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Home My WebLink About1194-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located al _Map No...G~.hwe~h~}lock No ........... ~.~..Lot No ........ ~ ................................................................ conforms substsntially to the Application for Building Permit heretofore filed in this office dated ............... ~.~..-~. ........ 19.~.. pursuant to which Building Permit No. -~....~.~ ...... ~ated ............... ~qB~.2...~.0 .......... l~O..., 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 Th~s cer%~fica~e ~s ~ssued to .......................................................................................................................... (o~ner, lessee or tenant) of the aforesaid building. Building Inspector FO~[ NO. 2 TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS P, ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1194, Z Dote .................... ~lg.~t~,~ .....3 C) ............. 19_.60 Permission is hereby granted to: Wm. ~e~be..... &/C~.... ~a.~.~.cl.. · .. ~ucl~ ......................... ......... (~.u~hc~g~e-f...'- ~. ~'; ................................. to..Bu. ~.t4.. ~n.. a¢t~.~.c~n .. en...ar~...e:~:e.~o ~ag...c~e ~.]:~ng ........................................................ at premises located at ......~/S""'~Jz~"'r~c]C"~D~d ......................................................................... ............................................... Sou~.ho.Z.d.~..... '~ ~.::~ ~ .............................................................................. pursuant to application dated ................................ ~,~L~S¢""~'O ....... 19~.0..., and approved by the Building Inspector Fee $..~**.00 ............ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19 ........ Perrmt No. Application No....l..!..~..~i .......... Date ......................................................................... 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 adioining 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 coYered 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 issuanoe 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 a Iterations, or fo~r 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) ............................. ~,~;~';f"~'iic"~')' .............................. State wheth.er applicant is o~r, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ........ ~.t~......'-~r..~.c.'..%~r. ...... '.I....~.L.~..:~-k..Y..".:~:: ............................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which, propos~d work will be,done. Map No:,~...~..~,~ ............... Lot No: ..~...~.. ............ Street and Number ..,~../...'.~. ....... ..~.~.~...,~.......~...,~...c.:../..~....~::..~.. ................................................................................. Municipality 2. State existing use and occupancy pr~mise ~nd i~tended use and occupancy of proposed construction: o. Existing use ond ocduponcy ..... .~..;.~ ............. .~ .............. ~..r~ ............................................................... b. Intended use and c pa cy .............................................................................................................................. 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 .................... Addition .....~...~... ....... Alteration .................... Repair ....................Removal .................... Demolition ....................Other Work (Describe) .................... 4. Estimated Cost...../....~....~...O..~ ................................... 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 ............ 9 ............ Rear .......... ~ ...............Depth .~ ................... Height ............................ Numb% of Stories ....../'~..'.~.....~.. ' ...... ' ./... 9. Size of lot: Front ...... ~'~'..~...~... ........ Rear .......... ....... Depth ...... 10. Date of Purchase ........... /...~.....~....~ .......................... Name of Former Owner ...~¢.....~.~ ............. 11. Zone or use district in which premises are situated ........ ........ ~ ................................................................ 12. Does proposed construction vi/~late any zoning law, ordinance or regulatior~? .......... /.~.....O. ................................ 13. Name of Owner of premises.....~......~..d/,..~..: ........ Address ....~...~ ................. Phone NO ..................... Name of Architect ........................................................ Address ................. ....,..... ................. Phone NO ..................... Name of Contractor....l~...~..~.~ ............. Address ...... ~ ........... ~ .......... Phone NO ..................... 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 STATE OF NEW~O~, ,~ ) q S COUNTY OF .,..~¢,~..~F~....~...) ~ ' .......................... ~.../~.~ ............................. being duly sworn, deposes and says that he is the applicant (Nome of individual signing application) above named. He is the .......... ~ ................................................................................................................ (Contractor, agent, corporate 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 true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. J~DIT~ T BO~ Sworn to befor~ me this ~ ~*ta~ Publi. *,: ~N f - ' .... ~Uffolk Co ........ ........ .