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Home My WebLink About698-zFORM NO. 4 TOWN OF' SOUTHOLD BUILDING DEPARTMENT TO%V~I CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ..... Z'~47. ........... Date ............................. J~L~. · ~L.~ ............... , 19..~9.. THIS CERTIFIES that the building located at.W/~.]~r.~..Roacl-~/~.~...V.~.~w..A.v~ .... Stree, t Map No. ~.~.~.tl~ ..... Block No ......................... Lot No..~ ...... ~og:~he.].d.~-...~'f.~., ............................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ......................................... ~b~....~, 19~g...., pursuant to which Building Permit No ...... ~-~9~ .............. dated ............................. ~/~,~......~ ......... , 19.~..,., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .............. ..................... P.~e..one..t~il~r..~well~ ..................................................................................... This certificate is issued to ..... ;~gezle..?~.£,~oz.~&~ ..................................................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector FOI~M NO. ~ TOWN OF $OUTHOLD 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.° 698, Z Date ............................... .,tl~.. ~., ~,,~. .............. 19..~J.. Permission is hereby granted to: · ~.t.v.f,~.;L..~,~.~.~,~..~/.e...~g~.~..l~.er~ .............. · ~ut,~o~:~..~::~..Y.~k .......................................... to ....J~,~.~,~ ..ll{~,..~tt.~ .-.~,. ~ ~.],7...l~'~]),J,~ ............................................................................................. at premises located at ..a~:~.~..l~t~.,..~.~..~.~.,..2 ................................................................................ ...................................... Jeml~a~l.d.r. ~...~ ...................................................................................... pursuant to application dated ........................................ ~:~'..2.~. ........... 19..,5.cj.., and approved by the Building Inspector Fee $.~G,r~ ............ Building Inspector FORM NO. 1 TOWN OF $OUTHOt. D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHO~-D~ N. Y. Application No......~...'.~...~ ........ Examined ............. /...~./...~',~.,,~;,.~.... 19.. Approved ............................ ':~ .......... 19.....~...Perm't No.......~..~...~.....~.~..~.. ........ Disapproved ale ....~/~.~(;.~.~.~(~ (Building Inspector) .................. ..... INST~UCTIOMS o. This opplicotion must bo completely filled in by typewriter or in ink ond submitted in duplicote to the Buildin~ Inspector. b. Plot plon showin~ Iocotion of lot ~nd of bui[dinos on premises, relotionsh~p to *d~oinin~ premises or public streets or oreos, *nd 0ivin~ ~ detoiled description o{ I~yout o{ property must be dr~wn on the d[o~r*m which is port of this Ioc~tion. c. The work cov,ered by ~his ~pplicotion moy not bo commenced b~foro issuonce of Buildin~ Permit. d. Upon opprovol o{ this ~pplicotion, the Buildin~ Inspector will issuo o Buildino Permit to the ~pplic~nt. Such permit sholl 'be Iqept on the premises ovoiloblo for inspection throughout the prooress of the work. e. ~o buildin~ shoal be occupie~ or usod in wholo or in p art {or ony purpose whotever until e Certi{~cote of Occu¢oncg shall hove been ~ronted by tho Buildin~ Inspoctor. APPklCATION ~S ~ER[BY ~AD[ to tho ~uildin~ Deportment for the issuonce o{ o Buildin~ Permit pursuont to the Buildin~ ~one Ordinonce of the Town o{ Southold, Suffolk Count~, ~ew Yor~ on~ othor opplicoblo kows, Ordinances or Refiulat~ons, for the construction of buildings, odditions or ~lterotions, or for removol or demolition~ os herein described. The applicant agrees to comply with all applicable laws, ord ina~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 whigj,l,h, proposed work will be done. ~~ ........ Lot No: ..i~ ..... Street and Number .~~~ ......................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy .......... ~~ ............................................................................ 3. Nature of work (check which applicable): New Building ...... ../..... ...... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ....... ,~--~'~,.~..~....~.."~... ............................. Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... .~ff...~ ......... 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 ................................ Reer ................................ Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front...,.,~.~l ............. Rear ..... ~'~..O. .............. Depth ..~....~ ................ Height ....../....7.. .............. Number of Stories ....... ~;~;; .... 9. Size of lot: Front .....~....~,~..~ ........ Rear ...... ./...~..~.. ......... Depth ,,,,~,,,,~,,,~ .............. 10. Date of Purchase ...... ~ ~ ......... .~...~..~..~.. ............... Name of,,~ormer Owner 11. Zone or use d!strict in which premises are situated ........ ~_--~.~ ............................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? .... i...~....~. ....................................... Nome of Architect ........................... ~ ...... .._.,~ .............. Address ......... ,, ................................. Phone NO ..................... Nome of Contractor ~...~.,...~-~l~.:J,~'~*.,..Address~ ..(~r~ .............. Phone NO.-~..~..2..~.:.~..(~. PLOT DIAGRAM Locate clearly end 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. STATE OF NEW )~RI~,..~,//~) S S, COUNTY-OF · ,' ................ i.~; ~i..~~.i.i ............. ':~. beih~ dgly 'sworn, ~ep,ose,s ot~d Says that he is the cant 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 arff,,tr~toithe best of his knowledge and belief; and that the work will be performed in the manner set fort,h in ,th¢~i~/~ filed therewith. Sworn to befor~e this ' ' ' ~ ~' ~ ~ ...~..~ day_of .................... ~.~. 1~..,~ ~ .,~s~ (S~gnature of appli~nt) ,~