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Home My WebLink About1354-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTFIOLD, N. Y. CERTIFICATE OF OCCUPANCY THiS CERTIFIES that the building located at ..1~./~...~..~.~....~.~.~,~ ................................ Street Mop No..~;~ ........... Block No ......~ ......... Lot No .... ~,~,~ ......... ~¢~,~e~'8, .......................... con[arms substantially to the Application for Building Permit heretofore filed in this office doted ........................ ~.g~ ............ .~.0 .............. 19~J... pursuant to which Building Permit No....~...]3.~'?.. dated .................... .~.~.8~..~ ....... ,~0. ....... , 19..6~L., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .......... ...... .?..?.$.y.~.t;..e....~.~..e....~.~m~,3,~r...~f~,~L,~m~. ........................................................................................ This certificate is issued to ,.~..~..~...~.,_.~,.~,,,,A~....~,.O,..~,,~,g, .................. J~g,~i~'. .................................................. (owner, lessee or tenant) of the aforesaid building. FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PER/v~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1354 Z Permission is hereby granted to: c~ .~4~: ~.~.'.z.~...~....S~.~.s....~......C..a.~..~.(~.~.o...n..t. 9 ........ .$..o. ~.f~.~. ~..... ~ ,.?f., .................................... to ........ ~..z.~....n..~.~.?....q~..e...~:t.~...~.¥.~..Z.~.~g .............................................................................. at premises located at ..... ~/.~..,,.J.f,~,..R~a~ ..................................... ' ............................................. : .......................................................... .~ .ou,.C.h..o. ,1,.0~ ~ ..~.,.~., ..................................................................... pursuant to application dated ......................... ~.~.C~ ....... ,~.{) ............... 19~q..., and approved by the Building Inspector Fee $. ~L .0.,.O.0. .......... Building Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. APPLICATION FOR BUILDING PERMIT Date. ..& ........ ................... .... 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 dr(zwn on the diagram which is p(zrt of this Jocgtion. 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. / ...... (Sign'~=":'~u~'gg~Ji~:'~nt, or-'-"-~gme, if""'""~"corporation"'--'-'"-'"~ ......... (A dress of app ic~'ht) 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. tV~p ......................... '~/~. ......... Lot No: .................... Street and Number ......... Z~ ~'¢¢r4.s~../~../.~...7...O.. ....... ............... '~¢...(?...~....'....'.'....~....:..~..........~'..../~.. ................... / Municipality 2. State existing use and occupancy of pr, emises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... .~..../~....C~...~..~..]..~7... ·....¢~/. · .~... ~-....~.. ...................................................................... b. Intended use and occupancy ......... ./~..~...~.~..(.~.~...C~.~....~.'...~ ........................................................................... 3. Nature of work (check which applicable): New Building ................. Addition .................... Alteration .................... Repair ................. ,~,emoval .................... Demolition .................... Other Work (Describe) .................... (to be paid on filing this application) 5. If dwelling, nurnber of dwelling units ....... D../,~ ......... 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...,,,~..O. ............... Rear ...~...c~ ................ Depth .~ .................... 11. Zone or use district in which premises are s~tuated ...... ,. ~.~..Z)..~-.../4/...~.~,/4 ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ..... ~....~. ....................................... 13. Nome of Owner of premisesf~Zz~..l~'...~....Address 4~.~,~,~'xdZ~,2Z'..~.~¢/I. ............. Phone NO ..................... Name of Contractor./..,4.:..(</,f....~.-':~.~.~...Address~. ........... z. ................ 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 sho~v street names and indicate whether interior or corner Jot. (Name of individual signing ~application) /~, r;~ duly sworn, deposes .and says that he is the applicant above named. He is the ............................................................................................................................................................. (Contractor, agent, corlborate officer, etc.) of said owner or owners, and is duly authorized to perform or have per~ormed the said work and to make and file this application; that oil statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in th~0~a~.r~. ~set forth in the applicati,q_n filed therewith. ,~ Sworn to before me th~s ~siai h( o 80~- ...~..~ ....... day of ......~..~., ....... ~i*4 ~ FOr, (Signature o~ opp[icont)