HomeMy WebLinkAbout1149-zFOI~M N~. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF' OCCUPANCY
THIS CERTIFIES that the building located a( ~[~.....Q~%}~...8.~ ........................................... Street
Map No ...... Y.xY~ ........ Block No. ~; ........... Lot No.... XX~; ....... ~!.~8,%ti%l~ck~......~..~g, ...................
conforms substantially to the Application for Building Permit heretofore filed in this office
July. 21
dated .............Itul~ll:lglll~ ............ 19_60 pursuant to which Building Permit No. ~,..~,9 ........
~lated ...................... J.tlly.....2 ...... , 19.6~.., was issued, and cenforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is
.......... p~.i~a~.e ...o.n~ ..~.a~.tiT... dwe.l.l.~ng. ..............................................................................................
This eertificale is issued to ..~lllo~¢l..~ihiJ,..'b~.~.~..&..~W,. ............. Ow~o~ ......................................
(owner, lessee or tenant)
of the aforesaid building.
Building Inspector
FOP~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? 1149 Z
Date ....................... ~.~.~...*.~!.;~. ............... 19.60..
Permission is hereby granted to:
Che?,.. 0~. lo',~skl.....A~*C..-.. Ra;y"~ond..
................. Cu~og. ue~.....N...~. .........................
to .....B~..~..~ev...o~e...£em~.Z.~..~we~.],~- .................................................................................
at premises located at ..0 .e~'...--~.t~ ........................................................................................................
............................................. ~tti.tu~.....~,~, .............................................................................
pursuant to application dated ............................... Jt~.~t-*.-..~.. .............. t~.(~.., and approved by the
Building Inspector
Fee $5.00 ..............
J
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Exemined ............ ~~19.....~.~..~
Approved ......... ~~.. 19~..(). Re r mit No ............ .~..4/'~...~..~.
Disapproved a/c ................ ~ .............................................................
.................... ~~z~4...~././..:.~.L....~..~...4..~...~,
(BuiJding Inspector)
APPLICATION FOR BUILDING PERMIT
Date.. ........... .......................... ............
INSTRUCTIONS
o. 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 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 Certifico/: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 Lows, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described.
The applicant agrees to comply with oil applicable laws, ordinances on¢,~regulotions.
............................... b ................. ?~.~.~r. ......................
,,,~S~,q~noture of applicant, or name, if o corporation)
...... .....
qtote whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
................................................. ...................................................................
N a
me of owner of pre
raises.
--y
/
If applicant is o corporate, signature of duly authorized airliner.
(Name and title of corporate officer)
1. Location of land on which proposed workwill be done. Mol)No: ..~,~...~.,.~, ..~..J,,~,.:~, Lot No: ....................
Street and Number ......k~..~¢2~l¢'.C.......z~......,.....~.~..t.~~~-..~...~...~...: .............................................. Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
Existing use and occupancy ..........~..~ ....... ~. ~.~,~T: ........... ~t ...............................................................
Intended use and occupancy......./..\~..~.....~,~¢.....,zg,~Z...~kwt~.'s4..~.~.........~....~.~-~.~....~..~.~..~' .................