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Home My WebLink About1046-zF0'I~V~ N;0. 4 TOWN OF ~OUTHOLD BUILDIHG DF..,PARTM~HT TOWN CLERK'S OFFICe- ~RTIFICA'I~E OF O~CUPAI~CY ,/ THIS CEI~'I'IFIES that the building located at .~/~., .~ay~3,0wer....~oa~ ..................... Street Mason , . ' Map No ....................... Blocl~ l~o .................... LOt No~ XX ......... Ma~.tl~ck~....N,Y., ....................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ ~.I~1'i[~1-.-.22..., 19~0.. puf'suant '~q which Building Permit No....~...~L0~.6 ..... dated ................. Apztil......~..., 19.~0., w.~s i~sued,'\and conforms to ali of the requirements of the applicable provisions of the law. The })Cc~pancy. for which this certificate is issued is .................. l~.mrago...ono .. Sams :L7.. d~elt.J;ing.....~ ........................................................................ This certiflcaie is issued to ..... ~ll~l[XJ[lr..&...~qDll~...l[rl(~ ........ (o!alol*.8.~ ...................................... ( ' ~ (owner, lessee Or tenant) of the aforesaid building. FOi~M 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) N? lO46 Z Date ........................ ApZ'~].... ~ ............ 19..6.(~. Permission is hereby granted to: · ..A,,Ttel~,~..y...g..~...Ir~ ................................. ............... ~ftuek,,..I...~..z. ......... ' ................. to ... autld...new., one.. f. al~t. ly... ~l.~e~ Ltn~ ........................................................ at premises located at ...R/~.....ltiayt. io~e~..D,tt, t,ire ......................................................................... ................................................. ~t titu~i~ r .....19,.~f, .......................................................................... pursuant to application dated ............................. Al~ril....2;2 ............. t96.0..., and approved by th~ Building Inspector Fee $.3,0,.O0.....pd,-eheel~ Building Inspector'~ / ~ FON,~ NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved .................................... , 19 ........ Permit No ............... Application No. ! ~' ~-/(~ 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 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 ava.liable for inspection throughout the progress of the work. e. No building shah be occupied or used in whol~ or in part for any purpose whatever until o 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, os herein described. The applicant agrees to comply with all applicable laws, ordinances end regulations. (Signature of app~,~ant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect,,engineer, general contractor, electrician, plumber or builder. Name of owner of premises...,.~...~. ..... ~ ........................................................................ If applicant is a corporate, signature of dury authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: .............. Lot No:,,../. ............... ~.v Municipality ~ ~/ State existing use and occupancy of premises arid intended use and occupancy of proposed construction: a. Existing use and occupancy ......... .~.../..~/...(..~..~...~....~.x~..:.M~...~=.... .................................................................. b. Intended use and occupancy ........... ...~.. ;~..~..~.... ~.~Z~(, (; .................................. 3. Nature of work (check which applicable): New Building ........ ..~.......... Addition .................... Alteration .................... Repair .............. .~f.. Removal .................... Demolition ......... ~ ......... Other Work (Describe) .................... 4. Estimated' Cost ..../..~.~..C~)u"~...r ................................ 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 ............. L...~:.~..~..4.,~..:.[,~..' .................................................................................... 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 ....... ~..~... ......... Height ............................ Number of Stories .......,~. ...................... 9. Size of lot: Front .......~..~).(~. .......... Rear ...... ./...,,,~;.'...~. ...... Depth ........ ../'..~.~....c'.?.... 10. Date of Purchase ............. ./..~'~...~.. ............................. Name of ,,Former Owner ........... 11. Zone or use district in which premises are situated .... ,':.z. :..'~ ...~¢~ g,~:.~...~.~..<l....:~.4'., .~.~.~,<'.,~.'.4'..~K.~..~..-d' ....... Does proposed construction violate any zoning law, ordinance or renu at onp ~1. 13. Name of Owner of premises/Xr./.c..~-~'K~.~.~.~.'./.~'..~.~-~.,.Address Phone NO Name of Architect .................................................... Address .......................................... Phone NO ..................... /t tt Name of Contractor .................................................... Address .......................................... Phone NO ..................... P.LOT DIAGRAM [~ocate clearly and distinctly oil 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. STATE OF NEW,~YOI~I( ,~ ) COUNTY 01~~.~/~ S.S. (Name of i i above named. He is the ................... .~,.~..~..~,f~.~.....~....~,~g~?.~.~.~?. ...................................................................... (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 ~pn~l~tT~~ in the application f ed therew th ' ~m~ Public St~ ~otory Public,