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Home My WebLink About791-zNO. 4 TOWN OF SOUTHO/D BUILDING DEPARTMENT TOW~N CI,ERK'S OFFICE SOUTHOI. D, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the, building located at .,~. ,/.~....~.~.~.?.-....~.~,l~,.~.Z..~..~..~..~.~..... Street Map No, ~ Block No. ~*~ Lot No. ~*~ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................ A'!.~J~..t3..~..'~..~. ........ , 19..~....~.., pursu,ant to which Building Permit No ......... ~..~..~.~. ....... dated ............................ ~La, g~g~...~ ...... 19.~.¢~.., wa,s issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ................ ........................................... .~"~A~...~E...E~ ~. ~C~ ..................................................... This certificate is issued to ,~O'~'L~ C~e ~: I~,D,~(~ ~ ~D~',lt'B~.~.t .O.~..G..~.~ (owne, r, lessee or tenant) of the aforesaid, building. Building Inspector FOR~ 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) Permission is hereby granted to: ..~.~..~.!.L.~. ...... ~,..~.~....¥::.~..:..~ .................. .......... i~.~..~...~.~ ...... ~.v...~.?. ............................ ............ ~:L~....m... ~..~...~ ~..~..(~.~......~..~.?./.:. to .~.r~`.~:......A. ~.~.~.:t....?.`....T..!..~.~.~.~:....~. .~.~.:. ~.`~...c::.4.~...~..~.~. ......4.. ..~. ..~...~..~..~L~..~.~.~ ........ ......... .~..~.~.~.:~.~..~.~"~.~".~.~.~.~..e~.~.~..~.*:.~J~ ............................................... at premises located at .~./2~- ....... '.~....~.....~..J..~. ...... j~...~...L?. ................................................................... ...................................................................... ./.):.~...¢...~....-E..!....T..~.....~,...~..-..~ ........................................ ........................... ~..V..(~.~:.~...;...~.....~.. ....... 19.~.~..~.., and approved by the pursuant to application dated Building Inspector Building Inspector OWNER FORMER OWNER STREET SEAS. VL. LAND IMP. TOTAL ~ mo AGE VILLAGE BUILDING CONDITION FARM coMM. t IND. DATE [ REMARKS NEW NORMAL BELOW ABOVE' Form Ac re Value Per Acre Value lb DISTRICT ACREAGE TYPE OF BUILDING SUB. LOT -illable riilable 2 :illable 3 ~Voodland ;wampland ~rushlan~'"~'~ ~ ~...' ._: -louse Plot Fetal, CB. { MISC. ~tension ~ ~ ~/: ~ ~ Basement ..~-~- Fl~rs c~~ ~9 ~t. Walls ~ Interior Finish ~tension ~1: ~ /~ ~ ~.~., ' Extension ' ~' ~ ~ Fire Place J Heat Dorch Porch Rooms ~st Fbar Breezeway Patio Rooms 2nd Floor O.B. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLEP, K'$ OFFICE $OUTHOLD, N. Y. xamined .......................... ~. ......... 1 ........ Approved ......................... ~. .......... './...19 ........ Permit No....~: .Z..~...! ........ Application No ........ 'Z. ~]..( ......... APPLICATION FOR BUILDING PERMIT Date ~"'J~ ~ ~ 19 '~' ? 1 NSTRUCTIONS 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 fo 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 p art for any purpose whatever until a Cert-Jfica~e of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuanoe 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, ~dditions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signaturek0ff applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractoh electrician, plumber or builder. ................................................... i ...... ......................................................................................................... If applicant is o corporate, si!~nature of dulg authorized officor. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Mal) No: '~ Lot No: ...]~...'~ ..... Street and ~,~umDer ...................................................................................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Bxisting use and occupancy ................................................... .~ ................................................................................ . .......... ....... b. Intended use and occupancy ......................... ~..~ ................ ~. ........ .....z .. 3. Nature of work (check which applicable): New Building .................... Addition ...... ~lteration R~pair ............... ~..Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estl ated Cost ....... ~..'Z.. ................................................ Fee ...~. ...................................................................................... (to be paid on filing this application) 5. If d~elling, number of dwelling units ........... ..~t...~.~."...~..~.. ...... Number of dwelling units on each floor ............................ If gaFage, 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 ................................ /' ..7 ....................... 8. Dimensions of entire new construction: Front ........... ~.. .............. Rear ............................Depth Height ............................ Number of Stories ........ ..O~..~ ..... 9. Size of lot: Front ......./..Q...O.. ........... Rear ......... ./..?....~. ......... Depth ......~......~.~..~). ......... /'~ ~- ¢~ ~am of Former Owner ........................................................ 10. Date of Purchase .......................................................... e 11. Zone or use district Jn which premises are situated ................................ .,-z...~. ......................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? .................................................... 13. Name of Owner of p ~L~ ........ : ...................... :~'~ ......... ~'none NO ..................... Name of Arch tact .......................... ~ ............................. Address ............................................ Phone NO ..................... Name of Contractor .................................................... 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 street names and indicate whether interior or corner lot. STATE OF NEW~Y(~/I~tr ) S S COIJNTY OF ..~.. :.,..~...~.~.~..j: .~../l ..... ) .............................. ~./.......(.~ ............ ~'~ ............... ' ............ be,ng duly sworn, (~-- ~-~ ~ ' deposes and says that he is the applicant (Name of indivi~ol signing application) above name~ 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 appl cation', that. all statements contained, in this application, are true to,~the., . best of his. knowledge and belief; and that the work w.ll be performed m the manner set forth ~n the o~~d therewnh. Swarn to before me th~s ~ ~ ,~ ~.~ o~ ~9~~' . ~ day of ........ ~.~ ..... 1~-.]~,~,,. ~,::q~% ~ (Si~nature of~pplicam> Nola~ Pubbc,~~....~~ ........ t ~¢ ~,:., . ~