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Home My WebLink About352-zFO~M NO. ~ TOWN OF SOUTHOLD BUll. DING DEPART/~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY at T~ack ~v~n~e~ F~t~ Neck THIS CERTIFIES that the build,ng located "~;~'~u;A¥;X:;.'-;~;z,""'~j"~.,~,~ .................... Stree. t Map No .~.?..~...~...~;n;...~..... Block No ......................... Lot No .................................................................... conforms substantially to the Apphcation for Building Permit heretofore filed m this office dated ...................... L.T~..,?......~... .............. , 19...~.~.., pursuant to wh,ch Building Permit No...~....~..~ ............... dated ................ .~....1~.:?.....~..2... .................. , 19.....~..., was issued, and conforms to al I of the requirements of the apphcable provisions of the law. The accupancy for which th~s certificate ~s issued is .............. PRIVATE D¥~LLING This certificate is ,ssued to ~l~,k ]~J3L~,~h (Ot~1~) (owner, lessee or tenant) of the aforesaid building. Building Inspector FOP, k~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS ~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 352 z Permission ~s hereby granted to: ......... ~ch~gu~ ........................................... at premises l~ated at .~.~..~ .............................................................................. pursuant to apphcat~on dated ........................... ~....~ .................. 19.~.., and approved by the Bu~[d~ng ,Inspector Bu~ldm~ Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ......................... Date .......................................................... , 19 ........ Map No ~*~* ~ Block No ........................ Lot No .................................................................... conforms substantially to the Application for Building Permit heretofore f~Jed in this office da~ed Z .................... ................. , 19.~.., pursuant to which Building Permit No. dated ................~...~'~ ..................... , 19....~., was issued, and conforms to all of the requirements of the applicable provisions of the law The occupancy for wh~ch th~s certificate is issued is ............. This certificate ,s ,ssued to (~ner, lessee or tenant) of the aforesaid building Building Inspector FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined...~...../...~..... 19...~....~.-~ Approved...!.-:~.. .......... r..~ .................... 19.:.!....Permit No........... ~'' 3.... ...... ~' ~...... .... , Application No ............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. 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 ~dioining premises or pubiic streets or areas, and giving o 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 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 pu?pose 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 o 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) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Municipality 2. State existing' use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................................................................................... b. Intended use and occupancy ......... ~_,Z~Z....~ ..................................................................................... 3. Nature of work (check which applicable): New Building ....... ~ ......... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition ............. .l~,...Other Work (Describe) .................... 4. Estimated Cost ...... /...6..~'....~......~.. ................................. 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 ...... i ....................... 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 ......... t~AF../. ............ Rear ......~.../. ............... Depth ....~.....~. ............... Height .......... /..~...~ ......... Number of Stories ...... ~ ........... 9. Size of lot: Front ..... /..~ .............. Rear /'/'"'r Depth 10. Date of Purchase ............................. ~..~..5.~..~. ............. Name of Former Owner ....~.../.~ .................. 11. Zone or use district in which premises are situated....._~,~...-.........~........o=..~.....-. 12. Does proposed construction violate any zoning law, ordinance or regulation?~J- ........ ...~.......'. ................................. 13. Name of Owner of premises...~.,Z~...~...Address .~~Z...~..;~...:....Phone NO Name of Architect ........................................................ 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 N~O~I~, j J/ ) S S COUNTY OF ..~..k~.....),,.~..,. , (Name of individual signing above named. He is the .................................. .F~...:: .................... s ............................................................................................. j (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorlzed to perform or have performed the said work and to make and fi e this application; that all statements contain~ in this application are true to the best of his knowledge and be ef; and that the work will be performed in the~t~a.n_~eer.~set- forth in the application filed therewith. Sworn to before me this r\ t~ ~-- ' - ~J~"L"~' a~ll~" (S,gnature of apphcant)