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Home My WebLink About1320-z TOWN OF SOUTHOLD 'I'OWI~' CI,,~ERK'S OFFICE SOUTHOLD. N. Y, C~-RT~FICA'TE OF OCCUPANCY THIS CERTIFIES that the building located at J~l~.t~ll~..tl~...~..QJ,~l...,J~.~..o....~.g.... Street Map No.....~ ............ Block No. ~ ................Lot No.X..~ ..........~....~...~.~[.~.¢.~i~......~?...~.: .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................... ~.e.~).....~_3. ..... 19...6...1.. pursuant to which Building Permit No. ~.~.~.9. ...... dated ....................... l~l~l~.¢h.....],~...., 19...~.J;, 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 ............................................................................. This certificate is issued to ...~t[:~.~..1.~l...~.~...~..1.~ .................... .O..~.e.~ ................................ (o~vner, lessee or tenant) of the aforesaid building. FOR.~'I NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S O~:FICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1320 z Permission is hereby granted to: . ~, .. ]~aill~...~...SO~ S.,... ~¢...~.il ~.~..~.~ ,.. ~ills ....z~...~..i.~..~... ,...,~.. ~9 ~-.k.. ................................ at premises Iocc~ted at ...'.~.~.~.e..~.....-....~../.~....~..~.'~..~'.~.....~.~..~...~....~.~..~..~..~.~.~.~ ........................ ............... ~.t,.t-.J,.t.~.~, ~..w....'~rg .................................................... pursuant to application dated ................................ ..~.~,.~..~..~.,...1..,3. ............ 19,,~,..1..., and approved by the Building Inspector Fee $.. ,1. ,0..... ,0..0., ..~..~..l. d · Building Inspector / TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ......... .~ ~....,~. ~...~.~..../.'C~lg....~../..Permit No...L~.?....~...~ ...... Disapproved a/c ......................... ~ .................................................... (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 a 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 a Iterations, or for removal or demolition, as herei~ described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ............... .,~. . ,~. ~'. ~,'r.':. . . . , . ~, . , .~, ......... ~.. ........................................... (S,~.~u,r.~ or .n~.~oration) .......... ..................... ( dress o app ican State whether applicant is owner, 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 of~'iceri wh ch proposed,work will be done. Map No: ............................................. Lot No: .................... 1. Location of Iond on ~/.~.~.~ Street and Number ...... ~-~.~.'. ....... ~ ............... ..~..~' ........................................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy .......... .~..~..~~ .............................. . .................................................... b. Intended use and occupancy......'t~..~)... .....~...~..~..z ..................................... 3. Nature of work (check which applicable): New Building....-//..............Addition .................... Alteration .................... Repar . ...,.Re, nova .... Demo t on .. Other Work (Descr be) r,,,(-' f .................... 4. Estimated Cost ...... ~.~Z/.~.LZ..~.., ................................... Fee ....... .................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ................................ Number of dwelJing 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 ............... .,;/~.~.~r ,of Stories "~;~.'~'" Size of lot: Front :...¢:~.~ ...... Rear ~...f_~...C;? Depth ../...~.--../..'../.../...., 10. Date of Purchase ....... .~...:/.... ............................... Name of Former Owner ....-~~~-~c..... 11. Zone or use district in which premises are situated ......... ~.......~...-:...Z'~'~z~... ......................................... 12. Does proposed construction viol,ate~gny zoning,[a.~, ordinance or regulation?/~"~'/'"~..~.: .................................... 13. Name of Owner of premises..~f('~/.,'~'"~..Address ...~~~hone NO ..................... Nome of Architect ......................................... , ............. Address ............................................ Phone NO ..................... Name of Contractor..~..:,~,~..~..~..~...-~.. Address .....~..~'Z~~.Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly oil 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. STATE OF NEW Y.~J~R~C~,~z~,~) S S COUNTY OF ..~.) ' , ~.~....¢/..~..~::... ben du sworn de osesand sas ,hath ,s e , , ....................... L~~ .......... ~ ...................... ' g y , p y e' th appl'can (Name of individual sig~g app~otign) above named. He is the .............. ~~ .............................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this application; that all statements contained Jn this application ore 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~with. Sworn to before me this ~o~ //5~ ,, Nota~ Public,~~.~~Co~'''a' '" ~' "' s '