The URL can be used to link to this page

Home My WebLink About706-zFOR~I NO. 4 TOWN OF SOUTHOLD BUiLDiNG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. CERTIFICATE OF OC:CUPANCY No. Z..2,~,8:L ............. Date ....................... ~.1~ .......J~ ............. , lC).6~.. THIS CERTIFIES that the building located at ..N/~.....Nck~'.:I:;~..]~.~)acl,...(~R;~A) ............. Street Map No.Z~tT,.Z ............. Block No=aCZ~C .............. Lot No. ,:Z,~l[~ ....... (}~'.~el~]~,~..~,~...~,~, ............... conforms substantially to the Application for Building Permit heretofore filed in this office doted ......................................... ~.,,~....~ ........ , 19...~.~1. pursuant to which Building Permit No. ~.0~..Z* .... dated .................................. ~T~xt~....4,....., 19..~.., was issued, and conforms to all of the requirements of the applicable provisions of the iow. The occupancy for which this certificate is issued is ........ P~,i~a.te...om..~a~i:LT..~.w~.l;t.~ng ................................................................................................. The certificate is issued to ....P.e~.Z'~...S~:I.o~:~,t~,I3, ..................... Ol~i~i~ ......................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector FOI~M NO. 2 TOWN 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.o 706 Z Dote .............................. ~tz~....~, ............. 19.~l... Permission is hereby granted to: ~ · ~l~#~ ..~,~.....~r~...~.~,e.!~.~. ................................... ..... ...~. ~o.~....~.:~... ............................................. at premises located at .~/.~......~.~..h..~.9~ ........................... .................................................................. ....................................................... ..0.~.e.~ ,.....~....~.: ......................................................................... pursuant to application doted ................................... ,T:,tt~.e.....L .............. 19~/~...., and approved by the Building Inspector Fee $.~,r~ ............. FOR~ NO. 4 TOWN OF SOUTHOLD BUilDiNG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY ,3'une Z4 60 No. ........ Z............623. .... Date ........................................................ , 19 ........ THIS CERTIFIES that the building located at .~[g~.1;,~*X..~,.9.~,,....~.~?~.~.~ .................. Street Map No ......................... Block No ......................... Lot No ................................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated 4 19..~ .D..., pursuant to which Building Permit No. ?06 dated J'u~ 4 ~9 ...................................................... 19 ........ , wes issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ................ This certificate is issued to .................. Z.r.t.t~.....~..'7::~;.~:;.%~3.%t?......r. 77?.~.2.; ......................................... (owner, lessee or tenant) of'the aforesaid building. Building Inspector TOWN O~ BUILDING DEPARTMENT TOWN CLERK'S OF~:ICE SOUTHOLD, N. Y. Examined .......... ~......~... 19..~,-~ Approved ....... ~~......~19.~..Permit No. ~.~...~... ....... Disapproved ~/c ........... ~.z=>'~~ ..................................................... .................... ............................ .............. (Building Inspector) Application No ....... ..~.....(~..~.. ..... APPLICATION FOR BUILDING PERMIT' Date ......... ~..~...(~...~......~.. .......................... 1 9.~..~.. .... INSTRUCTIONS a. This application must be completely filled in by typewri.ter.or in !nk and .su/omitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or p0blic 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 coYered 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 shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issu6noe 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 a Iterations, 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, Jfa corporation) (Address of applicant) ~/ State wheth,er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, si~natuj'e of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Municipality 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................................................................................. : .................. 3. Nature of work (check which applicable): New Building ...... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4.Estimated ................................ Fee (to be poid on filing this applicotion) 5. If dwelling, number of dwelling units....~,,f~'~ ............... Number of dwol]ing 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 ....x(~..~../. ........... Depth ...'.~..~..°...~ .............. 10. Date of Purchase ..,¢~..J~...~.~x../.~.~.~. ...................... Name of Former Owner .