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Home My WebLink About933-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ........ ..~....~...~..1..... Date ~ne 't,~ 19 SO THIS CERTIFIES that the building located at ..,~.t,...~,....V~.~...~.~...~.~,~...¥...~..e..V....~...o.~ireet Map ~o ............. *** .... ~,o~k ~o ........ ~.~ .......... ~o~ ,~o......-- Cre~&.~ou~old conforms substantially to the Application for Bu~Id~ng Permit heretofore filed in this office doted ~ Dece~e~ 11 59 Z 933 ]9 ........ , pursuc~nt to which Buildin~ Permit ~o. doted .................. ~=~r...~ ......... ]9..~., wes isled, cnd conforms to ~11 of the requirements o~ the cppliccble provisions of the Icw. The occupcncy for which this ce~ificcte is issued is ................ ~A~ ~ F~Y ~LL~G This ce~ficcte is ~ssued to RO~r~ ~esges, ~er (owner, lessee or tenant) of the aforesaid building. Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 933 Z Date ...............~.,g.~.~e. ~..]~ ................ 19...~.~... Permission is hereby granted to: ~..~. r..~.., .~..~.~.~.e.~ ............................................. ......... .~Z..Y~.? ?~ ............................................ ........... I~.~e. ~.~1 ~....~.: ,T.~ ........................................ to ..... ~,~,~.. ~,.~;~..~.~.~..~.e,.z...~...,~ ...................................................................................... at premises located at . ~/'~ ..,~r.¢,..~,~O.*~*~..?~.~..~l.,~l~,,~4¢~'..k~l.,.-...~.~....~...~..~9...~.~.~.~. ................... .................................................. ~t,t~]~ ~,,. ~.~[ ................................................................................. pursuant to applicahon dated .................... ~[ec~a~....,],~ ................. ]~ .... , and approved by the Building Inspector Fee $..~.~1.l~1....~_~- ¢~e~ FOum NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...... ~......(.!.....~, 19...~'...~ Approved .................................... 19....~.:.'./Permit No....~.....?.....~.....~. ........... Disapproved a/c .....~.....~....~....~.~.~...~r..~........?~.....c~..~ ................ ......... i ; -( tC. ; ; i ............................ APPLICATION FOR BUILDING PERMIT Date .............. .~........C~...../...(. ................... , 197..~.. 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 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 any purpose whatever until a Certificate of Occupancy sholl have been granted by 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 5outhold, Suffolk County, New York, and other applicable Laws, Ordinances or ~/ (A dress o applicant) 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) I. Location of land on which proposed work will be done. Mop No: .,~.......Y':...)~.....i ...................... Lot N .o~...~.../~ ........ Street and Number '.~..~...~...~....~........~../~'....~.....r...~.~.....~.../-~,~.:.......~......(~....~../....~./-~'.....~..~.~..~~ MuniCipality 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 .......... ~....~..~r ................................................. ~ J 3. Nature of work (check which applicable): New Building ....... .~'~)x... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost .~./. ~..@...0....°....~ ............................. Fee ..../...8...~ ........................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling unJts.....~ ......... 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, Jf 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 ot Front ~ ....... Rear ........ ~ ................. Depth Dot P~ ~/~ ~' ............ 10. e of al'chose ............................... ~ ..................... Name of Former Owner ....~..~....~...~......O'2Y~....~[ ................ 11. Zone or use district in which premises ore situated .......... ~/~i~......~.~'..~.....~ ...................................... 12. Does proposed construction violate any zoning law, ordinance or regulation.;) ~ ....... ../~.....(~... 13. Name of Owner of premises..~.~.......~...~..~4.~j~.:..Address . .~.~.. Phone NO Nome of Architect~ ~ ' ' ~1~ '11~1~11~~ ...... Address ....... _ /] .~.~...~:.....~.,..~....~ ......... Phone NOi Name of Contractor (~3~r::..~ ....... 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 st[eet names and indicate whether interior or comer lot. \ STATE OF NE~LYOP, K J ) S S COUNT',' OF · · ......................... ~......~...~.'.~..~..~.....~, ............... being duly sworn, deposes and says that he is the applicant ' (Name of individual signing application) above named. He is the ......................................... ~:~..~ ..................................................................................... (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 applicg~tion filed therewith. ........ Sworn to before me this ~.. 19'""~'"'~'' .' Notary Public, .~.~...~ .....