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Home My WebLink About1239-zFOI~IW 1'~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT '~OWN CI~EEK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located .at ~)~0~;~8..~, ..~O. llt~llO.~.~ ....... Street Map No ........ ~ ........ Block No..~ ............... Lot No ............... e~ ............................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. (~(~.~.,O...~..e...~.....]t~. ............ 1~..0...... pursuant to which Building Permit No. dated ........... .0..q.~.o...b.~.~....~.8. ............. 19...~...0.., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is .............................. :..L'¢/~/~ ..O. tl]~. l~J~t~Tf..~.l;}l~3. ................................................. '/'his certificate is issued to ........ .~,.~.,~..~.....C.~...~.~.¢~...~ ................................................ (owner, lessee or tenant) of the aforesaid building. .... ~..¥ .......... ~.~ .................. Building Inspector / TOWN OF SOUTHOLD BUll. DING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Yo BUILDING PERMIT (THIS [~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1239 Z Dote ................... .Oc.~oher.....]..8.~ .......... 19_6.0. Permission is hereby granted to: Baker ~ .. ~. ,~_ g..k.9..z..s. ?:..e..n...., ,~....C.....8..a...n.~7...C..q .s..e...n..z...o' ......... .................... S.o~;['l:ho. ld.,....M. ............................. at premises located at . ~lakO.~,~...t~O. ft0, ........................................................................................ .............................................. ~..O..u...~..h.p...Z.~.,......~..(,. ~ ~ ............................................................................... pursuant to application dated ........................ .0.C.~.OI3~/L....I~ ............. 19_6.0, and approved by the Building Inspector Fee $..1...0..~...0..0. ........... Building Inspector FOR~I NO. 1 TO~'N OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. APPLICATION FOR BUILDING PERMIT Oate .......... z.~/...'.,:...~ .......................... , ~.~..~.. 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 property must be drawn 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· 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 awilable 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 Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance 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· as.herein described. The applicant agrees to comply with all applicable laws, ordinances~ regt~ations. .~ (Signature of applicant, or name, if o corporation) (Address of applicant) State whether applicant is ow, neB lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................... ~.u...,:.....z.-;. ~ ~ ....................................................................... premises .......... ,,~,~,,~,,~v' ~.~ ~.-.~ .~.. ~ Name of owner of ,~.- ........................................................................................................... If applicant is a corporate, signature of duly,?thorized officer. {Nome and title o~ corpor*te, officer) I. Location of land on which proposed work will be done. Map No: ..;..... ....................................Lot No: .................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................................................................................................................. b. nte dedusean occupaney ....... .......................... 3. Nature of work (check which applicable): New Building ....~ ........ Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... (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 ..... ~....~.. ............ Rear ...... ~..~....~. ........... Depth .~'....'.~.l'~ 10. Date of Purchase ......................... . ............................... Name of Former Owner ................. ...~..../...~...:~..~J~4~.. 12. Does proposed construction violate any zoning law, ordinance or regulation? ..... 41C..0..; ........................................ NO Name of Architect .................................................. ...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 or description according to deed, and show street names and indicate whether interior or corne, r lot. STATI~ OF Ni:W Y.~R~.///~/ ) S S (Name of individual signing application) (Contractor, agent, corporate officer, etc.) of said awner or owners, and is duly authorized to perform or have performed the said 'work and fo 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.