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Home My WebLink About1148-zFOR~Y~I NO. 4, TOWN OF SOUTHOLD BUILDIHG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ........ ~..~1,2.7.5 ....... Date ................... ~.~..,~ ........... , 1 THIS CERTIFIES that the building located at .~./.~...~E~,~;.*~'~.~..C~O~tle ...... Street Map No.~.t..~..*...~...~..~.~.... Block No...?.?.? ............. Lot No ......~.~../~...~EI .............................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. ~.~]¢...~.0. .................................... 19..~i0.. pursuant to which Building Permit No.~..~l,tl'41~,.. doted ..~.~...~.....2..0. ................................. , 19.....6..0., was issued, and conforms to all of the requirements of the applicable provisions of the la.w. The occupancy for which this certificate is issued is .......... This certificate is issued to ............ ~.~lg.~l~.~..~l,t~J,l~,~...O~r~/~ ........................................................ (owner, lessee or tenant) of the ~foresaid building~ Building Inspector FORM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 1148' Z Permission is hereby granted to: Bray Avenue ~*kt..~ .t.~c,~ ,... ~..~o~ .................................. to .~.u.,~..~..e..w....~...~.a..~...?.~.e....~.t. kL,~..e.~.:Z.~ .................................................................. pursuant to application dated ....................................... ~4~1~..,~0 ........ 19~0..., and approved by the Building Inspector Fee $.lO.,,.O:G..~he.uk paid Bulldmg Inspector TOWN O~ $OUT~OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c .............................................................................................. Application No.././.....,~...~..... .......... (Building Inspector) APPLICATION FOR BUILDING PERMIT ~ Date ..................... ~/,..v.. :. ~.....'.~...... 1 INSTRUCTIONS a. This application must be cqmple~ely filled Jn by typew?iter or ir~ ink and sd/omitted 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 opplication'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 Dep~artment for the issuanoe of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other opplicable Laws, Ordinances or Regulotions, 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. . ............. ......................... ~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of ............................................................................................ If applicant is a corporate, signature of duly authorized officert (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ....~..c.¥..'/.,.~~ Lot No: .~..Z.~....~..(~., Street and Number .......... ...'~.ZJ..'~.'~...~....~.~fcC'~,...~.~cf~...~..,~~. ............. : ........................ / Municipality 2. State existing use and occupancy of premises end intended use and occupancy of proposed construction: a, Exist ing u se o nd acc upa n cY, .....~. · .~/.~..IC~.¢~'.~.¢. ~.~...~*....*~... .................................................. ,~ .................................... b, Intended use and occupancy....f~.~.~.~;~..<.~¢<~.¢.¢..~...~..~..~....~/c¢.,¢~'~¢ '¢ ............................. Locate clearly and distinctl, property lines. Give street and whether interior or corner lot. 3. Nature of work (check which applicable): New Build ng .................... Add t on .................. Alteration .................... Repair ............... ,~,..Removal .................... Demolition ........... Other Work (Describe) ......... 4. Estimated Cost.....xf.~:~-2..~,Zc~...~.~ ................................ Fee /.. ....................................................................................... (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 ............................ 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 .......~....~..~..~...~...~.... Depth ....... ~..'/~-'-'~.--'..~...~./.// 10. Date of Purchase ...................... ./..~..i..(O......~. ................. Name,~o~f.,~:~ ~orme~ner ~/~..'~Y ................ 11. Zone or use district in which premises are situated ........ 4../... ............................ :~ ....................................... 12. Does proposed construction violate any zoning law, ordinance or~,regulation?, ~.~......'~,.~.: .............. ~ ........................ 13. Name of Owner of premises.~.~:~,~..~....~.......~.Address ~.~..~:~...~..~.~........ .~, p n ~~,....~..~ ................... Name of Architect ....... .~/,.~.....~..-., ...........~.....Address -.~ ..................... v .......... ././. ho e NO ..................... Name of Contractor.~.~...~...~......~..~..~ess~//,c.~...'z~. 7,..~.-~...Phone/;~'- '~ NO ..................... PLOT DIAGRAM all buildings, whether existing or proposed, and indicate all set-back dimensions from Lock numbers or description according to leed, and show street names and indicate s-rA'r OF S S .................... ~~ ................................ being duly sworn, deposes and says that he is the applicant (Name of individual~~~slgning application) above named.~e is the ...........~~..~..~.~.;~.-~ .................................................................. ~ ~ . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly autRorized 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 ~st of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to befor~ me this JUDITH T. B0[EN ~ ~ ~ ~ota~ublic~ate of Ne~ York ~ .~ day of ............... ~~.~or~ cou, ~ _ (Signature f applicant) ................ . ~ ~ssion ~pJres March 30,