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HomeMy WebLinkAbout982-zTOWN OF SOUTHOLD BUILDING ~EPARTMENT TOWN CLERk'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY "('HIS CERTIFIES that the building located at Map No .......... .~.~ ...... Block No ....... .~.~ .......... Lot txlo ....... .~.~.*. ....................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............../~b.~/a~...~.4....., 19.6.Q.. pursuant to which Building Permit No ........ ..Z.._~.~. dated ............. ]~.~X.y....2~ ........ 19..6.~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is ~ssued is ............. ~.~.S..~.~...~..~.~.,...(..?~ ~.c,~. ,~!!~...m..g.~..S.~..~0?.~.~. ................ (owner, lessee or tenant) of the aforesaid building. Building Inspector FOI~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 982 Z Permission is hereby granted to: .... ~.t,..~o.~.~. 1~.~ ................... at premises located at .R/,~ ~.r~l:~Jla~ l)xrtar~. ( F.~.~.e ) .......... . .......................... ................................................... ~,t~i~u,~,....~ ...................................... [ ........................... ~..~... pursuant to application doted ..............:~ ......... L...~.e~.~....2~; ..........19.(:t),.., and approved by the ~ Building Inspector Fee NO, ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. omined ...... Approved .................................... , ]9...'.:...Permit No.....~.....:.~'.. .................. ............................ ............................ APPLICATION FOR BUILDING PERMIT Date .................. ~...~..~., ] 9.~;.~.. 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 m(3y 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 shell 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 Certificate of Occupancy shell hove 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 or applicant, or name, ir a corporc~Jon) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................. ............................................................................ .. Name of owner of premises.~.~/...v~',~......~.~~ .................................................................... ~ ..................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate, officer) 1. Location of land on which proposed work will be done. Map No: .................................... ii[~....'Lot No: .................... Street andNumber__ unicipa, State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~~..~.~ .............................................................................. ............ , ......... 3. Nature of work (check which applicable): New Building ....... ..~... ....... Addition .................... Alteration .................... Repair .................... [?,emoval .................... Demolition ..................... Other Work (Describe) .................... 4. cstimated Cost .........~ ................................................. 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 ........................................................................................................................... ~ ~.~'~J~~~~ 6. business, commerclaJ or occupancy, specify nature ex,en~ of type use.~...~.r~ 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 ......... ../.~....~ .......... ../.~.. ~ //"2 I 9. Size of Iot:,Front ...... ~ ..................... Rear ............................ Depth ............................ 1 1. Zone or use district in which premises are situated ......................... ..~..../Z~.~ ........................................... 12. Does, proposed constrUction violate any zoning law, ordinance or regulation? ........................................................ NO . ddress ..... .~ .................................. Phone NO ..................... Name Co nt racto O~'~Z~'~'~,~/#~~d d r ess .Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Gi~e street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW~YO~,~ n~ , ) ~4~O~:- COUNTY 0~.) (~l~gning application) above named. He is the ......... ~ ............................................................................................................................ ~ (Contractor, agent, corporate, officer, etc.) of said owner or owners and is duly authorized to perform or have ~rformed the said work and to make and file this application; that al( statemen~ contained in this application a~ tme to the best of his knowle~e and belief; and that the work will be performed in the mann~o~n the application filed therewith. Sworn to before me this ~li~4~t~u~o~e~o~ ~ "/' ........... ............ / "-' / u,e o, i o., Not~ P~lic, ...~.~~. ~=~ '" I t'