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Home My WebLink About280-zFOIt~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICAT~E OF OCCUPANCY No .... F~ .~56 ..... Date. . . ClC.t:Obe~ lO. ..... , l~O · ~S CE~TIF~S that the building located a~~ .~d. ( N~...~k.' . Street Map No .... ~ .... Block No .... ~ ..... Lot No. ~ ...................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ~..~ 1~ pursuant to which Building Permit No. ~ ~80 dated ................~ .~ ...... 19.~ , was issued, and conforms to all of the requirements of the apphcable provisions of the la~v. The occupancy for xvhich this certificate is issued is This ce~lif~ca~e ~s issued ~o .W~l~e~ & .~vel~ G~a~h~ (owner, lessee o~ of ~he ~o~esaid buildfn~. FO~ NO. 2 TOWN 0¥ SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 28o, Z Dote ...... ~l~:~' ~ Pe~mission is herel~y g~cnted to' ~ .t...Z~.~l...(~.& .t~:l~ ................................... ................... · tI,~'. ............................................... to ..... ~l...m~..a~L~L~...t~.~...e~.~...~t~t~,~ ................................................. ct premises Ioc(~ted ct ..... l~'!lr .. ~'i~.~'i~,li~]E ......................................................................... pursuon{ to opphcobcn doted ........... &~:~,'"t~' ............................ 19~8...., ond opproved by the Budding Inspector Fee ~.~.~ ................ / Buitd~ng Inspector TOWN O~ $OUT8OLD BUILDING DEPART/~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ...... Approved ........................................ ]9 ........ Permit No ............................... Disapproved o/c ................... ...... Application No ............................. APPLICATION FOR BUILDING PERMIT uate ........... z..-..~/-.--~..~ ............................................. 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 drown on the diagram which is part of this location. c. The work coYered 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, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. p · ....... ........ ............................................. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number ...... !~.~?..(.9.....~...~....~.~ ........... ./.~...¢...J:~...~J....~¢...~..~.- ...................................................... Municipality [~ 2. State existing use and occupancy of premises arid, intended use and occupancy o,f proposed construction: a. Existing use and occupancy ...................... ~~C....~ ................... b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ......... .~.,-~. ......................................... 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 .............. ..~..~1, ...... Rear ......... .A~..c.~. ............ 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 ............ J..../~.. ......... Rear ....... ./...~.. ............... Depth ....... (...O.. ............... Height ............................ Number of Stories ............................ 9. Size of lot: Front ...... /. O O Rear ....... /. ................... Depth .....~'...~.~....~. ........... 10. Date of Purchase ........................................................ Name of Former Owner ..... ~ ....... A ...................................... 12. Does proposed construction violate any zgnin~g~ law, ordinance or regulation.> .......... ~...¢.?. ................................ 13. Name of Owner of premises....~d.....~°.....~....'~.C~-~..~ddress ..... ~.~,v~.. .............. Phone NO ..................... Name of Arch.tect' ....... ~- ............................ Address ......~.....~- ~.~,-~w Phone NO ..................... Name of Contractor ...............k .................................... Address ............................................ Phone NO ..................... 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. STATE OF NE~Y~0~I¢,/, ) S S COUNTY OF~~ /~)~ ' ..~, .~f..~..(~.) ' ...................... ~?~.....¥~-K~.Z~...~..~ ............... being duly sworn, deposes and says that he is the applicant (Name °f individual signing ~pplicati°n)~~ above named. He is the ...................................................... ~.~.~:~ ................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to p~rform or have performed the said work and to make and file this application; that all statements contained ~i~li~}jon are true to the best of his knowledge and belief; and that the work will be performed in the ~nn~"~he applicat~fil~therewith. ~ , Sworn to before me this ~ ~ ~. ~o. ~u(f~ ~]~ ~ ~ .... , I ~ ~,. ~f ~-'"'-'~~~~(. ~ ~'~i~~" ~f(Signature~of apphcant)"