The URL can be used to link to this page

Home My WebLink About1333-zFOI~ ~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CKERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ..... .~...~..~.4...~. ...... Date ................. TH~S CERTIFIES that the building located at ~.. ~.~.f....~...~2....~g Map No. *** Block No..~?~.. ............. Lot conforms substantially to the Application for Building Permit heretofore filed in this office dated .................... ~q~...~ ......... 19...~ pursuant to which Building Permit No...~...~.~.~... Ma~ch 25 dated .................................... ~ ............. 19 ........ , was issued, and conforms to all of the require- ments of lhe applicable provisions of the law. The occupancy for which this certificate is issued is .................................................................................................................................................... This certificate is issued to Ed~a~ ~a~ 0~ (owner, lessee or tenant) of the aforesaid building. 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? J333. z Date .......................... ~..-..2~ .......... 19.6:L.. Permission is hereby granted to: ................. ~tl~ho.~ue~..-...N.~-E.~ ......................... to .. Bui.]:.d...at~.. ae~d.~.~-i~n...o~ .. a.~.. e~.i.s.~.~n~.-~,,ze~.l..i-~g ....................................................... at premises located at "8'~"-'~%'"~0~'~' ........ ~'~':~%~"'~d[~ .................................................... ............................................... Cutehogu~ ~'"'"~'u~ ................................... .......... pursuant tc~ application doted ................... ~V~eh......~ ....................... 19./0~.., and opproved by the Building Inspector Fee $'~O0 .............. Building Inspector "I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved .......................... '~. ............. 19....~....Permit No. 2 / ) 5 ~ Disapproved a/c ........... ~ ........ ~ (Building InspectOr) APPLICATION FOR BUILDING PERMIT Application No. ! ~ ) ~ 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 Jot 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 Bui[dlng 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 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 herein described. The applicant agrees to comply with QI[ applicable laws, ordinances and regulations. ...... ...... .................. (Sign~ature of applicant, or name, if a corporation~ ... ................. (Address of appl[~c~t)' ........ 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 officer) 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No:/~ ......... Street and Number ..... ~ .........Z~.,~..~ ............ : ............... Municipality 2. State existing use and occupancy of p~ern~ises and intended use and occupancy of proposed construction: o. Ex st ng use and occuponcy.....~..'~.:~.~ ................................................................................... b. Intended use and occupancy .......... ~.~.?.~ ....... .G...~..~........~......~....~...~.... ............................... V~ 3. Nature of work (check which applicable): New Building .................... Addition ..... ,.~',..,.r/<..,,...Alterotion .................... Repair ....................Removal .................... Demolition ....................Other Work (Describe) .................... 4. Estimated Cost....~'~..~'....O.....~... ....................................... 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 occup~/~jy, sp~ecify nature and extent of each type of use .............................. 7. Dimensions of existing structures, if any; Fr~nt..~ ............... Rear ...... ~ ................ Depth ...~. ....................... Height ............................Number of Stories ~ .... Dimensions of same structure with alterations or additions; Front ................................ Rear ................................ Depth ..............................Height ....... .'~.'v~ ............. Number of Stories ................................ 8. Dimensions of entire new constructiont:~/J~r~nt .......... ~ ........ Rear ....... ~ ............. Depth ~ Height ............................ Number of Stories ............................ 9. Size of lot: Front ............................ Rear ............................Depth ............................ 10. Date of Purchase ........................................................Name of Fo~mer Owner ........................................................ !1. Zone or use d~stnct m wh ch prem sas are s tuated...'..~. ....................................................................................... 12. Does proposed construction,-~ Z~~vi°late' any zon~in~_~ ordinance or reg~/lati, pn? ...... ............................... 13. Name of Owner of premises.~F~..:..~.~ ....... Address ....... ~.~ ............ Phone NO ..................... Name of Architect .......... .~-./,~....~.~..,- ............ Address .......... ....,~,.~ ........ ............ Phone NO ..................... e~u~ , Phone Nome of Contractor ......... ..~...'..~.~.Y~.~ ............ Address ...... ~ ...... ~ .............. NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oll set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or carnet lot. STATE OF NE~.YO~,~J~___) S S ~' ? "[ ~'Z-C,-~ c~..~-~ /.../[! ~c .('...~be na du sworn, deposes and soys that he is the applicant (Name of individual sl~lng app,,hcahon) //! (Contractor, agent, corlSorate 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 applicat on; that al statements contained in this application are true to the best of ~is knowledge and belief; and that the work w I be performed in the manner set forth in the application filed therewith. Sworn to before me this JUDITH T. BOKEH' N~tarv Public, State of New York