The URL can be used to link to this page

Home My WebLink About346-zFOII~ NO. 4 t , TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY Date .... THIS CERTIFIES that the building located at _Map No ...... ?~ Block No. .??..~ ..... Lot No. **~ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. ....o~....9. .... , 195.8.... pursuant to xvhich Building Permit No ...... ~..$..4..4 .... ~ated ............. , ~....u~.e ~. , 19 ~8 , was issued, and conforms to all of the requirements of the apphcable provisions of the law. The occupancy for which this certificate is issued is This certificate is issued to . .8~e~ 8~0~, ~ ............................. (owner, lessee or tenant) of the aforesaid building. Building Inspector ~O~M~ 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) No. 34§ z [Date ................... ~T~131e..~ .................... 19..~.. Permission is hereby granted to: ..~te~e¥.,...~.tone ............................................ ...................... ~. c.u ~I~ole~ .................................... to ......... i"' l~..-new. ~wet.l'~T, ........................................................................................ at premises located at .-,~/'~....~Jj~l,l[llj~,...~.~}~ .j~,~ ........................................................... ............. , ................................................. ~o~t~u~l~ ............................................................................ pursuant to applicatzon dated ................................. ~1J.~¢ .... J~. ........... 19..~.., ~nd approved by the Building inspector $ [ FO~M NO, 4 TOWN OF SOUTHOLD BUILDING D£PARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~CER~TIFICATE OF OCCUPANCY THIS CERTIFIES that the building located a~,~..,,]~...~..~,O, ,.1~,.]...~,~,~',~,0,~ ........... Map No ........................ Block No ........................ Lot No ................................................................. conforms substantially to the Apphcation for Building Permit heretofore filed m th~s office dated ........................... ~...~ ............... , 19....~, pursuant to which Build,ng Perm,t No ..... ~.~ ............. ~ed ........................ .~..~ .............. , J~.F.~.., w~, ,,,,ed, ~n~ ~o~o,~ ~o of the applicable provisions of the law. The occupancy for which th~s certificate is ~ssued ~s .............. ........................................................... ~.~..g~t~G~..~~ ................................... This ceffificate is issued to .~~...~...~.~9~.j...q~ ........................................................... (owner, lessee or tenant) of the aforesmd building Building Inspector FOBM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........................... 19 .... Approved ........................................ 19 ........ Permit No ............................... Application No....'<....~..~ ................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Dote ........... ...... ............. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and su~)mitted 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 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 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. M.a_p No: ............................................ Lot No: ............~--~. ....... Street and Number ...~../....~........~...~....~..c,.,...~..~......j ...... ~.~..~.. ....... ~-.~...! .............. Municipality 2. State existing use and occupancy of premises and intended use and eecup, a~cy ~ proposed construction: 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair ................... Removal ................ Demolition ......... Other Work (Describe) .................... r '~ Boo ~ ~, 0._~.-- 4. estimated Cost....L.....~ ................................................. Fee ...~..~....~ ............................................................................ (to be paid on filing this application) §. If dwelling, number of dwelting 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 ....................: ....... 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 ..~....7...'...~.i; .......... Height ............................ Number of Stories ....1.~ ............ 9. Size of lot: Front ......... i~...?...0. ....... Rear ........ ,,~..~.~. ......... Depth ....~....~..~..~...~... ....... 10. Date of Purchase .... ..~....~....C:~1.......{~j ..~....~.... Name of Former Owner ..~'.~..: .............................., ............... .................................... 1]. Zone or use district in which premises are situated ........... .~--- ........ ~......... ................................ 12. Does proposed construction v~,t,e~ ~.~, ~ ..,,, ny z i g law, ordinance or regulation? ........ 13. Name of Owner of premises....'~...~~..Address ............................................ Phone NO ..................... Nome of Architect.~..v~....~e.....[...~. ' t~J.,.~.~.:Address ............................................ Phone NO ..................... Name of Contractor.....~~ ....................... 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-'Vv~YO~$ j)~, ) S S COUNTY OF ......'~¢R'T...~..~.:.) ' _ ,, (Name of individual signing ~applicatlon) above named. He is the ............................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform 'or hove performed the said work and to make ond file this application; that oil statements containefl-ln this application are true to tJl~.,l~est of hi.sDknp'~v,~dge and belief; and that the work will be pe~ormed in the ~nn~et~h~[n the application~ t~erewlt~] Sworn to befgre me this ~ '~i~Ne, ~W~ ....... 7.....~.. day of [ ........ ~ ............ ~~',~;~j!~~ ~r~ ~i~~' , Nota~ Public, ~~...~gty ~ ~ duly sworn, deposes and says that he is the applicant