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Home My WebLink About1690-zTOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .~....2~,...D~.J~'~t ................................ Street Mop No ..... .~.~.~..~. ........... Block No ......~.~. ......... Lot No ......... ~.~ ....................................................... confor~ substantially to the ~plication for Building ~rmit heretofore filed in this office dated ................... ~...~ ............................. , 19...~. pursuant to which Building Permit No .......... .~...~690 dated ......... A~.[..~ ............................ , 19..~2, was issued, and conforms to all of the requiremen~ of the applicable provisions of the law ~e occupancy for which this certificate is issued is ........ ......... ~~.. ~~ ........................................................................................................... The certificate is issued to ~[~e~ ~[~ ~ (o~er, lessee or tenant) of the aforesaid building. Building Inspector ~o~,~ No. ~ 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.° 1690 Z Date ................... ..~.?..~..],.. .... ~ .............. 19.6.~ ... Permission is hereby granted to: Tcm~ N~.k3,~,~.....A/¢...~aite~...Ual../z~ .......... ....... ~z'~ent ..................................................... to .~ow~..e~.stlng..huLldIn~s...to...tb.~..loca~lon..f~r...b~e~.~..~R~.~ ..... at premiges located at ...~..~..2~ ..... ~nt...P~nt ......................................................... ......................................................... ~1~; .... ~.~. ...................................................................... pu~uant to application dated ................................ &~t~....~ .......... 19~,., and approved by the Building Inspector Fee $. i~t. 00 .......... Building Inspector FOP. M NO. ! TOWN OF $OUTHOLD Town CLER' 'S OFF,CE Sou'r. OL, . N. Examined ...... ]9 ........ Permit ~o. Ox. Disopprovod ~/c ........................................................... APPLICATION FOR BUILDING PERMIT 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 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 arc,liable for inspection throughout the progress of the work. e. No building shall be occupied or used in whale 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 a terat ons, or for remova or demolition, as herein described. The app icont agrees to comply with o I applicable lows, ordinances and regulations. (Address of applicant) State whether ~?licant is owner, lessee, agent, architect, engineer, general contractor, electric an, p umber or builder ff opp~cont is ~ cor~r~te~ sion~ture of duly outhori~ed o{{icer. (Name and title of corporate officer) Location of land on which~ropased, work will be done. Map No: ....... ..~.....~ .................... Lot No: .~.,....~. ....... Street and Number ......~...~........~....~...'~.. ........ ...~..~......~...~.:. ........................................................... Municipality State existing use and occupancy of premises and intended,use and occupancy of proposed construction: O. Existing use and occupancy ...... ....~....~, ..~..Q~ 0 ' w, ................................................... b ntended use and occupancy.....-'~:~-. '~J,"D~-~--~ .................. 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair ..............~_~,.. Removal ......~'.... .......... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ..~ ........................................................ 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 .............................................................................................................................. rD";' .............. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use..~.~.~ ....... ~-/ ~ Z,I ................................ 7. Dimensions of existing structures, if any: Front ...... .~. ................... Rear ....... Height 1~/ I 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 ....... +/(..~...(. ........... Rear ..... ..~'.....~...!. .......... Depth Height .....J..~...~ ................ Number of Stories ........ ~ ...................... 12, Does proposed construction violate any zoning Low, ordinance or regulation? ...~.-~...~......; ........................................ Name of Architect ........................ ~,_ ~ ~;~,_~/ ............. Address Phone NO ..................... Name of Contractor .../......~...~~ ...... Address Phone 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. STATE OF NE'~J Y~RL~ ) S S COUNTY OF .,~}~lk, ........ ) ' ' ~~~-~ \'~' application) be'ng duly sworn, deposes and soys that he is the applicant above named. He is the gdrs~j~ (Controctor, ogent, corporote officer, etc.) of soid owner or owners, ond is duly outhorized to perform or hove performed the said work ond to make and file this application; thor all stotements contained in this application are true to the best of his knowledge ond belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .......... ..~....---. ....... da~, of ..... ~ ................... 19..L.....~-.... No,o Pub,,c, ....... ....