~ ~'~' ' ~'_,(?~iro'6~l ................... ...... '~l{.t~l~ju, e'i ..... ~, I';; ........................... at premis, es, [ocated at 'Pl~"eliti~"!~l~'"~'f"Pii/~i~i[~'"~" BI~'; ..................................... ............. r ................................ {,am~i-t,. · · · · .W'~ "/'~ ....................................................................... pursuant,',to apphcat~on dated ................ JJl~"~]~ ......................... 19~..., and approved by the Braiding ,Inspector Fee $'~00 ............. Building Inspector FOlt~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUT.OL,,, N. ¥. E×amined ........ Approved ........................................ 1c) ........ Permit No ............................... ............. .............. / ............... Applicotion No ....... ,?,,~,..~',. ........ APPLICATION FOR BUILDING PERMIT Dote ...... ~.:.../...~ ....................... ~ 9 .~.;.] ..'k.... 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 Jocetion. 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 pui'pose 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ($1gnoture of applicant, or name, if a corporation) ) , (Ad'ess of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. \ ,/ o Name of owner of premises ....... .J:...~klgsT.,...Ll.~..~......,.'9,.~.....~'.'...~ ................................................................... If applicant is o corporate, signature of duly authorized officer,u (Name and title of corporate officer) 1. j / MiJnicipality -- State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ..................................................................................................................................... b. Intended use ond occupancy ............. .~.......-7. ......................................................... 3. Nature of work (check which applicable): New Building .................... Addition ..... )ff.. ........... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost .............. ~...~..~.:......uZ~.. ........................ Fee ............ ?~...:..~ ............................................................... (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 .......... ~ ............. Depth ..... ..~...c). ............... 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 ......Z.~..~.~ ......... Rear ....... ~..~.~. ......... Depth .......... ~..~ ........... 10. Date of Purchase ...... ~.:...L.~..)2.¢ ........................ Name of Former Owner ..~.F~.:.~.....~..~.~ ........... 11. Zone or use district in which premises are situated...,~~ ......................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? .... .~...~ ...................................... 13. Name of Owner of premises.~.:.~.~...Address .~.~....(~:~;.~.:~..Phone NO Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor..~..~: ....... Address ..,.~.:.~.,..Phone NO.~..'~z.f..~.~.~ PLOT DIAG~M Locate clearly and distinctly oil 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. .... .................................... ,. (Controctor, o~ent, corporate officor, etc.) of sold owner or owners, ond is duly outhorized to perform or h~ve performod the sold work ~nd to m*ke ~nd file this opplic*tion; that all stotements contained i~hi~,~plicotion ore truo to the ~st of hi~ knowl*doe ~nd belief; ond thor the work will be performed in the monn~.~;}~*r[~.~[n the ~pllcotion f~, t~erewith. Sworn to before me this a,~ ,, 0{.?/: ;:,~., ~. :'r,~ ~ ) ~ /[ J V/ _ ~ , ...... 4..~.. ........ [.. day of ...... ~.~.;.J.....~ ................... 19..~.~...::J :' ~ ~ (Signature of applicant) Nota~ Public, ..~:..~.~.~.b~:~f. ............... Coun~ , ¢.~