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Home My WebLink About1177-zTOWN OF SOUTHOLD BUILDING I]EPARTMENT '~'OWN CL~RK'S OFFICE SOUTHOLD. N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .V.&~$.t;.c~_.~..d.:. ,.,..lq.~.~$.a..~..~..:.. Street cut:cheque ~Na~s. au Pt. P2cop. Assn. **~ Lot No.$.~..&...3,~ ........................ : ..................... ~vtap :~o ........................ Block No ......................... conforms substantially to the App!ication for Building Permit heretofore filed in this office dated ................ A-~.~..~...~...~. .......... , 1~...O..... pursuant to which Building Permit No...~.....1'...~.?.? .... elated .............. ~gq.~.~...~,.9 ........... , '19. . i.~. .0. ., was issued, ahd conforms to all of the requi~e- merits of the applicable provisions ,of the law, The occupancy for which this certificate is issued is .......................... ~XVA~...C~,. r~X~Y..}~.~;~ ....................................................... This certificate is issued to .~..~.~.._D,.,~.,..~..~...,~...~...~..._,?.,~.~.~..O...~...,...o...'f~..,~.~.~. ........................ (owner, lessee or tenant) of the aforesaid building. ...... Building Inspect~ .... FOI~M NO. 2 TOWN OF $O~THOLD BUll. DING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1177, z Date ................... .~....U~..U. ~..~......~. .............. 19.....~...O Permission is hereby granted to: Chet O~ tarsal.-... -.&/t~...D~h~m.. ~c -*~a~te~, ................... .......... Cutetzog*tu~'~'*""N'~'~; ............................... to ..... 'Brai '1~ ' ' ~e w · 'one" ~ ami:ly" ~zl. tn~ ................................................................................ at premises located at '"LO~"~"3~'"&'*'~6~'*"'~'~a~"~oi~ ................................................... ~ ................................................ Cu'bc~og~e'f'"'"N;'~"~ .......................................................................... pursuant to application doted ................................ ,~'~g~./~l~'"'*~6 ........ 19..6~)., and approved by the Building Inspector Fee $.10.,.00 .......... .............. ~ ?.~C.~,~ ...................... Building Inspector ( FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19 ........ Permit No ................. Disapproved a/c ................. ~~: ................. ................... ................................. APPLICATION FOR BUILDING PERMIT ) Date......~..~...x.~....x ................................. , ............. 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 muCt 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 Building 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, it a corporation) (AddreSs of applicant) State whether applicant is owner, lessee, agent, architect, engineer, gsneral ~ontractor, electrician, plumber or builder. ................................. .................................................................................. Name of owner of premise ~. ~kO~... ~ ...... ~ Z~ ........................................ If applicant is a corporate, signature of duly authorized officer. ........ (Name and title of corporate officer) 1. Location of land on which proposed work w, llbedone. MapNo:~ ~? ~)'~' '~t .................. ....... No: ...... Street and Number .....~..~r~.../~.~ .~.c.~..~..~. ~...L;~....~?~. . ~unicipafity ~J l 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ~..~.~..~.~;~.~(,~"';.~,r~ ............................................................................... b. Intended use and occupancy.....~,~'.'...~.....c~...:.J~...~ ...................................................................... property lines. Give street and block numbers or description according to deed, whether interior or corner lot. 3. Nature of work (check which applicable): New Building.....,r~ .......... Addition .................... Alteration .................... Repair ............... ~...Removal .................... Demolition .................. ether Work (Describe) .................... (to be paid on filing this application) 5. If dwelling, number of dwelling units.....c~...~ ................. Number of dwelling units on eoch floor ........ ~ ................ If garage, number of cars ............................................................................................................................................ 6. If business, commercial or ,'nixed 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 ...3..~ ................... Height ..../..~....! ............... Number of Stories ....~ ............ 9. Size of lot: Front .... /..~.../ ............ Rear .... ............ Depth ....... ......... ../. 11. Zone or use district~n which premises are situated../~.~,,,~.~ ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ..... ./'.~..~.. ...................................... of Architect ................. ~....~..'~ .......... Address .................................... : ....... Phone NO ..................... Nome of Contracto ............ Address. ...... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from and show street names and indicate S'"'""""""'~E OF NEW Y,K)RJ¢,/,/~/ ~ S S COUNTY O~F_....,~.~,.~-~.~E.~-_-.~ ' .......... (Name of indivi~~ ~pplicotion) ' . above named. He is the .......~~.~ ................................................................................................................... (Contractor, agent, corfforate 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 application; that all statements contained in this application are *rue to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the appiicat~ filed therewith. Sworn to befor~me this ............ /ZCd , of ................ ~.~c s,r; ~ (Signature of applicant)