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Home My WebLink About1368-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMEt~T TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..~,~,tac]..~.~a¢~...D~.,~.-..~.t~:~.~... Street Map No.~.~.~;.~[~l,. Block No....*~'~ ............ Lot No ................... 5,,~ ............................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. A~i~....4 ........................... ~ .... 19..~. pursuant to which Building Permit No. ~...~..~6(~.. dated ...~.~'.~.Z....4 ................................ , 19.....6~ 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 .......... This certificate is issued to ................................... ~'~...T~.~,%,~P,~'/J,~.~.,.O,~,,~~,'~ ................... (owner, lessee or tenant) of the .aforesaid building. Building Inspector TOWN OF SOUTHOLD BUILDIIqG DEPARTME~IT TOWN CLERK'S OI:FICE SOUTHOLD, H. Y. BUILDING PERMIT (THIS P,ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1368 Z Date ..................... .A~prtt---.~ ................. 19..6.1.. Permission is hereby gronted to: St a~.t.~y.....~e~kc~....A/¢,..D~-,...~/e&n~,nn ................ ............... ~i.t ~dc ........................................... to ..... .~u.£1d...~n.. ad~.~ %1o~.. ~n..~..e~ls£L~...d.~e3.1i.n~. ................................................... at premises located at ...t~'t'"~"~"'l~'~t~"~fil.~"'~:~'~. ....................................................................... .............................................. S.o~J~...beach.. ~:~ 1.ye ~ ....... ~4~.t t ~.tu¢.k .......................................... pursuant to application dated ........................... ~]~r~L.': ........ tl, ............... 19(~.~..., and approved by the Building Inspector Fee $..~.00 ............. FORI~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOU'mOLD, N. 'r. xom neo ......... [1 .................... ~. ........ Approved .................... !.~. ................. 19..L*../..Permit No. Z I ~ (od Disapproved o/c ................................... ~ .................... ................ ................................. Application No. J3 ~' ~ APPLICATION FOR BUILDING PERMIT o,e ............ ......... ..C.. ............ ...... INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and su~omitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adioining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagrorn which is port of this location. c. The work covered bv 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 buiJding shall be occupied or used in whole or in port for any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuonoe of o Buffding Permit pursuant to the Building Zone Ordinance of the Town of Soutbold, Suffolk County, ,New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or o Iterations, or for removal or demolition, os herein described. The applicant agrees to comply with oll applicable lows, ordinances and regulations. ....... ....... .............................. (Signature of applicant, or nome, if o corporation) ........... ................................. (Address of applicant) State whether applicant is owner, lessee agent architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises ..... [ .....~~~ ............................................................................................. If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work wd~ be done. Map. No: ........................... Lot No: ..~ ......... Street and Number .......... ~..~'7....~..~*~..~.'~..~.......~~ ............ '...~....~~ ................. Municipality 2. State existing use and occupancy of pr,emises and intended use and occupancy of proposed construction: o. Existing useo do c p y .................................. i,.~ ............................................ ~ ............................................... b. lntended use and occupancy ........................................................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition.......~ ............ Alteration .................... Repair .................... Removal .................... Demolitlon ................... Other Work (Describe) .................... -,~ ~ 0 %1 Fee 4. Estimated Cost ............. ~ ...................................................................................................................................... (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 ................................ 8. Dimensions of entire new construction: Front ....... .~...q .............. Rear .................... Depth Height ............................ Number of Stories 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ...... ~ ...................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ........ .J..~...o. ..................................... 13. Name of Owner of premises...~..-b..'...~..~.'-~......Address ............................................ Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Nome of Contractor......~...~....~ .......................... Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, ond indicate all set-back dimensions from property fines. Give street and block numbers or description according to deed, ond show street names and indicote whether interior or corner lot. STATE OF NE~C~Y~p~qI~,/)~ _ ) S S ............................ ~.:~.~. ...... .,~.,........~.'...~...j(,-,O ........................ being duly sworn, deposes and says that he is the applicant (Name of individual si~ning application) above named. He is the .............. .(,-~-.....):)~...:.~TM ........ '~'"'"~ ................................................................ (Contract')r, agent, corlbJ~/tate 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 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 mann, e,r, ~, ,~...,_.setE/-t)~sr]h in the application filed therewith. Sworn to before me this , ~ ~f~r~.r'.u,t~l,c.L~?,~ ~ ,4,,, ,,f ~'"'~ ,., ~o ~.~."~'~, CountyY°~ ~ (Signgture of c~plicagt)