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Home My WebLink About1326-zI~OPdVi 1'~0. 4 TOWN OF SOUTHOLD BUILD{NG DEPARTMENT 'I'OWN CLERK'S OFFICE SOUTHOLD, N, Y. CEI{TIFICATE OF OCCUPANCY No., Z 10k~_~ .......... Date ............................. THIS CERTIFIES that the building located at lq/S-.0~klawn Ave...EXZ ............ Street Map No.(~.a.g.e..i!, ............ Block ]No.....X~_ ................. Lot lXlo.~.~ .......... ~.o...~..t..,h..o..%O~l....N..~..~.?. ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... I~la~el~ .......~,~. ............. 19..~,. pursuant to ,vhich Building Permit No.....Z.~3..2..6.. .... dated .........................~a~.~i;~.......l..~., 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~ci~a.~e...~ne..i,.amJl~..~]4ell.lllg .............................................................................. This certificate is issued to ~(~2~ ~lQ%:~.2q.0..~ ............. flWi:le~ ........................... (owner, lessee or tenant) of the aforesaid building. ~i~din Inspe~x~x~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS DERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? _1326 Z Date .................... l~lf~ ¢,h .......... ~L~ ........... 19.. Permission is hereby granted to: C and le&~.hC,..H~s.....A~...R~oh~.~d... ...... 21...Bzt. o~..B.t ............................................... ............ Rt:vel,~aea~ ~.....~ ,. ~, ............................... to ...... .Buf,.i d..-ne~.. ~ · ..i:am~..1.y:.. d~l. ~&.~g ................................................................................ clt premises located at .....-W/~.....O~,~.a~'n...~ve..~.~e~t,.iori ........................................................ .................................................................. ~o~tho.l~ ~.....~ ...Z., .......................................................... pursuant to application dated .................... -~[~.~..,,..1.,~ ...................... ]9...i~., and approved by the Building Inspector Fee $...'I ~), ~30 .......... Building Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ ]9 ........ Perm~ No ............................... D~sopp~oved (Bui~i~ I~ctor) 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 odjoining premises or public streets or oreas, 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 sha]l 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 issuanoe of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicab]e Laws, Ordinances or Regulations, for the construction of buildings, additions or a Iterations~ or for remova] or demolition, as herein described. The applicant agrees to comply with ali applicable laws, ordinances and regulations. (Sitar u re~6f..~ppJ4ca ,nt,~ r z~am~,4 f ~rporat ion) ......... .......... (Address of applicant) State whether applicant is owner, lessee, agen?~t architect, engineer, general contractor, electriclan, 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: ........... ,-'~,b', ......................... Lot No' ...,...~....~.. ....... Street and Number ........ ~6nicipality 2. State existing use and occupancy of pr, err;ises and intended use and occupancy of proposed construction: o. _ ............................................. b. Intended use and occupancy ......... ~;...:..~.~..~w..:..~,~~~ .............................. 4. 5. 6. 10. 11. 12. 13. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... Estimated Cost.......~.//....~..k~.~..,<...~ ...................... Fee ..~.~...~..~,..e.. ........................................................................ / (to be paid on filing this application) If dwelling, number of dwelling unit~....../.....?~y,._.z., "- ......... ,n, . ~ ~Number--~',,,~--,~'~*~,, . ~ ~ ,//of dwel~--~ eo~:h floor If garage, number of cars ............... If business, commercial or mixed occupancy, spe~'ffy nature and extent of each type of use .............................. Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth ............................ Height ............................ Number of Stories ............................................................................................................ Dimensions of some structure with alterations or additions: Front ................................ Rear Depth .............................. Height .............................. Number of~ Stories ............................... Dimensions of entire new construction: Front .......... ~..~4....~.... Rear ...~..~.....~. .......... Depth C~.~..~......~... ............. Height ............................ Number of Stories ....... .~.. ................. Size of lot: Front ......... ~...-~......~ ....... Rear ........ ~...~.-..' ....... Depth ...../..~.~...X ....... ,,_, Dote of Purchase ................. /../.,~e..z... ........................ Name of Former,~Owne ........ ~r.~.~ ........ ~.¢-~../.~.~..~ ............. £/ Zone or use al,strict in wh,ch prem,ses ere situated ~,.~.. ...... z.~-~. .......... ~..(..~ .., Does proposed construction vi,,~t,e.,zy,~.,~, _ ,,./.z°ning 'aw, ordinance~,~ ~ ,~ ~-/'°~ regu'at'on? ..................................................... Name of Owner of premises.~.'m...'-;ffK~F-,Kddress../_~ffz'ff.~.t':..~...: ............ Phone NO ..................... Name of Architect .............................. ; ....................... Address ......................................... Phone NO ..................... Name of Contractor~.~7~'~.~~-'~ss ..... ~...Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from )ers or description according to deed, al~d show street names and indicate property lines. Give street and block hum whether interior or corner lot. STATE OF NEW '~RI~/. ,'9/2~ S S COUNTY OF .~¢~(-,-~b~.~) ' - ......... be no duly sworn, deposes end soys that he is the opplicant (Name of individual si,qnlng application) above named. He is the....;~~¢~.~,C.~.~[;~;~..;~;.~;..~.~;~.;..;ff~;~..;~:~~ ~__ ........................................ of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be erformed in the manner s~p~t~ q~e~;Bplication filed therewith. Sworn to before, me this P ~ ~ ~ ~,~t~u~o~e~o~ ,. ¢~ ~ ....... ~day of ...... :..~~..~g~;~]~s Ua~c~ s0, ~a~ '~(~not~e o~pp~t) ~