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Home My WebLink About893-zFOE1M[ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..1/I/(.J~....~o~.])~. ..................................... Street Map No. ~O~,..~.e,l~Block No ......................... Lot No .................... ~D~t~b.O~:l,~...~.~ ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................... ,JI~.~!~1~1~.~..., 19(~...., pursuo'nt to which Building Permit No..~..~8.c)~. ................. dated ........................... ~j~r.~..../~ ..... 19.~...., 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 ................ ................... t~I.~.~...~.. ~...~.~..1..1.~...~ ........................................................................................ This certificate is issued to .... ~Tah~,.LoJ~j~ ........ Ch~-z'.~ .......................................................................... (owner, lessee or tenant) of the aforesaid building. TOWlq 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? 893 Z Permission is hereby granted to: to i~o:l.]Ld addition o~ exieting one family dwelling at premises located at ..,~..~.O,..~..,~.,.'~,.,t...,~-~?,.~.~-~-.?'.-~...a-~...,~-2.,'~.-'"' .................................................... ................................... ...~..~.....,~.......~...~...o..~...s.k~.~. .......................................................................... pursuant to applicat,on dated ................................ ..~..O..?..~..~....~J..r....~. ...... 1(;~...?..., and approved by the Budding Inspector H~WA~D M. ~ / ! I~'O~,M NOo 1 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved , Permlt No ....... ..... 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 drown 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 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 port 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 Bud ng Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other app cab e Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for remova or demo t on as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ............ ...~ ..~..~.. .;. ./... (Signarure aT applicant, or name, it a corporation) ..,,z...x..xx.., .... (Addr;;~s ~'~'1~'1~'1';~ ;~ B ............................... ~a~p;, ;~a ~;~: ra O[o~ rp~ rm~~'~':;.~e~' "'~""~'"~'~I ................................................................................ (Name and title of corporate officer) l. Location of land on whic~ proposed work will b,p~ done. Map No: .....~...~..~..~Lot No: .................... ~ Municipality / 2. State existing use and occupancy of pr~ises.~.).. /')0 ,and intended use and occupancy of proposed construction: Existing 3. Nature of work (check which applicable): New Building .................... Addition ........ ~ ........ Alteration .................... Repair ............... ~,.. Removal ........ ._~ ........ Demolition ................. ~. Other Work (Describe) .................... 4. Estimated Cost ....~.:.~ ................................................... ee .~.,.. ................................................................................... (to be paid on filing this application) 5. If dweJling, 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 ............ ~...~T.. ...... Rear ............ .?.J.....'~'....... Depth ......... ..~....? .............. L 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 ./....,~../......~.....0.. ...... Height ............................ Number of Stories ................................ 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Dote of Purchase ........................................................ Name of Forme~r Own?r ........................................................ 11. Zone or use district in which premises are situated ................//~.:....~ .......................................................... 12. Does proposed construction ~e~at~ any~zon'_.~law, ordinance or ~e~gula..~?.~.~ ............ ...~....0.. ............................... 13. Name of Owner of premises/~s:?~n-~..%,(....Address ..... ~:...~. ........... Phone NO ..................... Name of Architect .......... ~ --~ ............................... Address .......................................... Phone NO ..................... Name of Contractor~.:....¥.~'7~"'~....~...('~....Address ............... !.~ ........................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property Jines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corne, r lot. STATE OF NEWr~YOI~. ~ J(.. ) S 5 COUNTY OF ...~n~q~e, ...... ) ' ' ~ ........................... ~.i..~ .............. ..~.~.~.' ....................... ...~. eing duly sworn, deposes and says that he is the applicant (Name of individual signing appl~tion) . above named. He is the ............................. ~.~ ................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have ~rformed the said work and to make and file this application; that all statements c~tained Jn this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth i~the application fil~ therewith. , Sworn to before me this / 'l. ~ ~ ~~ ...................... t' ~a~of ...~.~...~ ....... . ""b"~'~lic, State of Ne',','~