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Home My WebLink About912-zFOI~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at~./.,~.....O,.,~..~...~,O..~..,R.,.O..~...~.~.....~..O...~,..~.,..O.,.1..~,. Street Map No ?..e.?.. ................. Block No .......... ?.~..~. ........ Lot No ......~.e..e.. .................................................... conforms substantially to the Application for Building Perm,t heretofore filed in this off,ce dated ]~O~e~ 21 19...?.0.., pursu.ant to which Building Permit No ........ ~.,.gl~, ...... dated ........................ N....°~..~.e.~...~.4.... 19...~..0..., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which th~s certificate is issued is ................ FRIVATE ON~ FAMILY DW~LLIN~ This certificate is issued to ..F...~.~....~.~..e.~..~..O..~l...~...~.l....~..~. .............................................................. (owner, lessee or tenant) of the aforesaid building. Building Inspector k HOWARD M. TERRY FOR~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT fi.HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 912 Z Oot~ ........ ~ev~=~er ~ ~..? .... Permission is hereby granted to' ]~,,~d new erie family dweill~g at premises located at pursuant to application dated ............................ ~~.~. ~ ........ 1~...., and approved by the Building Inspector Fee $.~..~.~.~ FOltl~ NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. App roved ~~'f.....'~.....~.. 19....~..x~e rmit No .... ~..,~...¢~.~.. ..... · ......................................... ::., ........................ ::..-'.. ~; i~.~.~.r.~ ...... ~...~...... ::.....~. :.'-~.'.' ......... ........ (Building Inspector) Application No .........~....-~/~.. APPLICATION FOR BUILDING PERMIT Date ...... .............................. INSTRUCTIONS a. This application must be completely filled in bv 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 o 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 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 anV purpose whatever until a Certificate of Occupancv shall have been granted bv 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 alterations, 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. Name of If applicant is a corporate, signal, ire of duly authorized of 'ce . (Name and title of corporate officer) 1. Location of land on which~.proposed work will be~ done. Map No: ~;~;;~;;;.J2. i;;'"'"'"""'"'"'."'"'""'" Street and Number .....~...:...~........~.~. ...... ...~.....?....T. ...... :..~...: . . Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use ond occuponcy........~...~.~_ .................................................................................... 3. Nature of work (check which applicable): New Building ....... /~ ......... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost .......... ./...~...z,...~ ............................... Fee .......... /...O'...:....~ ............................................................. (to be paid on filing this application) §. 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 alterations or additions: 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 ....../....6..-~...~...~ ......... 10. Date of Purchase .....~.'~..~....=..../...~...~.....~.. ................ Name of Former Owner ..~.~.'... 11. Zone or use district in which premises are situated....~.~.~--...'..:.~.....~.....~ .......... 12. Does proposed construction violate any zoning taw, ordinance or regulation? .......... ...~......:. ............................... 13~ Name of Owner of premises..~.~.~.'.Address"~ ~-'~- - .~~...,~:.~....'...Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Controcto .~..~.....¢ff~...~ .............. 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. /o~ ! STATE OF NEW YORK, ) S S. COUNTY, OF ............................ ) ~,~x.~ ~.~. ............................... being duly sworn, deposes and says that he is the applicant (Name of individual s i~p~g. ~ti~ / i'io~i'~imed. He s'i'~e ............... --~"~'~-~'~~=...=:..-* ............................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the appl~gtion filed th~with. Sworn to befo~e this ......... ~.~.~day of ...... ~~.~ 19.~..~t~ ~~ture of appllc~nt) ~ ~ ~~ ~ ~ -- O. 52-0344963, Suffolk County ' ~''/~. Nota~ Pubhc, ~~.-~..