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Home My WebLink About1136-zFO~I~V~ ~0. 4 TOWN OF SOUT/~OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. C~-RTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located a( Southold, New York _Map No .......... ~**..... Block No .......... .~......Lot No .... .*~8..~ ............................................................. conforms substsntially to the Application for Building Permi~ heretofore filed in this office dated ..............~.,,l~y...1.~, .............. 19.~0.. pursuant to which Building Permit No ..... .Z...t~.3~ .... 4ated .................. ffu].y-~[.% ............. 19..6.0., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ............................................. Pt%i~/ATE 0~ !~AMILY. D~F.J~L~/qG .............................. This certificate is issued to ...... ~o....I{,,...V&l~oda~.r...own~ ............................................................. (owner, lessee or tenant) of the aforesaid building. Building Inspeclor FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS ~FRMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1136 Z Dote ........................... ~.t~.....~]~ ........... 19..~0. Permission is hereby granted to: H, ·, C lar~z-. &.. ~o i~s... ~-ne-...-A/~.. J. ~.I~ ,.V.it.1 ¢,~e~ ......... ........... ~r~en~ort ~'""N';'~'~ ............................... to ...... B~d'"an' "a~d iJ;i~n' · 'orr" an · 'e'~i's tin'g '- d-w~]: iJ:n~ ................................................... at premises located at .~/~......T~.f~.Me]..,~.i.e~..~,a~ ......................................................................... ...................................................... G,~.een.,'~..t ~.....[~ ~.~, ..................................................................... pursuant to application dated .............................. ~t~'T~r ...... ~ ............. 19~0..., and approved by the Building Inspector Fee $'""~i:(~) .......... ~x ) , . ,:~..; ............ .~. ~ ~;'.. ;<...':'. 74 ................. Bui ding Inspector ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Vx . Approved ........................................ 39 ........ Permit No .............................. ............... ............................................ (Building In~spector) APPLICATION FOE BUII..DI~G P[RMIT INSTRUCTIONS 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 o detailed description of layout of property must be drown on the diagram which is port of this location, c. The work covered by this application may not be commenced before issuance of Building Permit. dl 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 Certificai:e of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuonc,e of o 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, os herein described. The applicant agrees to comply with all applicable lows, ordinances and regulations. (Signature of applicant, or nome, if o corporation) ' ' (Address of applicant) qote wl.~her applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... t a... ............ . ................................................ Nome of owner of premises If a~licant, is a~corl~orate, signa,tc~fe of ~u¥ au~'honzed officer. 1. Location of land on which pr,~oposed wor~k will be done. Mop, No: .................................... ,~ ...... Lot N~.~.i~ .................... Street and ......... ...... Municipality 2. State existing use and occupancy ~,.C)p,r,em~ses and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ .~,~.~.$..t. JD..~..~.~.~, .............................................................................................. b. Intended use and occupancy ........ ~..~.Lf)..f,.~.LL .......................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition ................... ..Other Work (Describe) .................... 4. Estimated Cost ............ ..~.....I...~:T...(~..¢~..~.-". ........................ 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 ....... .~.j ................ Height ......... l.~ .............. Number of Stories ........ ! .................................................................................................... Dimensions of same structure with Mterations or additions: Front 3~ Rear Depth ........... ..~...~. ............ Height ............. ;~ ............... Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... l....~.' ............... Rear Depth ....!....~. ................. Height ....... !...~:.. ............... Number of Stories ..........~ ................. 9. Size of lot: Front ........~. .................. Rear .......... ..~.~.i .......... Depth ............................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ........... ~.~...~,.%.t..f)..~.M,/k%..~..~..~. ............................................... 12. Does proposed construction violate any zoning [aw, ordinance or regulation? ............ ..~....O. ............................... Name of Architect .................................. i ..................... Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an~.d_~dicate all set-back dimensions from property lines. Give street and block r~umbers or description accordin~g- ~--~e~d, and show street names and indicate whether interior or corner lot. ~/~ ~/~ 0 D rAJ S ~-- STATE OF NEW/I'O~J~,~,Z' S S COUNTY OF ,,~q.~¢~f/,C(,~M'.... ' ...............--~.~.,..'- ~~~..~.., ............ , ................ being duly sworn, deposes and soys that he is the applicant (Name of individual sign~g application) (Contractor, agent, corporate officer, etc.l of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file th s appl cat on; that al statements contained in this application ore true to the best of his knowl~e and belief; and that the work will be performed in the m~r~e~0~[th in the application filed therewith. { / Sworn to befor~me this ~ota~ Public, State of N~w York I/~ ~ J /~ ,