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Home My WebLink About327-zFOP,~[ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLDo N. Y. CERTIFICATE OF OCCUPANCY No .... ~. 7.1~.6.. Date ..... jltlla..20 ........ 19~0' THIS CERTIFIES that the building located at e./s..H.o..rt:o~..~e~ .~..ot!..tl~.0...1..d... Street _Map No ...... ?..*..* . Block No.. .*...*? ..Lot 1N'~?.*. ..................... conforms substsntially to the Application for Building Permit heretofore filed in this office dated ............ ~i~lr ~6 ........ 19.~[l. pursuant to which Building Permit No.. ii ~i~'~ ..... fated .............May 2~ ...... 19 ~8, 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 ce~t~fma~e ~s ~s~ued ~o ..... .Ole .Car. lsen~ owr~.e~. .................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector 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) 327' Z Permission is hereby granted to: ~'. 1~, D~ok~o~....,ILgC ...O!e..Ca~_~en .......................... .......................... $~nthuld ~ .... K.~. ............... to ....... ']~'~d ne~-.dwe.~t~.~ ................................................................................................. at premises iocated at ..... ~-~-...~l~l~'.t~O~..~iU3~l..4l~'.. L,.I-~ ~O~t,~[:~ .................. '~,. ................... ............... I ............................... e,,~o~,~, ..... ~.:~, ........................................................ '~i .................. pursuont {o opphc~tion dated ................................ ~,~-.-~6 ................ 19...~'~., on'd opproved by the Building Inspector F~e $--I0~, O0 .......... FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........ ~...~..... 19...~.~....j~' Approved ........................................ 19 ........ Permit No ......................... Disapproved a/c ..../....,~ ......... ~ .,~..J .............. ~ .............. ~ .......... ~ ............... ........................... ........................ ........................ i'l~'~'i'l~J'i'~ inspector) i 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 o Building Permit to the applicant. Such permit shall be k. ept 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 Certificat~ 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 Soufhold, 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 applicon, agrees ,o comply with o11 opplicable lows, ord ,nonce~ ~_gulotions. ~j~..~ (Signature of applicant, or name, if a c,o, rporation) ..... (Address of applicant) 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.~Aap No:~~.~ .......... Lot No: .....-~T... ............ Street and Number ....~Z~..."./~...~......~~ii..t~ .......... ~"~'~ ......... .../~....7~...'. .... 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........................... ~:...i.~.~..- ............... ; .......................................................... b. Intended use and occupancy ...................... ..~.....................[J~ ........................................................ ~ .............. 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost.......~./....~ ...................................... Fee ..l.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 ......... .~......~.. .......... Depth ......-Jm...~ ................. Height ............................ Number of Stories ..~ .......... 9. Size of lot: Front ................ ~...Q.... Rear ......... ..~..~ .......... Depth ..../..,~...~. ............ 10. Date of Purchase ............... ,~...~.i..~......(~.. ....................... Name of Former Owner ...~....~,c~,~t,.......~ 11. Zone or use district in which premises ore situated .......... /~......~ ................................................................... ' (/~ 12. Does proposed construction violate any zoning !aw, ordinance or regulation? .................................................... 13. Name of Owner of premises ........................................ Address ............................................ Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor .................................................... Address ............................................ Phone NO ..................... PLOT DIAGRAM 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. orhlgf~, STATE OF NEW ~0,~::~..~ ) S S COUNTY OF .... ~/'..~.'Z...) ' ,~ ......................................................... ~ ....................................... being duly sworn, deposes and soys that he is the applicant (Name of individual signing application)/~1 above named. He is the ............................................ ..?.~.....]....o....~....~ ........................................... t4Sontractor, 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 in__ this,.a~pplication are true to the best of his knowledge and belief; and that the work will be performed in the rnan~AIIl~l~/~t~n the application filed therewith. . Sworn to,befpre, me this _ ~.~.~1~ ............ .~....~day of .......... ....~....,....~. .......... L~.~...~z~c~ e~ (Sign~l~re of applicant, ....... ~:~ , ~ u , ,~ "~t~ ~. ~,, Notary Public, .~,~H~...~......~County