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Home My WebLink About1339-zFOl~ NO. l TOWN OF $OUTHOLD B,UILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .Os.~r~'..~T~t~.J~[~.....l~cfJe~-jlj~.1~.... Street Map No¢le~ve~..~t,,Block No.e.e,~ ................ Lot No .................. ~/ ................................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. .~...~..~...~..~.....~.~ ................................... 19..6...1... pursuant to which Building Permit No.~..JL3139... doted .~..2~ ............................... , 19...~3., was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is .......... ............ l~:B/J~Z~ ...QNE, .~r~Z-~..~G .................................................................................. A~r~an St:ahl~ owner ~his certificate is issued to ..................................................................................................................... (owner, lessee or tenant) of the o.foresaid building. Building Inspector ( TOWN OF SOUTHOLD i~UILDING 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? 1339 Z Date ...................... ~R.~'X~h ......... ;~.~. ......... 19...~...~. Permission is hereby granted to: Original Ho~e.s ..A~4G - · .. Ad~..i.a~. ·. · ~ab~ ....................... ...... Micl~e.. 'I.~ .~.~nd. ~......N.~-~'.~ .......................... to ... ~u'i't~l... new---ot~e.-'famt'~¥.. ¢]we.!.l. ir~g .................................................................................. at premises located at '~u~"~'"~ ....... (~'~'~'~V~S'"PO~'~t .................................................................... .................................................................. ~Ae..e..~.~ ........ ~.:.~.'. ...................................................... pursuant to application dated ........................... ~r:~. ...... .~-~ ............ 19...~.~, and approved by the Building Inspector Fee $"t0~ ~)0 .......... FORiV[ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUT.OLD, N. Exor'nined....../~.Z...'~.~.....~/.....~. ....... 19..~.../ Approved ........................................ 1 9....~....Permit No .............................. Disapproved a/c,~~ ....... ............. ......................................... (Building Inspector) Application No..../...?...~...~. .......... APPLICATION FOR BUILDING PERMIT Date ................. .~,.~ ~ .~. ........... 19.~...( .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and su(>mitted 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 alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ...... .................................. (Signature of applicant, or name, if a corporation) .......... ............. (Address of applicant) 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:-'~C.~.~..c~.....~.~......' ....... Lot No: ..~.. ............... Street and Number '"~'~"~"'"'"~'"~"'""~'"~"~'""~Munlcipallty~'t~': .......................................... 2. State existing use and occupancy of pr.cruises and intended use and occupancy of proposed construction: Ex stn use andoccu anc /~cr~c~ ~ a. g p y .................................................................................................................................... b. Intended use and occupancy ........ ~..~~ ~~..~ ......................................................... 3. Nature of work (check which appllcable): New Building.....~.....Y'~.. ........Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cast'S/! ~.OO C~.~~ Fee /'0, ~ (to be paid on filing this application) 5. If dwelling, number of dwelling un,ts...., ..f~.,. ..................... 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.....~?....,~.. .............. Rear ........... ..-~..~ ....... Depth ....~...~ ............... Height ............................ Number of Stories ..~ ......... 10. Date of Purchase ............... ./..,~.. ...... /. ......................... Name of Former Owner ...... 11. Zone or use district in which premises are situated ........ ~.~...~. ...... ..~....~ff....: ................................................................. 12. Does proposed construction violate any zoning lay/,,,ordinance or regulation? .......... /.~ .................................. Name of Contractor.. ..~..~.....?~...~ .......... Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all 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 corner lot. STA'I'E OF NEW~.,YO~P~(,~ ? ) S S COUNTY OF .~,..C~r.....) ' : ............................ ~..'.~.~.-C:...~J~....~-... .................. being duly sworn, deposes ,and says that he is the applicant (Name"of individual signing agglication) ~ abow~. named. He is the ................. .~~~ ................................... ~, ............... ~ ........... ~ ............................. (Contractor, agent, co~orate offic~e.r,, etc.~ of said owner or owners, and is du y authorized to perform or have perf/~rmed tile Isa~a worB an/~Jto make and file th s application; that ali statements contained in this application are trcje tc~ the/)b~lst of hi.~J krJ~vJ, ledge~and belief; and ~hat the work will be performed in the manner set forth Jn the appli~:ati/~n fiJ~d '{herew~tl~. I/J Sworn to before me this ]UDITff T, BOK£N t i~ . ~ ~- ~ ~ ",* / .~ ~ ~/~. ~'Ote~ P~lic, State of .e~v York \ I/.%Z~l/~ J~ 4i I~/