The URL can be used to link to this page

Home My WebLink About1232-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CI~ERK'S OFFICE SOUTIiOLD. N. Y. CERTIFICATE OF OCCUPANCY ~o ....................... ~ate ............................................................ 19 ....... ·'HIS CERTIFIES that the building located at Map No. ~ Block No. .~. ........... Lot No. conform8 substantially to the Application for BuilOing Pemait heretofore filed in this office dated OC~Obe~ ~3 19 60 g 1232 ...................................................... ,... pursuant to which Building Permit No ..................... O=to~= 13 19..~. was issued, anti conforms to all oi the require- dated ................................... ............... , ments of the applicable provisions of the law. The occupancy ior which this certificate is sued is .................................. ................................................. This certificate is issued to ]tlli~ ~ll~l, (owner, lessee or tenant) of the aforesaid building. FOI~/ NO. 2 TOW~4 OF SOUTHOLD BUILDIHG DEPARTMEI'4T TOWbl CLERK'S OFFICE SOUTHOLD, H. Y. BUILDING PERMIT (THIS F~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? ]232 Z Permission is hereby granted to: ~'ecl C~ az' cl.ot~ ....AZ..C.....~/.~. ]_l~,a~.....Z~u].lez- ..................... .... C'~Z~ e~n~z~.t, ~----.N.~.'~r., ...................................... to ....B.uild..a~...addi.tioz~..or~..a~..e~i~t~ng...~t.we3.~i.ng ...................................................... at premises located at ....Lo&..~......]i*~e.~,~.].~] .............................................................................. ..................................... H~d.~e Zt o~..t~oe~ ,.....~e~r~o~.t ~.....~ aZ:. ............................................. pursuant to application dated ......................... O~'~,O.~e,Z'.....~L.~ ............. 19..~, and approved by the Building Inspector Fee $..~,.00. ............ Building Inspector Examined ..... ~......J....~. ......... , Approved .................................... , TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ,, . .~;~,. ~- ]9 ........ Permit No ............................... Application No..../....;)-f..'2.....)TZ-.. ............. Disapproved a/c ...~ ....... ~. (BuiMing In~ector) APPLICATION FOR BUILDING PERMIT ..................... , 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 a detailed description of layout of prope, rty 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 o 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, if o corporation) .!. ......... (Address of applicant) ~ State whethe, Er applicant is. owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................. !.~...,,¢,..~.. .~...b..~f~ .................................................................................................................................. L...¢... '.L....c...:. L.L...i A Name of owner of premises.. .:...:! ......................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate, officer) 1. Location of land on z~ch proposed work will be done. Mg.~_No: ............................................ Lot No: .................... Street and Number' i......~.. ........ . .~...~..~.~..L...C.-~....O....!.~........~..~....f~...~..-'~...., ................................................................ Municipality, / 2. State existing use and occupancy of pr~cses and intended use and occupancy of proposed const/ction: a. Existing use and occupancy ................. .(;:M..~'~O..~,~. ................................................................................................ b. Intended use and occupancy ...'.....~...i..6.).JJ~-~....~......O..~.lr~2~..;..-:.......~z(.C~.9?O..~- .......................................... 3. Nature of work (check which applicable): New Building .................... Addition....~....Alteration Repair ........... 3' Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost-~.'.....~..-~...C~....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 r~ature and extent of eafh type of use .................. ~. ............ - 7. Dimensions of existing structures, if any: Front.......~...!.....~ ......... Rear ...~...~ ............. Depth .......~....~. ................ Height ...... .~....~.. ............... Number of Stories ............~...Y~......~...-~....c~..(~.l..~...~ ..................................................... Dimensions of same structure with alteratlo~s or additions: Front ...'"~.....~. ....................Rear .....~.......~... ................. Depth ........ ..~.....~.. ............... Height ........ 1..~. .................. N,umber of Stories ......... 8. Dimensions of entire new construction: Front ........ !....~... ............ Rear ........ .[..~. ............. Depth .......!....~. .............. Height ....... {..~. ............... Nut, her of Stories ........... I..f ................ 9. S zeof ot: Front ....... ........... Rear ..... ............ Depth ....... ..... 10. Dote of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance~/~r regulation? ...... .~Q ........................................ 13. Name of Owner of premises.~.J..k..L.....~.[/J(J....~.ld~-~"f~ddress ..~......~.~...!.0.0.~...~......~. ,.. Phone NO ..................... Name of Architect__~_....i .......................................... Address Name of Contract~r-~..,~ ~'(~.(~t~(~..~ ................ Address '['~.'.~.'"'i'i~i~iiiiiiiiii Phone NO ..................... ............................. Phone N (~..~...?..--...J...O...~.. ~, 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 or description according to deed, and show street names and indicate whether interior or corner lot. / ~-Of STATE OF NEW~,YOP,,I(., ~, .,,, _~ ) S S . · ~'~, ~;~-~ c,~--'- ' ein ........................................ ~..:. ............... ~...x ............................... ~ g duly sworn, deposes and says that he is the applicant (Name 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. Sworn to bef/~e ~ this ~~~~ ~~ ~