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Home My WebLink About324-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .~.~....~[f~.:[;LQg/.e~..~o~d ............... Street Map No . We.~t~.~9/ ....... Block No ...........X.~.,~ .............. , ~ . Jc,~I,t,t_,4L~;~,c~I...~,,.~, conforms substantially to the Apphcat~on for Budding Permit heretofore filed in this office dated ...................... ~a¥ 'q'~ ............. 19..~ , pursuant to wh,ch Budding Permit No ...... ~...3...~...~. .......... , dated ..................... ~?,.~......~ ........... 19~.i~ .... was ~ssued, and conforms to all of the requirements of the apphcable provisions of the law The occupancy for which this certificate is ,ssued is ............ ........................................... ~.RIV~..~LL~.~ .~ ...................................................................... Th,s certificc~te is ~ssued to .... ~..~..~..~....~......~.O...~.~.. ...... .(...o.~¢t~..e.?..) .......................................... (owner, lessee or tenant of the aforesaid bu~lcbng t Building Inspector N? Pe r~ FOH~ NO. 2 TOWR OF SOfT,OLD BUILDING DEPARTMENT TO~VN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS I~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 324' Z ~ission is hereb~ granted to: ............ ~.~..;~ .......................................... ....................... ~r~a~h~l~...N~.Y~ ..................... to ..~l~l: ,d..~..~r~.~;/,~ ........................................................................................................ ! at prem,s~s located at ..~....~lll~.~1:r~Z'. ~ ..................................................................... ...............'! ..................................... !~tz..~iew~. ............................................................................ ............... ~ ................................................. I~.~J~l.ti~um~.. ~.~:. ..................................................... pursuant !o apphcat,on dated .......................~ ...... 2..~ .................. lc~J~...., and approved by the I Building 1/nspector Fee $1-0I0~ Building Inspector FOR, I~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ,/ · Approved ........................................ 19 ........ Permit No. ............ ~1~'~' 'r ~" 'ri 's~(~ ;i'~ ............... Application No. ~'~ ~'( APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and su6mitted 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 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 puFpose whatever until a Certificafe 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. (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. Name of owner of premises....:~'~-- ...... ~ ............ ..~....~~ ......... [, ........................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building......~.....Addltlon .................... Alteration .................... Repair ............ ~.....Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost..'..~.~..,~...~..~...~.. .................................... Fee ..~...~....0~... ............................................................................. (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 ............................ 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 ........ ...'~...O. ............. Depth .....~.....~. ................. Height ............................ Number of Stories ............................ 9. Size of lot: Front ...... L..O....O.. ........... Rear ........ ./....O....0. .......... Depth ......./....~....?... ......... I0. Date of Purchase ..... ~..~....~.......L.~..~ ............... Name of Former Owner ....~~ ............................ 11. Zone or use district in which premises are sltuated....~. ...... ~..~...~ ......................................... 12. Does proposed construction v o ate anv zon na aw ord hence or reau/at on> - ' .................................................... NO 13. Name of Owner of premises.~...i.~..-.z...l..-..~..:....ch~A, ddress :..~..~.mzr.~z....Phone ......... Address ............................................ Phone NO. Name of Architect .......~.~,~ .............. ~.~.....~,... ~ .................... Name of Contractor...~.~...~k~.....~....Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or comer lot. STATE OF NEV~YC)~o,~,~ h ) S S COUNTY OF ...;~'n:2,~ ............. ) ................................ .~...[.:....~_~..~.l~.... .......... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named He s 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 application; that all statements contained ir~this~application are true to the best of his knowledge and be ef; and that the work will be performed in the manh'L~/~l~llrt~oin the application filed therewith. Sworn to before me this ~, ~ a~'~,i.~*/~ ........ · ~.....~ ...... day of .~ ...... ~.....~.. ............~J~;[~co~e,l'°~'~lgnatur, of applicant) Notary Public,. ...................... ,. --....:..~.~.,,,~.,.,,....~ nty