The URL can be used to link to this page

Home My WebLink About1052-zEORM N0,. 4 ?OWN OF SOU?I~OLD BUILDING DEPARTMENT TOWN CLERE"S OFFICE SOUTHOLD, N, Y, CERTIFICAT£ OF OCCUPANCY No.Z.. 10~1 .......... Date .......................~,~......~. ................ 19~..~.. TH]IS CERTIFIES that the building located at ~.~...~[0.~.~...~/~.. ~k.....A...~..e.. ..... Street Map No...~.X. .............. Block No..~ ............... Lot No....~ ........ .~:{..8,...t..t.'%..~._~..~...k..,........N.,..~.~., ............. conforms substantially to the Application for Building Permlt heretofore filed in this office dated ............................ A.p~.il.....2~19...60 pursuant to which Building Permit No...~.....~...0.~... dated ................ .A..p~r..]: ........ ~.~. ....... , 19...6..0..., 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 ...~...I'.~. Y.g$.~...Or(q...~..lt~.J,~[,7...il~:q~,~[~,llg ................................................................................ This certificate is issued to ..... (owner, lessee or tenant) of the aforesaid building. 'T Building InspeciDr FOI~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1052 z ~ote .................. ~..r..$.~....~., ................... ~9:~0.... Permission is hereby granted to: m ~S,~. 8attt..h &Sone ~ ~s ~e~a to Build an ad~on on existing dwell~ pursuant to application doted ~ ~ 1~60 and approved by the Building inspector ~ $ ....... 5.~ ....... Building /nspector FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. App, co.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 13uilding Inspector. b. Plot plan showing location of lot ond of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drown on the diagram which is part of this location. c. The work coYered by this applicotion may not be commenced before issuance of Building Permit. d. Upon approval of this applicatioh, the Building Inspecto~r will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for ihspection throughout the progress of the work. e. No building shall be occupied or used in whole or in p ar! for any purpose whatever unt!l .o Certificafe of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE tothe 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordlnan/c/es and regulation~s/ .... or name, if a corporation) ~,~~~,,,~,~,,~ ................ ~,~ .............................. (Address of a~li~nt) State whether applica~t~ is own~erD_L~see, agent, architect, engineer, general contractor, electrician, plumber or builder. If applic is ~ corporate, sifl~'~ of duly authorized officer. (Name end title of corporate officer) 1. Location of lend on which proposed work will be don~. M~t:~ No: ........................................ :... Lot Munic:pality .i . , . 2. State existing use and occupancy 9~f.J~r,emises~and intended use and occupancy of proposed construction: o. Bxistlng use end occupancy .......... "2 ........................................................................................................................ b. Intended use end occuponcy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition ...,~ ........ Alteration ~ ............ Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated 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 ............~-,,~ ...................................................... 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 ........ ~..~C../ ............ Height ........ .~..7~ ............... Number of Stories ..... ~ ....................... 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front .....~....~.~.,...-~.. ....... Rear ............................ Depth ,.~...~...~......77. ....... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ........ .~.C---~c. ........................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ~ 13. Name of Owner of premise, s~m~fwr...~,~.Address" ,.~.~.~-- -- .............. Phone NO Name of Architect ........................... Address ........................... Phone NO ..................... Name of Contractor...~.:;...~.f.~.~..~ .......... 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 corner lot. ~h STATE OF NEW YORK, ) S S. COUNTY OF ............................ ................................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing opplicgkion) above named. He is th '~..~~ ...................................................................................................... (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 apQJi_cation are true to the best of his knowledge and belief; and that the work will be performed in the mannertJ~l~fl~/,J~ir~u'~.application filed therewith. Sworn to before me this . ~UI~olk ....... ...... o, ...... ................ Nota~ Public, ~.~J.~~ ........... County '