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Home My WebLink About1680-zFO~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOV~N CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..~.~..iT,~...~.~..~..~...~..~.f....~..lJ.~.g~. ....... Street Map No ....... .~.~t ........Block No .... ~.~. ........... Lot No ......... .*~ .................................................... conforms substanhally to the Application for Bu~ld,ng Permit heretofore filed in this office dated .................................... ~.~-~...~ .......... , 19.o.~..~. pursuant to whtch Butldmg Permit No..~.....~...~..~...0.. dated ..........................~..C~ ..~.~......, 19..~.~.., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which tbs certificate is issued ~s .......... .................................. ............................................................ This cert~f,cate is issued to ..3/..O..~...~.....~.~....~..~..*.~.~.e.~.~..,....~..~.,.,....~...~1.....1~ .............................................. (owner, lessee or tenant) of the aforesmd budding. FORM 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? 1680' Z Permission is hereby granted to' ~Rldgley &..B~Y/~.tflX~ ...... A~....J~]3~L.F.,....~..~.s..~... .... . .~...~Ao...~... .............................................. at premises located at~;~...2.0.~..~l~.~.~.~1~..:~i,T~lll .................................................................... ~ ..C. uteh ................................ l~Am~...t~..~d., ..... o&ue~ .... ZL,.Z., .............................................. pursuan,t to application dated ......................... ~:.~C][~....2~ ............ 1~,...., and approved by the Budding Inspector Fee $ ~..~ .~. .............. Budding Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Examined ....... . ..~....;~,.....~.....~..... 19....~....~ Approve~l ........................................ '19 ........ Permit No ............................... D~sapproved ?/c ~ Application No....!..~...~ .......... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in bv typewriter or in ink and submitted in duplicate to the Building I nspeetor. b. Plot plan showing location of lot and of buildings on pre,raises, relationship to adjoining premises or pubtic 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 co~ered by this oppllcation 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 pu~'pose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Buildin§ Department for the issuanoe of a Building Permit pursuant to the Building Zone Ordinance of the Town of So,hold, Suffglk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, odditi0ns or a Iterations, 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 .......[~...~.~...~....~.;~l~.e..~i. Jj.~...[~, ............................................................................................ 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 Nd: ............................................ Lot No: Street and Number ......~.~.~....~.~.,~....~.O.~.~...~.~l.~;.~l~.~..~e~...Y~k~ ............................................................. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~.~.~..m..m..~'...~'.~.~,~,O,~k~.O.~ ........................................................................................ b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Buildit~g.., ................ Addition ...... sr ........... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost .............................................................. Fee., .............. .~.~.~.g..0.. ............................................................ (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 ........ .J~J.I. ............. Height ......8..~. ................... Number of Stories ....... ~-.. ................................................................................................... Dimensions of same structure with alterations or additions: Front ...... .~...~.~. ................... Rear ..... ~.~.~. .................... Depth .~.! ...................... Height ......8.~. .................. :.Number of Stories ..... ~, ........................ 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ....J~.?. ................. Rear _..80.! .................. Depth ...2/~8.?. ............... 10. Date of Purchase ..'lg6'l ............................................ Name of Former Owner ..r'-o~8.hot~,e ................................ 11. Zone or use district in which premises are situated .................. ~..~0~.~ ............................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? .......... nj) ..................................... 13. Name of Owner of premises.~.:..T'..e..?.~.e...J~.~.~..~T..:~...· ...... Addres~..0...-O...l~f-.....~.~.,....~.~.~.O.~...e~...JJ~nJ~ NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor~,Cl, l~.~...~..~Q~'.~g~ ............ Address g.l~l~.0J~.O.~l.~l,~[,~., .......... 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. (Name of individual signing application) ~ ~ above named. He is the.....(~,.~. ....... ~.. ................................................................................................................. (Contractor, agent, corporate 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~stgt~ements contained Jn this application are true to the best of his knowledge and belief; and that the wo[k will~erformed in the manner set forth, in the application filed therewith. Sworn tolbefp~r~e t~i~a:e o~ ~ew ~ork .......... ~m~ t~[ ~~,~.,...<.....~.~. ]9.-.- ........ (Signeture of opplic~nt} ~