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Home My WebLink About790-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOD-r~OLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .......... Pe.oOlli.C..j~y...l~l,V.d .................... Street ~ap No ...... ~ ....... Block No ........ ~.....Lot No....~ ........ ..~..~1~.~..1. ........................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ..~_.1~......~. ..................... 19..~.~. pursuant to which Building Permit No...~.~..Q ........... dated ............... ~...1~.$..~...t....~ .......... 19~.~...., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certilicate is issued is .............. ~.r...i.y..a...t. ~....~.n..~....r...s.~.l.!~... ~ !.! ~..n. ~. .......................................................................................... This certificate is issued to ..~...t...1...1..1...8.~.....~..$.O..~.~ ............. .{..~.~..~.) ................................................ (owner, lessee or tenant) of the aforesaid building. FORI~ NO. ~ 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.° 790 Z Date ............................ A~rml.~....& ........... lf/~. ...... Permission is hereby granted to: Chet. Orlc~e~t... &/C....~illia~... 2arc.us ...................... .......... Ca~eho~e.r...~..~ ........................................ to .. I1~i~.. jl.t~-at4~oa -. ~t~u. ~. ~J~..~r~t a~.. ~e,ll,t~-......(~...~...e~.) ................................ at premises located at ...ll/J..,.~.®oQn~.c..Bl~..Bl~d ............................................................................... .......... , .......................................... I~i~uck.....N..ff.o ............................................................................ pursuant to application dated ..................................... Al~Jll~.t....~ ......... 19~....,, and approved by the Building Inspector Fee $...,~....~. Building Inspector ~ORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ....... .............. (Building Inspector) / Y?O Application No ............................. APPLICATION FOR BUILDING PERMIT -. 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 port 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 o Certificate of Occuponcv shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) (Address ~j~ applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises ................ ~.~ ........................................................................ If applicant is o corporate, slgnoture of duly authorized officer. (Nome and title of corporate officer) 1. Location of land on which proposed work will be done. Mop No: ...................... Lot No: ......'~. ............. Street ond Number ....~..J~.../.S.w~n~...~..}"~'.~¢-'"'"/~'":~'' ............. / Municipafiry 2. State existing use and occupancy of premises and intended use and occupancy of proposed ,construction: a. Existing use and occupancy .............. ,....D~.......J.~' .......... -- ~ ' ~..~../..~...~. ..................... b. Intended 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ................ .~.........e~.. ................................. Fee ............. ~.-.:.....~Z~... ............................................................... (to be paid on filing this application) ? 5. 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 .....~.R. ................ Number of Stories ............. /. .............................................................................................. Dimensions of same structure with alterations or additions: Front ........... ..~..~ ............... Rear ...... ~..C. .................. 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 ........ /i.~ .......... 10. Date of Purchase ....~c~ ./..~..~.~.~ ...................... Name of Former Owner .~.~..~.:.~..: .... 11. Zone or use district in w/tach premises are situated ....... ./.~.~----~ ...................................................... 12. Does proposed construction violate any zoning law, ordinance o.r regulation? ........ ....~.......-. ............................... · es s-. ~' , 13. Name of Owner of prem,s ~..~ ~.~ ....... Address ...fc~~.,....../. ....... Phone NO ............ oc' c/'--/...~,....~ Nome of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor~.,.~i~'LJ~.,~: ........ Address~..~.l.~..'.~/....Phone NO. f~,~....~.~..~...1~...~-z._ 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 tot. 3~ STATE OF NE~YO~I~,~- ) S S (Nome of indi~lfi~lFsioning oppli~jon) _ ~ . obove nomod. Ho ~s th~ .............................. ~ .................................................................................................... {Contractor, o~ent, corporato officer, etc.) o{ sold owner or owners, ond is duly ~uthorixed to per{otto or h~ve performod the sold work ond to moko ~nd file this opplicotion; thor oll stotoments contained in this opplic~tion ~ro truo ~o tho ~st of his knowledoe ond beliof; ond thor the work will be performed in the monner set {orth in the opplic~tion filed therowith. Sworn to bef~e me this ~ -- ~ [ ; ~ ........................ aay of ....... ~. .............. i~.; ......... ~. 19../.. ...... sUD~ff T~ ~gnature 6f applicant) ~ /-'-/ ~~., ~ N'ot~ry PuHc. State of New Nota~ Public, ..~:.;/~.~., ............... y ~o 52.2~,~.;~3. Suffolk County