HomeMy WebLinkAbout1304-zTOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWE CLERK'S OFFICE
SOUTHOLD, N. Y,
CERTiFICATe- OF OCCUPANCY
No.z. t0~+. _... ..... Date ......................... Ap~.il.....20 ............ 19_61
ff'H~S CERTIFIES that the building located at "~AI~;O~' "l~t'"l~Oa(~ ....................... Street
Map No...~rabte ...... Block No. ,XXX ............... Lot No ..... YJ~X .......~4~.~..%,1~1~._N..~. ............
conforms substantially to the Applicatiou for Building Permit heretofore filed in this office
dated ...............Febtla~M-..2..7. ...... 19~.1... pursuant to w_qich Building Permit No ........
dated ................... ]~]~U&~'-y'...-.i~.., 19.~:L., 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 ...... Pt'i%,aye. ol9o...~a, mi..1.y-.elw~l]:~ .............................................................................
This cert'Jicate is issued to ...~Iat.~ltl~..lP. ho~l_J~, .............. 0.wrie~;t ', ...........
(owner, lessee or tenant)
of the aforesaid building.
/ W TM Build~g Ingp~ctdr /
TOWH 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? 13o4, Z
Date ......................... .~.e...b. ~.u..a. ~Y.....2.7. ...... 19--.6..1.
Permission is hereby granted to:
.... ~..e..v..e... ~. ~..e. ..............................................
..... ***a~**,~,'.z,~.u,.,c~.,,.. ~.e.~.. X**q~. .............................
to ..~.t..~...~.e.~....o.~...~..t..Z.y......~...e..~.Lt...n.g. ...................................................................................
at premises located at ~.~./.~.~.~?.~.t~..`e.~.R.~.~.~.c]~.~..~.~.L.t~..~.Q.~.~..~.~.~.~.~. ......................................
........................................ .~...a..C.%~..t:..u....c~..,....~...e~.....y..o.~.k.. ..........................................................................
pursuant to application doted ............................. .F..e..~.~.~.~..~.y....2..?. ......... 19..6..~.., ond approved by the
Building Inspector
Fee $...~.0.~..0..0...~..~Cl check
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Application No ..... ./..~?~..(~....~... ......
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ...................... ~...~...~.. 19..~.~ ....
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 Insp,ector 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 Occuponcy
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 ~egulations. ,
...................
(Signature of applicant, or name, if a ~poratian)
.......
(Address of opplicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,~ plumber or builder.
If applicant is o corporate, signature of du~y authorized officer.
(Name and title of corporate officer)
1. Location of land on which proposed work will be do~e. Mop No: :~ .........................................'L~)t No: ...... ~ ........
Street and Number ...~~..~..~.'.x~'~7'/.~,... '~'/'/'~4g-~ · '~'~'''', ,,, ,, ,-..- ~ ~ ..................
2. State existing/~sex and c~upancy of pr, emises and intended use and occupancy of proposed construction:
property lines. Give street and block numbers or descript, ion accor
whether interior or corner lot.
3. Nature of work (check which applicable): New Building ...... /,¢~...........Addition .................... Alteration ....................
Repair ............... .~...Removal .................... Demolition ..................... Other Work (Describe) ....................
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 ........... .k~ .......... Rear ........ ~ .............Depth ..~......~.... ...........
Height
............................ N, umber of Stories ........ ./.. ...... ~ ....... .j2¢/'4~r
9 ................ Purchase /~'~"~^ .............. ~'~'~'~"~ F~rmer'',w:er ...~..~.~.-.~..~r ~ 'r..~...~..(.~ ~....~
11. Zone or use district in which premises are situated ............ ~.........~,.~.4~'..,......~..~:
12. Does proposed construction violate/q /),¢-. .¢'2 ¢,any zoning law,,gr.dinance~°r regulatign? ..... ?..,, ........................................
13. Name of Owner of premises..~.C~-~ff/:~../(..~.~.-~../~.~.Address ..... ~~~Phone NO .....................
Name of Architect ....................................................... Address ........................................... Phone NO. ....................
Nome of Contractor ................. Address ....... Phone NO .....................
P/aT DIAGRAM
Locate clearly and distinctly oil bu[Idings, whether existing or proposed~ and [ndleate all set-bock dimensions from
to deed and show street names and indicate
._
'
STATE OF NEW Y.(~R,~/.,,~_~' ) S S
COUNTY OF ..~--¢¢,--'~(~..~.) · '
................ ~.~ .................................. bein~uly~ deposes and says that he is the applicant
(Name of indivlduol ~~c~ti~n)
obeys named. Ho is tho ............... ~.~~ ................................................................................................................
(Contractor, oflont~ corporate officer, otc.)
o{ sold owner or owners, and is duly authorized to perform or hove performed the s~id work and to make ~nd file
this application; that oll statements contained in this o~plicotion ~re true to the best of his knowledge and belief;
~nd that the work will be performed n the m~nner sot .fo~0~the .~pplicotion filed therewith.
orn to befor e th s JCDIlHe~te o[ HeW