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Home My WebLink About934-zFOIIM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No .~...~65 ........... Date ................................. ~.....~. ..... , 1~O... THIS CERTIFIES that the building located at ..L1/~;heI~../~..&..~&p:~..K~d~..~. ........ Street Map~o.~t ........ Kidd. ...... ......Est .... Block No..~ ............... Lot No...~-9.~$ ....... ~Lt~ekt ..... N.,.M, ......... conforms substantially to the Apphcation for Building Permit heretofore filed in this office dated ....................... ~.~..~.~..~..~.f~.....,~..., 19~.~..., pursuant to which Building Perm,t No Z,.9~.~ .............. dated .......................... ~D~t~I~_~ ..... ]~]9..~., was msued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ............... ......... ~. ~.~.a.te...cm..et.. ~.a~ ~... clue...~ ...................................................................................... This certificate is issued to .,I.o~e~9]l..~..~b, al~r~;Ltt& ............~J~B~.~ ........................................ (owner, lessee or tenant) of the aforesaid building. Building I nspe,~/1~r FOt~M NO. 2 TOWN OI~ SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 934' Z Dote ....... Permission is hereby granted to. ............................... ... ~t.2~ &.l~arlinm.!,.ne ........................ ....... ~e~tfJ-tu~k~. ~.Zo .................................. at premises located ct .... I,e%..~..194s..Cl~t~.Zidd..~st~.~e~ ............................................. ........................................ Lm%kew..~_~-_~.&.~p~..Kf~. P,~ ......... ~.t~i.tt_~k, ...~..Y .......................... pursuant to opphcat~on dated ................. D~e~Jher..3! ................ ]~9 ....., and approved by the Budding Inspector Fee FOP,~ NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. Approved ............... ; ........... ; ........ , 19 ........ Permit No, .......~..~....?.. ...... D,sapproved Application No .......~ .~. ,t~... ........... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ........ ~.~....!..!. ....... , , 9"~""~.. 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 ava,ilable 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 shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issua.nce of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Count, 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, ordinance and regula 'ans. ..... (Address of applicant) ~ .......... State whether applicant/~..9)wner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a cat, rate, s~ature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be do"e Map No' ~ ...~...:..~....~. ~' Lot No' / ~' '-/- Street and Number .. .~ ...... i.,~..:. . . Municipality State existing use and occupancy of prer~ises ond intended use and occupancy of proposed construction: o. Existing use ond occupancy ..... M'.....":.....~.;..~ ................................. ~. ........................................................................ b. Intended use and occupancy ............... ~'~ -- f'~ '" ~'"" '~'"~'"'"~'I~ .................................. 3. Nature of work (check which applicable): New Building ...... ~ .......... Addition .................... Alteration .................... Repair .................. Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ......~.~ ........................................ Fee ./...o. .................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ~....Number of dwelling units an 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 ......... ~...~...'.Y'.....~.....~Rear ....... c~.~) ............ Depth ~....~.....i ............ Height ............................ Number of Stories....~ ............. 9. Size of lot: Front ~ O Rear ....... ~...~ ......... ~... Depth ......... ]0. Date of Purchase ................... /..~...~....~ ................. Name of Former ~ner .~....~..., ......... ] ]. Z~e or u~e district in which premises ore situoted ............... 12. Does proposed constructionti .~ ~vi~l°te ~ny ~oni~ I~w, ordinonce or~ --tl~ ~,re~ul°ti°n~ .......... ~. .................................... ~*me o{ Architect ............ ~ ~~~ ..................................... Address ..................... ~...; ............... Phone ~0 ..................... Name of Contractor ...~..~..~~ .................... Address ...~.~~ ....... Phone NO ..................... PLOT DIAG~M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from proper~ lines. Give street and block numbers or description according to deed, and sho~ street names and indicate whether interior or corner lot. , ~ ~ ~7'-~o" . I , , 36' L,., Th, e- STATE OF NE~¥,YQP, J(,,) ) S S COUNTY OF .~..Cc.....) ','~ (Narr(e ~f individual signing app~catio_n) above named. R~ 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 wilt be performed in the ~l~rTsel~l~th in the application filed therewith. · l¢0tary P~ubiic, St~'te of New Yorl< ................. .day °f .......... Notary Public, ,~,,~......~,o,,~r..~~ (Signature of applicant)