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Home My WebLink About1156-zFOI~V~ ~0. 4 TOWN OF SOUTHOLD I~U~LDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located al $/S 0akwood Drive Street xxxx . ._~ xxxxx 8outhold~ -Map No. ~ .. Block No ..................... LOT 1% O ............................................................................... conforms subsisntially to the Application for Building Permit heretofore filed in this office ,~August 1 19...6...0.. pursuant to which Building Permit No. Zll~.6 dated ................~ ............. , ....................... ~lated ................... ~.~....A.~.g..~..s_~.......~:., 19_..6.9, w.as issued, and conforms to all of the requirements of the applicable pro¥isions of the law. The occupancy for which this certificate is issued is ............ ?...r..i...v.a. ~..e....9..n..e....-r..a...m..% ~Y...d~9 lling .................................................................................... This certificate is issued to .~..t.9.P-h..e. rL...~.:~...~....o..n..s ........... .(.o.~n~r ) . (owner, lessee or tenant) of the aforesaid building. FORM NO. l 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) ~ate ................ A ...... ~ .G...u....,....[...../..~ Permission is hereJ~y granted to: .......... ~.:.,.:~.%. ....... ~:..v: ....... .. ,o ...~.~...~:~;.'L';~'.;.'.'~~ii~..., ........................... .............................................. ~~:.~......~.~...~.. ' .... iiiiiiiiiiiiiiiiiiiii.iiiii ...... ~urs.ont to application doted ......................... ~-~.~'~..&....l ........ ~9..~.~., and appr~e~ Building Inspector Fe~ ~..0...~...~ ~ORr~ NO. ~ Tow. or SOUT.OLD BUILDING DEPARTMENT Tow, C'ERK'S OmCE SOU'mO'D, N. ¥. E×om~ned .......... ~....I ............ ~ u · ~/lS~ Approved ........................................ 19 ........ Permit ~o ............................... ~isepproved ~/c .......~~~....~ ........ ................... ....................................... (~uildin~ Inspdctor) Application No. ii APPLICATION FOR BUILDING PERMIT 1NSTRU CTI ONS a. This application must be completely filled in by typewriter or in ink and su6mitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to edjoining 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 a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Buildin.g Department for the issuance 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 applicable laws, ordinances and regulations. ....... ................. (Signature of applicant, or name, if a corporation) ...... .......... :-. ?.:. .. ............................... (Address of applicant) State whether applicant is owner, lessee~ agent, architect, engineer, general contractor, electrician, plumber or builder. ................................ ........................................................................................................................... Name of owner of nremises ~ .... ~. 4',~'~r:h4'.~C~...~'h~...'~..~ ........... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ....~..~.N~..~....~...~.......~...~..~Lot No: ~ ................. Street and Number ...~..~...~.........~...~.~.,:~..c..~......~.~.~....~~ ..................................................................... Municipality 2. State existing use and occupancy of pr. emises and intended use and occupancy of proposed construction: a. ~x~st ng a o p y ............... ^ ................... ~ ................................................................................................ b. Intended use and occupancy ......... /~..~./,.~:,..~...~ll/~ .......................................................................................... 3. Nature of work (check which applicable): New Building......~......k. ...... Addition .................... Alteration .................... Repair .................... Removal ...... v ............ Demolition .................... Other Work (Describe) .................... /.0. 4. Estimated ...................................... 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 ....... .~..~..?.../..O. ...... Rear ......... ?....~...Z!.~... Depth ..~..~Z..~..~7.~ ....... Height ............................ Number of Stories ..~ ......... 9. Size of lot: Front '/. ~'"/' ~'. Rear ....~.. ..................... Depth ..~....~...~..~..?...2Z.,? .... 10. Date of Purchase .............. ./..~. ..O.. ............................ Nome of.Former Dwne~' ..... 1]. Zone or use district in which premises ore situated ...................... '. ...................................................... 12. Boes proposed construction violate any zoning Iow, ordinance or re§ulation? ...... ...~....0. ..................................... .......... Address ............................................ Phone NO. 13. Name of Owner of premise .................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Controctor.~~:...~....~..OT~...~.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 o,r description according to deed, and show street names and indicate whether interior or corner lot. STA'rE ,~ ~'~,,<r¢,-~,.,-~c,._~ e sorn .............................. [..~ ................................................... b ng duy w , deposes and says that he is the applicant (Name of individual signin~ppllcation) . z . 'o named Heisthe .~~ au ve ................................................ ~'~ ~ ~' ' ~ ~'~'~; ' '~'r'~'r~' '~ ~i'~ ~7' ~ ~ ........................................ 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 a statements contained in this application are true to the best of his ~nowledge and belief; and that the work will be performed Sworn to before me this ................. ~ ..... day of ............ ~~ .... 19..~.~ .....~ot~rv/~,~ ~o~gnature of applicant)