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Home My WebLink About1381-z~OR1V~ ~0. 4 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located ~l~//8......~/.est..~l~.e~k Aw.e ................. Street Map No....~X~: ............ Block No ........ ~2,~:1~ ........ Lot No ..... ~ ....... (~3aJ~o.g~e .................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................... A~0X~]:.~,.....~ ..... 19 ........pu~j~ant to which Building Permit No ...... ...Z.~1.3.8.~. dated ................. ~'""~pl~:'~ ....... .~.~., 19 ........ , ~s issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certific'ate is This certificate is issued to of the aforesaid building. Building Inspector [ FOI~V~ NO. ~ 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,o 1381, Z Date ...................... R'IJ~"i'~- .......... 2~ ......... 19"6']~' Permission is hereby granted to: F~anci's'" "~cC'~f~ery"' "f~/C, "" 'H~z~ry'" "~or ........ Ou~c ho g~e'F'"' 'N'~ ~ u ................................. at premises located at ..... ~'/~'"'~e-,~"'~eek"~',r~ ......................................................................... ................................................... (~ut. chog~e.f '."- I~"Y~ ~ ....................................................................... pursuant to application dated ........................... ~!~'~]u-"~'~ ............... 19~]:..., and approved by the Building Inspector Fee $..5,~,00 ............ /J · J~u'~ding nspeeT~ ' / t FOI~IV~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ',, Approved ........................................ 19 ........ Permit No ............................... Disapproved a/ccC .......... ~.~,,~z~ · .-~..:~ .......... (Building Inspector) 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 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 o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuanc.e 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. ..... ........................... (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. premises....~....~..'~ ::..~. k~..'~..'. ...... ~ ~:'.-'..~.? ': ~. ......................................................................................... Name of owner of ....~ If applicant is a corporate, signature of duly authorized officer. ' (Name and title of corporate of¥iceri whither,, proposed work~ will be done. Map No: ....~....'..~......~.....~......~ ............. Lot No: .~..'~'~ ........... 1. Street and NumberL°Cati°n of land on ~' ~:~/~ ..~..~.~..' 'c~/~Z.~-- C~ ~'~o~~ Municipality 2. State existing use and occupancy of pr.emises and intended use and occupancy of proposed~ construction: c. Existing use and occupancy ................................................................................................................................. b. Intended use and occupancy ....................................................................................................... ?..~; ................. property lines. Give street and block numbers or description according to deed, whether interior or corner lot. (ia. (,.~ ~c fi' J2 ]'h 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) · dY ~""'"" mb r 5. If dwelling, number of dwelling umts ........ -: ....................... Nu e of dwelling units on each floor ............................. If garage, number of cars ............................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of eac~ 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 ............................ - 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which' premises are situated ........ ~ ........ ~?:.~.~ ..................................................................... 12. Does proposed construction violate any zoning law, ordinance ~or ~g~lation? .................................................... 13. Name of Owner of prem,ses....~ ........ :~ ...................... Address ............................................ Phone NO ..................... Nome of Architect .............................................. ~;'~. ..... ...... /',~ ~"~'/~-,~" ......... AddreSSes ...... ...... ~ ~ ~ ........... ~"' ~' ................ Phone NO ..................... LL ...yx ...... :..: ..................... .......... Addr s .................... / PLOT DIAGRAM Locate clearly and distinctly aH buildings, whether existing or proposed, and indicate all set-back ~imensions from and show street names and indicate /mef~,f~ 'T0 I~/Z STATE OF NEV~Y~I:~.,/'r ) S S ' COUNTY OF ..:~'~'/~.~., ......... ' ' :),,'1,,1, /vIC ..... ............................................... :~....~,..~:.....'~ ............................ /4~eing au~y sworn, aeposes ana says that he is the appficant (Name of individual signin~ application) ,, ~/./' above named. He is the ..................... ~.~'"'.'~"~Z ................................................................................................... (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 ..... q ~ ¢~ J Nota~Y/Lu(~hc, State of New y~u ..... ~ ~- ~f /P ..... . 19 [~:~4~3 s .., ~ ~.'" ~b~gnaTure of app cant) ........................ ~ ........ g""'~;~"'"'~ ........ ,r - . ......... aunty - . //