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Home My WebLink About1715-zFOlt~l NO. ~t TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No Z :L357 THIS CERTIFIES that the building located at Map No ....................... Block No ...*fl.~ ........... Lot No .......*~. ......................................................... conforms substantzally to the Applicahon for Building Permit heretofore filed in this office dated ................................ ..A.?...~.?...1...~ .............. 19.....6..2pursuant to which Build,rig Permit No...~ ..1...?..1...5, dated ................... J~1~::Lt...24 .......... , t9..62., 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~IVATE ~ ~'AEILY DWELLI~G Th,s certificate ,s issued to .../J~l~.t, Ahi,t~..RO~.C,h.,...ow~aigz ................................................................... (owner, lessee or tenant) the aforesaid build,rig. ~OR~ NO. ~ TOWN O~ 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.° 1715 Z Date ................ ~I~.~1~.]- ,~I~ ......... 19(~.... Permission is hereby granted to: C~_ ~;.....O~.o.~k~... AZC.. ~.t.h~..lk~ch ........... to · I~? ..~tn.. ~Id& t &o~ ..on · · ~t. · t~r.~.~.l~r~. · ~t~1.1.~ ..................................................... at premises located at .. ~...~-;~l~...t~.-~O~l~ .................................................................... pursuant to opphcotlon dated ........................... ~',~L....;~ ..............19~.., and approved by the Budding Inspector Fee $..~OO ............ Building Inspector FORM NO.! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. pproveo ........................................ ]9 ........ Permit No ............................... Disapproved a/c .............................................................. ...................... ................................. INSTRUCTIONS o. 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 o detailed description of layout of property must be drown on the diagram which is port 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 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 port for any purpose whatever until a Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of a Building Permit pursuant to the BuiJding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with oil applicable laws, etd inonces ~n~ regulations. (Signature of applicant, or nome, if o corporation) (Address (~f applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premses .~ '. ~ ~ .................................................................... 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: ..... ..~/.....'~.....~. .................... ::..' [.o~t lq6: .......--~. ............ Street and Number '"~'"'~""~"~'"" '~' "n"t"~<'"'"~'~i~'''~~'''''~'''~'~'''~'''''~'~'~w ---'"-'~ -- 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction' a. s g use a a occupancy ...... 4~....~c..~ ............................................................................................................ 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 .................... R~moval .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ......... ..'~..~4?1~. .................................. 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, specifl// nature ana~xtent 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 ........ ~--..'Z~ ............. Rear ...... .~......'~... ............... Depth ...~.~..~..~,..'~.. ....... Height ...~..~,...: ................ Number of Stories ...........~'. ................... 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ · 9. Size of lot: Front ../...¢~...~....'.' ......... Rear ...... ./...~....~.. .......... Depth ...... .~.....~....~. ....... 10. Date of Purchase ........ . .~,,1~..../.~.,-.-/..~..$~.. ......... Name of Former Owner ........ ~~....-. ..................... Zone or use district inV I --which premises are situated ...... ../~.~....~...~.....~..-' ........................... 11. 12. Does proposed construction violate any zoning law, ordinance or regulation? .......... I/'~ _~...~. .............................. 13. Name of Owner of premises~...J~"~...Address ..... ~~./../!...~.Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor.~.~-~-~: ............. Address .~~...,...lD...7.'...Phone NO./~.,¢..~..-..~.~.~.~._, 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 NEV~ YORI~,,~ ) S S (Contractor, agent, corlSorate off car, 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;