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Home My WebLink About1305-z~OBI~ 1~0. 4 ?OWN 0~' ~OU'/'HOZ. D '/'OW~ CLEZiK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. "Z']'0~0 .......... Date ............................. t~ay'""' ~9 ............. 19'6-~' TH]IS CERTIFIES that the building located at 'l~l~t~ 'Roa~[ ................................. Street Map ,N'o .................... X~ Block No ...... .~X ........... Lot bro. ~;~.....~./;.~t.t~l¢.k .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ Feb~l~ry' .......... '2~ ..... 19..~t. pursuant to which Building Permit No....~1.~0~.-. dated .................. ]~etY/la?y'-'"'P,~"', 19.../~.~, 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 ......... P-I' ~a/;-~,-,-one ,,,f- am~: ~y-,-d~el ].~r~.g ........................................................ :.....~.~ ...... This certificate is issued to .... '~ames...~Y.~.-.Co~g~ov~ ............. : ............... ., .............................. ' ~owner, lessee or ~enant) of the aforesaid building. / Building Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1305, Z Date ................... Permission is hereby granted to: ~het Or~o~lc~'" "~C"Ja~:~"T ;" Co'~gr'o~ ..... .... C utehogue. ~. ·... it~.;.~.; ..................................... to "b~ti'Id'"at~"~r.~clTt~.'on"'~"a~'"~x~'~;~t~"'d~!'~rL~ ....................................................... at premises located at ...... ~/L~'""R~2t~"R'C~&C]';~' ........ Ma"ft~t~c~k']'"'"~$';'~Z'; .................................... pursuant to application dated .......................... F~l~'~y"'"20 ........... 19.~.1.., and approved by the Building Inspector Fee $'"~'~'00 ........... Building Inspector FORM NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exom t n e d......~..'..',.:.~..... ~...:/. ........... 19..(,t.(.. Approved ......................... ' ............... I g ........ Permit No. ~- t ~ ~> ~ Disapproved a/c ..................... z - t'~'"'":;; ........... ~:~:L~Z;.~: ........ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ........ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate g: Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship.,~.p adjoiMng premises or areas, and giving a detailed description of layout of property must c. The work covered by this application may not be commenced before d. Upon approval of this application, the Building Inspector will issue a ),plicant. Such permit shall be kept on the premises available for inspection throughout the e. No building shall be occupied or used in whole or in part of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Regulations, for the construction of buildings, additions or olteratlons, or for removal or demolition, as hereiA>dbscribed. The applicant agrees to comply with all applicable laws, ordinances and regulations. /// (Signature of applicar;~/or name, if (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of prem ~::.; .................................................................................................. If applicant is a corporate, signature of duly authorized officer· (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................Lot No: .................... Street and Number .~./...~..~....~.,c~......?.~,~...z~_..z~..~..~....,../~..,,..~... ...................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .............................................................................................................. b. Intended use and occupancy ............................................................................... 3. Nature of work (check which applicaNe): New Building .................... Addition ..~ ....... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Fstimated Cost .............................................................. Fee ...'~...~ .................................................................................... (to be paid on filing this appHcaHon) 5. If dwelling, n~mber of dwelling units...~ ............ Number of dwelling ~nits on e~ch 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......~.r ............. Rear ............................. ep .............................. Height ............................ Number of Stodes ...... ~.'~ ....................................................................................... Dimensions of same structure with alterations or additions: Front ~ ~/¢ .... ................................ Rear ................................ Depth ..... ~..~..~ .... Height ..... ~..~..~f ....... Number of Stories ....~.,~..~ ........... 8~ Dimensions of entire new construction: Front ............ ~ .............. Rear .....~ ..................... Depth Height ............................ Number of Stories ............................ 9. Size of lot: Front ..... 4:~.~..¢ .......... Rear .......... ~./ ....... Depth ....~.~.~, Owner~ ~/~E~ 2~¢ ' 10. Date of Purchase ..... .~.Z..~.~..C..~.~ ..................... Name of Former ............ ~ ...................................... 11. Zone or use district in which premises are situated ....... ~.(~.~.~....~..~¢~.cc~,~ ............. 12. Does proposed construction violate any zoning law, ordinance or regulation? ....... ~.~ ..................................... ' ~ ~ ~ e ~/~ ~' ~,~r~, Phone 13. Name of Owner of prem,se~...~,... ....... ~....~ddr ss ........................ N~:~ .... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor .................................................... Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. Y ~ ~ ~ being du sworn deposes and says that he s the app cant '~Name of ina~wau~ ~n,,u uup~ication) above named. He ~s the... ~¢~ (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 appl cat on; 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 applicon filed therewith. Sworn to before me this , ~-- ~ ..... j '~ ~ .~ ~ ...... o, ......