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Home My WebLink About308-zFOR1?I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. CERTIFICATE OF OCCUPANCY No .Z..269~ ........ Date ... P~e~tembe~......2.0. ....... 19.5.~... THIS CERTIFIES that the budding located at ..W~.~......Vl~tq.~..~ ....................... Street Map No ~assau..Poln~ ...... Block No ......... ~ ........ , Lot No ~.O.l~ ..... ~13,~G~C~§.~et~ conforms substantially to the Application for Building Permit heretofore filed ~n thls office dated ................... ~:~Y .... .5'. ............... 19..~, pursuant to which Bu,ldmg Permit No ...~..~.C~. ............. , dated ............ ~ .... ~' ................... 19.~.~.., was ~ssued, and conforms to all of the requirements of the apphcable prows~ons of the law The occupancy for which th~s certificate ~s issued is ............ ........................... PRI.V.A~.E..~LL~G ........................................................................... Th,s certificate is ,ssued to ...~_t_~7~..o~f]L....~'~f~.~S~l ..... .(...O.~D,I?..) ............................................. (owner, lessee or tenant) of the aforesaid budding FO~B~ NO. 2 TOWN Ol~ SOUTHOLD BUILDING DEP~RTMENT TOWN CLE~'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 308, z Date ......................... }~'...... ~. .......... 1 c~.~.. .... Perrr ~ssion is hereby granted to' Cl~;,z- o~Ze~,....~..~.....~..$.~...~...~.......~..~...~... ......... ....... ~'~,t,~c~,u~ ..... 1~ ............................. to ...11~, ...au.. ~ ~4tn~..aweZt~.. ~...tl~.s. n~w. lee_~tJLen ......................................... .t ct premises located at ~... i~' -~O~---..~a~,~&~.-~4~ ............................................................ ............... ; ...................... .~au~%on..~ _~ ........................................................................................... .............. J .................................................. ~,4~aaU....P.o~t,t....Cutcho~'ua~ ..... g...~, .............. pursuant ~o application dated ........................... ~'.....~. ............... I9~.~...., and approved by the Building lrspector Fee $. ~1,0~.00 .......... I~RM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ....... ~. F..~.... ..... 1 .9~..., ...~ Approved ........................................ 19 ........ Permit Na ............................... ............ ;.'~'~:~'"'::~/ ......... ::'~/ ......... :"~ ....... ::'z ....... ,.'7 .... Disapproved o/c .................................... .......... ./.C.. ~../.../~.~": .............. .~ ' ..~....:i'. ................. ~ ~. ............. .................. (Building Inspector) Application No ..... .~......~..~ ...... APPLICATION FOR BUILDING PERMIT ............................... 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 whole or in part for any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuanae 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 oil applicable laws, ordinances and regulations. ........ ..~..~:..~:~ulc.~.~..CL:.u~.~:~:~.~z ................................ (Signature of applicant, or name, if a corporation) (Add~s of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises ..... , .... · ................................................... If applicant is a corporate, signature c~ duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ..]~....../.:..'~....(-~. ...................... Lot No: ....~....-?'../. ..... Street and Number ~~~L``~4~C~.~'~.~r~.~!~:~.~:~k~£~.~.~.~...~...~.;~t~;:~(.~(/~r~`~/~;~ .......... Municipality (/ -- 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... .-...~..t,~.,:uf.~.. ......................................................................................................... b. Intended use and occupancy... :?.:L.':~... ~.£ .......... ,,..~,,..?.C:.~..~.;..¢.,.......... ~.../4 ...~.k · / i~ 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 ................................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature end extent of each type of use .............................. 7. Dimensions of existing structures, if any: Front........~..Z ............... Rear ..... .~......z.~.. ............. Depth ..... .~....~. ................ Height .......J...'?>, .............. 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 ..~..?.[Z.,~¢.-~..,.. U 11. Zone or use district in which premises are situated....//L/,..~.4.43~.~,-, 4J~--~,~..~. ...................................................... 12. Does proposed construct on v p ate any zon ng law, ord nonce or regulation;> ....... ~.-~...: .................. U Name of Architect ......................... v .............................. 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. /¸t STATE OF NEV~YO~I~, ~x ) S S COUNTY OF ..~.~.~....) ' ( ~ ,/ ',,----~/ '~ ,~, L, · . ..... ~.....~ -~ . '. ................................. be ng duly sworn, deposes and says that h~ is the applicant (Name of individual signing application) ~ above named. He is the ............................................ ~~~ .................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to ~rform or have performed the said work and to make and file this application; that all statements contai~i~ application are true to the ~st of his knowledge and belief; and that the work will be performed in the~Fe~ in the aRplication filed therewith. Sworn to b~fore me this ~ ~~" ..... ..... day of ......... ......... ~:!?qt,~''~ (Signature of applicant) .......: · _ - Notaw Public, ·