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Home My WebLink About888-zFORM NO. 4 TOWN OF SOUTHOL.D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCU~'ANCY No ......... ~...~. ~),1, .... Dote ............................... THIS CERTIFIES that the budding located at ...B..a.~...~..v..e..~.u..,e.:.....E..~...s.~.,...l~....~,~..o..n. ........... Street Mop No ............ .~.ef..,. ..... Block No .......... .*.t..*. ........ Lot No ......... .*..*...*. .................................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated October 30 19...5...9.., pursu~ant to which Building Permit No....~,..1~. ........... doted ..................... ..O..c..~...o.~.e..z.....~..0. ........ 19..~.~.., wes ~ssued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ................ PRIVATE, ONE FAMILY DWELLING This certificate is issued to ...,.B.~.~.?.e.,...B.,.a.~..~..z..t....°.',~..n...e..r.. ..................................................................... (owner, lessee or tenant) of the aforesaid budding. Building Inspector FOI~,M NO, 2 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 888 Z Date ................. (~¢.t~o];:~l~...~ ............. 19~;.9.... Perr~ission is hereby granted to' ~owg t~g. ez'.~....~/~...~zv~.e...~3&~. ............................... ...... ~,~.~t,..~.cm ~,....~ ,.! ................................... to ... :~2.¢..~..~¢~.t~.~...~..~.. ~;~. ~..t. ~g....~...e..~.~., .~. ~ ................................................................. ~t premises Iocc~ted ~t ...~df~..~Q .... ~/~I..]~.~'..A.~.~... ~,~..t,.....i~';~,....~..-.~.~ ............................... pursuant to applicahon dated ..................I)~.t~o]:~'... ~0 ....................... 19..~..., and approved by the Budding Inspector Fee $...~,.~,~.. ............. ' Budding Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........ ~...~....0. ..........19..~..~.. Approved ........................................ 19 ........ Permit No ...................... ........ ............................................... (Building/Inspector) Application No......~...~....?... ........ 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 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 B~ilding 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 pui'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. 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) 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number ...~.~..~...~.~'~_~?,.....~--~r~ ~..~..~...,__ __ .....................................~ .............. / Municipality 2. State existing use and occupancy of premises and Jntende~ use and occupancy of proposed construction: a. Existing use and occupancy ....... ,,,,~..~9,~,~4,~..~~ ....................................................................... b. Intended use a~d occupancy .............. .~,¢2,~.~ ...................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition ..L-<~...............Alteration .................... Repair .................... Removal .................... Demolition ........... .~.....Other Work (Describe) .................... (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 olterotions or odditions: Front ....... ~ Rear ...;...~...~.~... ............... Depth ....~:~...~..~ ............... Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front.....'..'~..~/. ............... Rear ....... ' ..................... Depth ......~'....~.....~.. ........... Height ....../....~.. ............... Number of Stories ..... ~ ........ 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 l. Zone or use district in which premises ore situoted2 ............................................................................................ 12. Does proposed construct0n violate ony zoning law, ordinonce or regulation? .... .~.....~... ................................. 13. Nome of Owner of premises. . .~.Address ..... .~ ...... Phone NO ..................... Name of Architect ...................................................... 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.~ to deed, and show street names and indicate STATE OF NE~/;,YO.~K,,.,. ) S S (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to ~rform or have performed the said work and to make and file this application; that all statements contained in this application are true to the ~st of his knowledge and belief; and that the work will be performed in the manner set forth in the application Jiled therewith. Sworn to before me this Nota~ PuDIIC~~,~,,..~(~......~uuUt~ommission Expires