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Home My WebLink About354-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the bu,ldmg located at .. W~ts~ ¥,~e'.~. ]),z'~-v~ ........................ Street Mop No ~e..~..~.t.~: .......... B,ock No ..... ~:..Z. ..................... ,Z~,~C~b ~t.~..U..e.~. ..... ~.~.:.~. conforms substantially to the Application for Building Permit heretofore filed m th~s office dated ................ ff..t.t~. ~....~..~ .............. 19 .~.~, pursuant to which Build,ng Perm,t No. ~..~.. ............ , dated ............. ~.t/lz_..~.~.....~.~ ............ 19~.~...., was issued, and conforms to all of the requirements of the apphcable provisions of the Iow The occupancy for which this certificate ~s ~ssued is ............ · ~z.~A~..,:.. ~'~..~r,,.~.L~. ......................................................................... This cert~fzcate ~s issued to . ..]~.O.:~F-F-F-F-F-F-F-F-F-FJ~ ~e~Z'. ....................................................................... (owner, lessee or tenant) of the aforesaid bu~ld~ng Building Inspector FORM ~0. :~ 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) N.o 354, Z Date .......... ~..~l,6 ~ .................... 19.~'~.. Permission is hereby granted to: A. Tlell 1.~...& -./~ns... · A,/C · ...-litoe. m-..gn. · l/ma. hen ......... .............. 3¢att/,tu~k ............................. t, ................. l~!dld · n~w"/~m'~'1~ .................................................................................. at prem,ses located at ...... -l/es'~--¥'/:ew ~t~'i~'e ...... ("lot'"~ 9') ......................................... ............................................ J~at~tUck ......... 1%.Z.. ............................................................... pursuant to apphcatlon dated ............... '~tl~e ..... ~6 ................ 19.~;8.., and approved by the Budding Inspector Fee A. I~E:ILLY & SONS, INC. MA~=i=ITU~K, LGNG ISLAND NIZW YORK FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWn CLER.'S OmCE $OUTHOLD, N. Y. -E×am'ned- .......................... ~ !...~...~¢..~'...~., .~ ,, ~ .. ~ ~'~ ~pproved ........................................ ly ........ ~orm~ ~o .............................. Disopprowd o/c.../......,,~. .......... ~ ........... ,~ ........... : ~ .......... ~ ........ ~ .............................. ~ ........ ~ ......................... ~ ........... ~ .................... . ............ ........ {Buildlog Inspector) Application No ............................. APPL,CAT,ON 70, BU,LD,NG PE,M,T Date .............. ~"...!...~ ............. 19...~....?.... 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 drown on the diagram which is port 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 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, end 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. (Address of applicant) State whether applicant is owner, lessee, age~ architect, engineer, general cont~tor, electrician, plumber or builder. ...................... L~.o ~ ...~./.~.:/..~..~..~.~...~,~. ................................................................ Name of owner of premises....~....~.~.......~.......'.~.. CI ~ ........ ~j.~ ............................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corparate officer) .~...~./~ ~/,~j. · /~ ~L t C~ ........... 1. Location of land on which proposed work wdl be done. Map No: .............................. ~ ........ o No: .......,. Street and Number .......................................................................................... Municipality 2. State existing use and occupancy of premises~and intended use and ~cupancy of proposed construction: a. ~isting use and occupancy .....................................................................................................................................r b. Intended u~e end ~cupancy ........................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost.~..~._~....0...O.. ......................................... 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 ............ ..C~......~....,~.,~.....{.,.77.,...~... ..................................................................................... 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 .......... ../z/......~:z... ...... Depth ......~-.....0.. .............. Height ............................ Number of Stories ..... ~ ......... 9. Size of lot: Front ....... .~....~_.:...~ ........ Rear ....... ..~...~...'..'.~.. ........ Depth ..~./.......~..~.?."-' 10. Date of Purchase ............... L.~'.~....~.. ....................... Name of Former Owner .....~./~...~...~....~..~.~ ..................... 11. Zone or use district in which premises are situated ...... '.j~:......~...(~....~...~. ............ ~ ....................................... 12. Does proposed construction violate~ /,jany zoning law, ordinance or regulation? .... 13. Name of Owner of'premises. Lv..~..~.....L3.~ddress .~.~....~....~...(~..~,./II~#Jbne NO ..................... Name of Architect ........................................................ Address ........................................... Phone NO ..................... ~..... _~__ Name of Contractor....~.:J.~......~- .~ ......... 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 corner lot. STATE OF NEW~.-YO~,I~, ~,/J ) S S COUNTY OF ..~.l~.....) , ' ......................................... A......~ ............................. eing du y swom, deposes and says thor he is the opplicant (Name of individual signing ap~licatio~,,~-~ _ ,~ '~--T.~ . above named. He s the ......................................... ~...~......'~....~...~...~.. .................................................................................. Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to this application; that all statements and that the work will be performed in Sworn to before me th~s rx ......... z...w.....r.; ,d.,~, or ..,.....f.~.:.~.......7. ............. Notary Public, .~~....5-~.:~.....~ ~erform or have performed the said work and to make and file ~_ication are true to the best of his knowledge and belief; h in the application filed tJ~,rew, ith. 0, lg ~'~ "(Signature of applicant)