The URL can be used to link to this page

Home My WebLink About1490-zFO~ ~0. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTiFiCATE OF OCCUPANCY THIS CERTIFIES that the building located at G:c~npo~t Mop .......................Block No, ~e~ Lot No. No ,W~ .......................................................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. .~..~.~.....2.~ ..................................... 19..~.]:.. pursuant to which Building Permit No. :~...~..~..~.. dated ,..~i, Ug~B.L.,~% ........................... , 1~)....~.1, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .......... This certificate is issued to ........ fcT..e~J~.~.J~...~.~.J.~.~,...O.~.~ (owner, lessee or tenant) oic the aforesaid building. Building Inspector FO~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.o 1490 Z Date ................... ....~....~..~.......~'... .............. 19~...]: .... Permission is hereby granted to: · T~se. ph....¥~iek .................................................. ........ ;~.~..C~.lt~..Ave ...................................... ................ F~s.t..Islll~,...L~ I~ ........................... to ._Build.. an..additic~.~r~..az~..ex/sttn~.. ~well~l~ ....................................................... ............ · (...V~.:ta~..grar~teS..~e~,..~/~ll~le..¥el-d.) ................................................................ at premises located at F~'l]......~].~t...~l~l~ ........................................................................................ ..................................................... ~.een~or.t, ...I, ..;t:, ........................................................................ pursuant to application dated .................................... ~'.~.....4~.~. ........ 19~q_...., and approved by the Building Inspector Building Inspector/ FORI~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........'f'"-'~ "~~.....~.(.l ...... ]~,..~....Permit No....~...../...~.....~....~. ........ D sopproved o/c ........... ........................ ................................. Applicotion No../....~'...~.....~. ............ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and su6mitted 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 o detailed description of layout of property must be drawn on the diagram which is port of this location. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon oppro¥ol of this application, the Building Inspector will issue o 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 port for any purpose whatever until o Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuonc~ of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other oppliceble Lows, 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 oil applicable laws, ordinances and regulations. ...d.. · ' X (Signotql'e of ~ppli~t, or nome, if ~ corporation) ...... .-:. (Address of a~licanf) ....... '~"' ..... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises.. .~..~.1~ If applicant is ~ corporate, signature of duly euthorized officer. (Name and title of corporate officer) on No .........................................../~ ~ ~ ~ l. Location of land which proposed work will be done. Mop : Lot No: ......~ StreetandNumber /A/LE~'ZA/~E' c~ ~J~h~T[ Arc- G~;~P°I'~'' Municipality 2. State existing use and occu~ncy of premises and intended use and ~cupancy of proposed construction: a. Existing use and occupancy ......................... ~ .................................................................. ~ ........................................ b. Intended use and ~cupancy ................................................................................................................................ 10. 11. 12. 3. Nature of work (check which applicable): New Building .................... Addition ..~....~. ......... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost.../,.Z..~....~,..~... ....... ~ .............................. 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 .............................. Dimensions of existing structures, if any: Front ....... ~...~.. ........... Rear ........ ~...~.6~.. ........... Depth ...~,,.c/. .................. 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 ....... /....7... ............. Rear ......... /...7. ............ Depth ..:~;L.~. ................ Height ....................... ..0.~f RS::rr'~ .............. ~i~. !: ........... ~ Size of lot: Fronl~....~. ..O.. ........... Depth .~...~..~.. ............... Date of Purchase ............ ' ............................................ Nqme of Former Owner ........................................................ Zone or use district in which premises ore situated...~l'.i......~.../..~.Z: ................ .................................................... Does proposed construction violate any zoning law, ordinance or regulation? ..,~..~..~. ......................................... Name of Owner of premises ........................................ Address ............................................ Phone NO ..................... Name of Architect ........ ._......~ ..................................... Address ............................................ Phone NO ..................... A^ NO ..................... Name of Contractor .................................................... Address PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, property lines. Give street and block numbers or description according to deec whether interior orlco~er lot. /~/~eA DOi, d/ ~ B/~ and indicate all set-back dimensions from and show street names and indicate STATE OF NEW~'OP-~,~../Z } S S COUNTY OF .................. ~....~..~ .............................. being duly sworn, deposes and says that he is the applicant ............... (~ame ~ individual~l'_ gning application) above named. He is the ........~ ............................................................................................................................ (Contractor, agent, corf~orate officer, etc.) of said owner or owners, and is duly author zed to perform or have perfor~d the said work and to make and file this applicat on; that all statements contained in this application are trge' to) the best of his knowledge and belief; and that the work will be performed in the maj~l~r set forth in the apg4ica~i'on filed t, her, e,,with. Sworn to before me h'0tary Pubhc ~ ~ /~/' ~- ~