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Home My WebLink About1675-zFOP~ 1VO. 4 TOWN OF SOUTHOLD B'UILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTifiCATE OF OCCUPANCY THIS CERTIFIES that the building located at ..lgd:e,lCl. J,ncj...P~l~c~,...G~cee,~l,-'~_.:i:~: ..... Street Map No .......... ~ ..... Block No,l~ ................ Lot No ........ ,~. .................................................... conforms substant~aIly to the Application for Building Permit heretofore fded ~n this office dated ............................... ll~il~P,,~..,~,6 ............... , 19...6~, pursuant to which Building Permit No ........ dated ..................... ]~.:~.~-~..;~. ........ , 19...~., was ~ssued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which th~s certificate is issued is .......... This certificate is issued to ........ ~ro~..Illlgi~,..13wr~'. .................................................................. (owner, lessee or tenant) of the aforesaid building Building Inspector FOP~M NO. 2 TOWN OF SOUTHOLD BUILDING 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.° 1675, Z Dote ..................... ~eZ~....~ ............... ~9.6~.. Permission is hereby granted to: Char le s..~m~bZe.... A/C...~.~s.e~h .... Rh.~.~. ............ ....... G~eenpor. t~......N..g. .................................. to .. ~.t~.-~-~.. ~ld.~ J~i. ol~.. ~n.. ~n...~t ~ttng...d~e.l.1 .t~g ....................................................... at premises located at ..~-t~'~]-.i. ng...~.~.~l.~ ......................................................................................... ........................................ Gr~upo~.t ~.....N~.i:. ................................................................................. pursuant to application dated ............................. ~il~l~,tl.....~.6 ............. ]9~....., and approved by the Building Inspector Fee $..~,,.(~ ............. FOR~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ....... ~ ......................C-~-~ ~- ~ , 19 ........ (~ ~ Approved ~ ~ 19.~!....Permit No. '~J/~ & Disapproved a/c ..~:..~,,,,.~. ................... ...................... ~J~s~e~t~i ................................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely fiiled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing Iocc~tion 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 application. 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 o 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 pa rt 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 nome, if a corporation) 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: ............................................ Lot No: .................... Street and Number ....................... ~/ Municipali~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. £xisting use and occupancy ......................................................................................... b. Intended use and occupancy .................... ~ .............................. 3. Nature of work (check which applicable): I~ew Building .................. Addition ...~.. ............ Alteration .................. Repair ............. J ...... Removal .................... Demolition .................... Other Work (Describe) 4. Estimated Cost ...... ~r..O....~T..V.~ ............................... Fee .......................................................................................... (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 natureond extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front ........ ~..0. ............ Rear ....... .~...~.. ............ Depth ~'~'~' Height ..~.....~.~... ........... Number of Stories .... ~ ........................................................................................... Dimensions o~ame structure with alterations or additions: Front ......... ~.~. ................ Rear ....~.....~.. ................. Depth ......~.~ ............... ~i~ hr~tc ........................... ~F'~ ..N.~..m.~.r. ~ f' RS~ rr'~i ...... ~.'i~:': .................. 8. Dimensions of entire new c t~on: ........ ~ .............. Depth ...../......~... .............. Height ...... .~..L ................ Number of Stories ...... 9. Size of lot:~'Front .....~..~6.~.~ ......... Rear ..._~...~...~..~..~. ...... Depth ....... ~.. ~ ~ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................... ~. ...................................................................... 12.~o~s proposed constru~ viol'~-~n~zoning law, ordinance or Fegulation? ......... ~ .................................. 13. Name of Own~ of premises ...~.......~.~.~.~..Address .~~./....~one No Name ~sf Architect ...................................................... Address ............ Phone No .................... Name of Contractor .....~..~......~~...Address ii~.~.i~'ii.'.~i~.'.~ Phone No. ~..~...D..?..?i.?. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensians from property lines. Give street and block numbers or descriptian according to deed, and show street.mames and indicate whether interior or corner lot. STATE Of NEW~.~ ) c c ~'~'~'~ being duly sworn, deposes and says that he it the applicant (Nome of individga~ni~ appli~tion) named e s the ~,,,~.4~ above .~ ......... ~ ............................................................................................................................................... " (Contractor, agent, corporate officer, etc.) of said owner or owne~, rind'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 ~~b~;~ the application filed therewith. Sworn to bef~r~ me this ~ N~ Public, ~te of