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Home My WebLink About1358-zFOI~M NO. 4 TOWN OF SGUTHOLD BUILDING DEPART/v~ENT TOWN CLERK'S OFFICE SOUTHOLU, N. Y. CERTIFICATE OF OCCUPANCY no....Z~L~L4~8 ............ dete ...................... D~ee,~t~ez'.....7. ....... , 1 THIS CERTIFIES that the building located at ..~//~..~a~.bO~..~ ............................. Street Map No. ~ ............... Block No ....... ~r~ ......... Lot no. ~ ...... ~t,o~¢)[.~e.~...~.~.~ ..................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................ ~{a~tL....~.O ............ , 19.~.. pursuant to which Building Permit No, ~.'I.,~.~... dated ....................... ~{~,~'.eh......~. ....... , 19../o~., 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 .......... ......... P.~.i~at ~...o~e.. ~emi].~...dw.e ~ lin~ ..................................................................................... This certificate is issued to .~.~,e~...O~,,~.~. ...................... O'~rte~ .......................................... (owner, lessee or tenant) of the aforesaid building. Building InspectOr TOWN OF $OUTHOLD i~UILDIHG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°, 1358 Z pat~ .................. 1~ar. ch....31 .................. 1~.61.. Permission is hereby granted to: Che ~.%~... ~ lowski ......................................... ................. Cu~¢h~u~ ......................................... to .. ~o...build..new...one.. £~nll~....dw.ell.ln~ ............................................................................. at premises located at ..W./-~q....-}[~O~'.-.~e .................................................................................... ......................................................... .C~tchog.ue~.....~,~'.,.Y .................................................................. pursuant to application dated ................................. ~aZ'.ch......~. 0 ......... 19..6],., and approved by the Building Inspector Fee $...t0, .............. B, Udi;'; "inspector [ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19 ........ Permit No ............................... Disapproved a/c .~..~.. ............................................. (Building Insp~ector) Application No.../..?.....~.....~... .......... 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 Certificai~e 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 pursu'ant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, OrdLnances or Regulations, for the construction of buildings, additions or alterations, or for removal or Cemolition, as herein described. The applicant agrees to comply with all applicable lows, ordinances and regulations. ........................... -[Signature of applicant, or name, it o corporation) ................. ...................... (Addr~ of appliccznt) 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 whic,h proposed work w~L~ be done. Map,~o¢Cim,rr~..~.....~......J~...~.~ot~.i ......... Street and Number ../~.....~...~.,..~:.....~.....'~.. .......................................... Municipality D 2. State existing use and occupancy of pr. emi~es~d intended use 6nd occupanc~ bf proposed construction: cz. Existing use and occupancy,.,..~....~.°.~Z .............................................. ..,/2.. .................................... (./ .-~"- r~ ' ,,~ _ -. b. Intended use and occupancy......~..~....~...~ ..../,.~...~.. ~..~...-~. .................... property lines. Give street and block numbers or description according to deed, whether interior or corner lot. 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... Cost / ~ Fee /..L/ , ~ 4. Estimated .............. .~'.. ~ .......................................................................................................... (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 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 ................................ t ...... .......... ;z (, ........... 8. Dimensions of entire new construction: Front..~...,~ ............... Rear Depth ................. Height /. ~.r . Number of Stories ~./..~ 9. Size of lot: Front ..../..~z,4.../ ........... Rear ..,..~...~...f ......... Depth ,...~....c'~....~....i. ........ 10. Date of Purchase .....~,/~.~....--...../....'~..~'../.. ....... Name of Former Owner ..~.~.:.~...~..f ...... 11. Zone or use district in which premises are situated~..~........~r...~~ .......... 12. Does proposed construction viola,.t,e any zoning law, ordinance or regulation?~.~~....'~.. ........................ 13. Name of Owner of premise~Address ....~,fs~~.~.l~.Phone NO.~'.~C~.~. ~ Nome of Architect ........................................................ Address ...................................... ]_...Phone NO ..................... Name of Contractor..~.~,...~.........Address . .~..~...~...~..Phone NO.f~,,R..~..:.....~.~..c-- PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from and show street names and indicate STATE OF NEW YORK, ) S S. COUNTY.~F ............................ ) ..... .k~,,~...~ .~...L~..,~?~ ...... ;.....,. ............... duly sworn, deposes and says that he is the applicant (Name of individua~ signing app icadom above, named. He is the...~...?~.....~....~'.., ................................................................................. (Contractor, agent, corlSorate officer, etc.) of said owner or owners, and is duly au~orized to perform or have performed the said work and to make and fiJe 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 performed in the manner se~t~/~r~/~e the app, l~cation filed therewith.