~.., ..~.,.../~.....~..~,~.~. .......................... 11. Zone or use district in which premises are situated ........ ~.....-r.../~,z~..~../.~..~..,~..Z'./.'..,~../.-m., ........................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? .... ~/.~ ....................................... 13. Name of Owner of prem.se~..~....~'..~.~.~.~.~.~-"./~....Ad~ress~-'..~..,.~...,~.~.~...f..' .............. Phone NO?....'.T~,~..~,~ Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contracto~/'/~,~..~..'...'.~.,¢:/~;/..~,~.~'.~z~.....Address ...~..0...O...~'j.~..~.~. ............. 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. STATE OF NEW YORK, ) S S. COUNTY OF ...... ; ..................... ..... ~.~....~~ .................... being duly sworn, deposes and soys that he is the applicant (Name of individual signing application) above named. He is the ............................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of sald 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 application_,,f$1ed the, rewith. Sworn to before, me this .......... ~'~L day of .................... ~,~,¢',',',',/~¢~>, 19.,..%~.,,~/~ JUDITH T. J~r0'~ignature of applicant) FORM NO. 1 TOWN O!: SOUTHOLD BUILDING DEPARTMENT TOWN CL£RK'S OFFICE SOUTHOLD, N. Y. Examined Approved .......... ..~ ........ 19..~,,.~errnit No ............................... Disapproved o/c~ .......................................................................................... .......................... ~:._.._~:;~ ...... .~....~:..:~ (Building Inspector) Application No ....... ..~....~......~.. ....... 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 Io~otion of lot and of buildings on premises, relationship to odiolning 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 cov, ered 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 shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuanc.e 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 applicoble laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) ................. ~:~: ............ :;~.,,,..~,.~ ............ z,;/ ...................... (Address of applicant) ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................ ,,' z ..................................................................................................................... If applicant is a.corporate, signature of duly authorized office. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... ....... .............................................................. Municipality 2. Store exis~ino use~hd occupancy of p~emises ond intended use ond occup~nc~ of proposed construction: o. Existino uso ond occuponcy ..................................................................................................................................... ................................................... 3. Nature of work (check which applicable): New Building......lc~.............Addifion .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost.....~.O..l~.~..~ ................................. Fee /o (to be paid on filing this application) 5. If dwelling, number of dwelling unlts....~... ............... 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.....-c,~...~....f ............ Rear .....¢~...~...: ............. Depth ..~...~...t. ............... Height ...../.~../. ............. Number of Stories ....... /.. .................. 9. Size of lot: Front ..... /~...~...~. ............ Rear ..... /../..~./'. ............ Depth ...~..~..~..f .............. 10. Date of Purchase ..,~J[4,~.~..~..~..~.~. ...................... Name~,~ -~°f Former Owner .~, .~.~...~....*¢-.~..~/ .......................... 11. Zone or use district in which premises are situated .......... ~....-~...,~.~.'~../.~.,~'~'[..~.(..~..~/~.. ........................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ..... ~.~1. ...................................... 13. Name of Owner of prem.ses ./~...~J'~/~/~J£~<.,.~'~'~...AddressJ,,~/A~.~..~..~'/~.~-.,4¢/.~..! ........ ~..Phone NO.~..."..~...Y~J Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractorli~'/'~..,~/~,?.~...,~.~/~',/'~.~.~/~....Address ...~.O.~..~./~J.~..~,.~. ............ Phone NO.4~...'t.~.~.~./.... 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. 0 STATE OF NEW YORK, ) S S. COUNTY OF ............................ ) . being duly (Name of individual signing appllcofion) sworn, deposes and says that he is the applicant 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 applicatjon,filed therewith~' Sworn to before,, me this /,,-~,~,~, ~ , ,Z~, ~,__ ............. ~.= day of .................... ~. 1~.. ~/ J,~ITH T. (~ture of applicant) ~ ~ ' / ~ ~. ~ ~ "~'~" Public, State of New Yor~ Hota~ Public,~.~c,.~~y~,,, .=~- ~44963, suffolk County ~_