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Home My WebLink About1003-z~OR~ MO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT ~'OWN C~RK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY TH~S CERTIFIES that the building located at N/~...~0.~l.n..$..oD .~d ........................ Street Sterling Harbor ;Map No ........................ Block No...Y,~X ............. Lot No ..... ~,~.......0_r..e...e..~.l~..o...~...t.$.......N..,.¥,.,. ........... conforms ~ubstantiaily to the Application for Building Permit heretofore filed in this office dated ................. lqar. eh.....21 .......... 19..60. pursuant to which Building Permit No ....... ~...~.0..Q3 dated ............... Ap2.11......~ .............. 19...~.Q, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ....... P2t.v.a.te...one...family. i .dwelling. ........................................................................... This certificate is issued to .... ]~9.~..a.~.d.....~.0.~.e_~.~ ............. .Q.~.~..~..e..~ ........................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector FOI~i~ NO. ~ ToWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT: MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1003 Z Date ............................................ ~ ../.. 1.~..~.. Permission is hereby granted to: . ~Lte~..~o~.e~ ............................................ ............... ~l.~een~o~.%~,.....~,~. ........................... to ....... i~l~t-. ~e~-.ozt~..~. e~l.i¥...d~.~.t~t~ ............................................................................... at premises located at .'..~J~!l~',l..~-O~l~ ......................................................................................... ............................................. {~eenl~o~-~"'"'~¥'~ ............................................................................. pursuant to opplicotion dated .................. ............. ~'~1.....2~, ........... lC~..6J~., and approved by the Building ,Inspector Fee $.,. ~1.0.~.00.....~i~,~[~ Building Inspector FOItM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ......./..~....o....~,. ............ 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 ~r 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 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 avai ab e 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 $outhold, 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. ]'he applicant agrees to comp y with al appl cane aws, ord nonces and regular ans. ...... ......................................... (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises.....'~..~r..~..~.~..%.~.....~~ ......................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate, officer) 1. Location of land an which proposed work will be done. Map Ne: ~.. . at No:..]~.....~....~. TM' ..... Street and-~m~er..~/~..C~....~ .....~.~...&~*.~ .......... ~,..~.¢ .... (;;~.,lai~existm¢'use ~nd occupancy of premises ~nd intended use and occupancy of proposed construction: ..................... ...... ................................................. 3. Nature of work (check which applicable): New Building ...... ...~.. ......... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition ........ ~, ........... Other Work (Describe) .................... 4. Estimated Cost ../~.....O...O..O......~'. ............................... Fee .../..0 .................................................................................. (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 r~, Rear Depth Height ............................ Number of Stories ................................ · I 0~' I 1'; 0 I ~ 9. S~ze of lot: Front ......................... :~. Rear ............................ Depth ....................... 10. uaTe at rurcnase ........................................................ r~ome az rozmer vwner ............. ; ........ .....-' ....... ~Z.. 1 1. Zone or use distr ct n which premises are s tuated ...... ..~.. ......... .?~'.z..-~..,~.(. ...................................................... 12. Does proposed construchon wol,,ate.any zom.n,g law, ordnance or regulation? ...................................................... 13. ~'~ame o~ uwner or premises ........................................ /~aaress .......................................... ynone ~-q~ ..................... Nami~ of Architect ......~..?~,.~:...~.~:?Z ................. Address .......................................... Phone NO ..................... Name of Contractor ...l!.~.~;~:).:?.~. ...... ..~...r.;,2?::~...~:.~.~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 an~ block numbers or description according to deed, gD,.d~h~9~ street names and indicate whether interior or corner lot STATEOF NEW~YO~fl~ ) S S ~,;~ COUNTY OF ' ' ~ ~~) ~ ~ ~' ,0 0,'~a ' e oes an s t t he isthe d ['cant ..................................... ~:~.L,~&~..~...~..~:~ff~.....being duly sworn, d p s days ha pp (Name of ind~w" 'dual signing ~pplication)~ ~ aO~ ~ ' above named. ,He is the .............................. ~.~&Z~......q'.....~?~..¢ ........................................ : ................. (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 before me this ~u~lm Notary Public,~.~..~.:.~~.,.. ~nty (Signature of applicant)