The URL can be used to link to this page

Home My WebLink About1081-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF'OCCUPANCY No ........... Date ............................... /[.Ul~. ;21 ........... 19.fi.0. THIS CERTIFIES that the building located al .t!r.~.a..d~...~,~.,.e.?.,..a....~..~.a.~.,.A%r.~.:..~....C...~...~.~(le _Map No. M~I~OIIS...... Block No ....... ~..*.~......Lot No .................................. ~.~ ..................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...............~...~Y.....l_.4 ................. 19.~..0.... pursuant to which Building Permit No ....... ~..,],.0.1~1.. 4ated ..............YI~...14t ...................19.~0.., was issued, and co~iorms to all of the requirements of the .applicable provisions of the law. The occupancy for wh'ich this certificate is issued is PRIVATI!: oIqE FAtllL%~ DW~I~ B~or Erikson, owner This certificaie is issued to .......................................................................................................................... (owner,~ lessee or tenant) of the aforesaid building. Building Inspecto¥ 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? lO81 Z Permission is hereby granted to: to ..... ~u~ '~ "an' · sdd'tt~ o~ "On'"~m"-e~'s~ Jmg ' '¢twel'tl~ .......................... :~ ........................ at premises located at ~/8......Say..Alre .................................................................... i..,, ......................... ................................................................. ~t¢-,~.~ ~......il,, ;~', ................................ i. ....................... pursuant tO application dated ................................ j~a4~.....1.J~ ............... 1960:." an ~' approved, by the Building Inspector Fee $' ~:~;1~) ............. FOEM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTNOLD, N. Y. o t Approved ~' ]9 ........ Permit No. ~7~ / APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. 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 shall be occupied or used in whale 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, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. .... ................................ (Signoture of applicant, or name, if a corporation) ................................... .............................. ........ (Addre,ss of applicant) State whether applicant is owne~E~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) 1. /ocotion of land on which proposed work will be done. Map No: ........ , .............. lot No: .................... Street and Number .... ~ .......................... Municipality 2. State existing use and occupancy of pr,~mises and intended use and occupancy of proposed construction: o. Existing use ond occupancy ....... ~ .............. ~.r ........................................................................ ,, b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition ...... ~% ......... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... (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 ....... ./...·~ .............. Rear ./..~ ..................... Depth ./..?. ...................... Height ............................ Number of Stories.....~ ......... 10. Date of Purchase ........................................................ Name of FormctOwn~lr ........................................................ ]]. Zone or use district in which premises ore s~tuated ................................................................................. ]2. Does proposed construction violate oB.v zoning law, ordinance ar reaulotion? ........................................................ Name of Architect ............................... ? ................... Address .......................................... Phone NO ..................... Name of Contractor ............................. t~ .................... Address .......................................... Phone NO ..................... propert whethe~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from lines· Give street and block numbers or description according to deed, and show street names and indicate interio~ or corner lot. ,r3 y Ave' STATE OF NE~,( Yp~l~. ) S S (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to per~orm or houe performed the said work and to make and file this application; that oil statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the ma~o~¢Hs~ ~K~ in the application filed therewith. Nota~ Public, State of New York Sworn to before me this He, 52-0344963, Suffolk County (S}gnoture