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Home My WebLink About1078-zFOFo~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPAR. TMENT TOWN CLERK'S OFFICE $OUTHOLD~, N. Y. CERTIFICATE OF OCCUPANCY No .......... .~..~..2..~ ....... Dote .................... ~Ual:~...:~ ........... , 19.i$2.. THIS CERTIFIES that the building located a~..~..~.~....'.~..~...~..~..t.....O-~...~.~.'/~..~.t....~.~...W-..~.Q.~]~.... Street Map No.~.~.e.. ................ Block No...?...~..e. ............. Lot No .................. ~.~.?.. ........................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. ..~.J~..~.~.~.....~...G. .................................. 19...~..0... pursuant to which Building Permit No ..........~...,1,078 dated ...~...~.~....]'...}: ................................... , 19....~..g, was issued, and conforms to ail of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .......... ............. .................................................................................. This certificate is issued to ..... ~'o~.~.L~..~, .~..~.~.~..~..~.~.~.~.. (owner, lessee or tenant) of the aforesaid building. Building Inspector \ FOF~I NO. 2 TOWN OF SOUTHOLD 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? 1078 Z Dote ............................ ~....!1 ............. ~.6~.. Permission is hereby granted to: ~se.~.~.~a~£ ........ i ................................ ............... ~,~i~:..Re, ad ............................................ at premisgs located:at ....... ~y~.....~t~,.~,~ .......... ,., ....................................................................... .............. ' ..................... ............... O~te~t~.....~.~ ........ ....................................................................... pursuant fg'appffcation dated ................................... ~l~.,..,~ ...... 39.60., and approved by the Building I~spector FOF,~ NO. ~. TOWN OF SOUTHOLD ~ '. '. BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×am, ed ..... ...... , D,sappreved ................... 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, end giving o 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 Bu.ilding Inspector will issue a Building Permit to the applicant. Such permit shall 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 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 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 comp y w th a~l applicable Jaws, ordinances and reguJotions. (¥gnature of applicant, or name, it 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 .......... ~,?.~..?.~..,~,,..'!~...,~,,,?,~,.?.~.~..~.. .............................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate, officer) Location of land on which proposed work will be done. Map No: ............................................Lot No: .................... Street and Number ............ .~...~..~...~....~...o..~ ......... .O..?..~.~,.N...e.~...~.,o...Z,..~.. .................................................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... ..1:~.,...O.~..0..1,t.~..~.~.~ ........................................................... .................................. b. Intended use and occupancy ................... ..H.0.~ .................................................................................................... 3. Nature of work (check which applicable): New Buildin~l .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe)~O~Zl~.¢l,..~.'l c~:~ 4. Estimated Cost ........... ~..~...~ ..........................Fee ~ O ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units.....~ ................... Number of dwelling units on each floor .................................. If garage, number af 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 ...~.~.~1. ................. 22' 1~~ ~ 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 ..~.Z~.~Z ........... I0. Date of Purchase ........................................................ Name of Former Owner~9.~g.~..~.~.~ ............... 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ..... 13. Name of Owner of premi~fl~..~..~gD~.~.~Address ~.~ ........................... Phone Name of Architect .......... ' .......................................... Address .......................................... Phone NO ..................... Name of Contractor .................................................... Address .......................................... Phone NO ..................... PLOT DIAG~M 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 descri9tion ,accor~ng to deed, and show street names and indicate whether interior or corner lot ..... ~/R ~_~. ~0~ STA'I~F.,OF NEW ~_ ,"7 ) ,.-ok S \ cot r TY OF ' ,// eppl cation) o.~w~ n~med. Heis the ......................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of sold owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this opplicotian; 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 ................. (Signature of applicant) MAP JOHN