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Home My WebLink About1718-zTOWN OF SOL~THOLD 1~UILDING DEPARTMENT 'I~OWN CLERK'S OFFICE SOUTHOLD, N. ¥. CERTIFICATE OF OCCUPANCY No. Zl~.2.~. .......... Date ................. ~_eptemher.._21 ..... , :19..62 ~[HtS CE]~TIFIES that the building located at ...~.~l~kso13..~t .... Street Map No. 3GX~ .... Block No .... ~., Lot No. ;T~ ... ~'~....~'f~.~.k ....... conforms substant, ially to the Application for Building Permit heretofore filed in this office dated ............. ~]~;1,... 2[~., 19~x2.. pursuant to which Building Permit No. ~.~..8 dated ............. ApriL1..~7, 19.~2.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. Tine occupancy for which this certificate is issued is ..~r~[~.ata..cne ..£am21.3r .d~e&ling ..................................................... This certificate is issued to .~a~e~ Go D~'~3. .... D'd~e.Z~ ....................... (owner, lessee or tenant) of the aforesaid building. FOR~ 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.° 1718 Z Dote .................... ~ll~i~L ....... 2-~. ...... 19~... Pern,sslon is hereby granted to' ..... ~thol~t ................................. to ...~ ii .a~n..~16!~i~m..ma- 'm~-'~lt~ting d~eiLti.z~ ................................................ at premises located at ~-S.--.~T-IIII~IEtO~-.~ ............................................................... ............................................... lls~..~t~t.~tk ............................................................................... pursuant to application dated ........................ ~,p~'I~.. .~,.~. .........19 .~., and approved by the Budding Inspector Fee $ .. ~.'ii)(~ .......... Budding Inspector FO~M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. Exam ned ...... ~, .~.....~....~...... 19..~.., ,)-~. Approved ....................... ,L..~. ............ 19.....~...Permit No. ~- / '~/~ Disapproved a/c ~ Application No. / ''~ /~ 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 available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole 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 issuanc,e 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 name, if o corporation) (Address of 6'pplicant) " State whett~er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome 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 ....~..~........~...~.......~,C~2~¢....~.:.... ,~:'....~...~ // Municipality ~// ............... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ............ ~ ................................................................ b. Intended use and occupancy ...~..~ 3. Nature of work (check which applicable): New Building .................... Addition ...... ..~.. .......... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... (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, speci~ nature and extent of each type of u~.....m ...................... 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 ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 10. Date of Purchase ........ C .............................................. Name of Former Owner ...~ .................................................. 11. Zone or use district in which .premises are situated.....~..~.~ ........................................................... 12. Does proposed construction~vi°late any zonin~ law, ordinanCe~ ~,~°r regulation? ~..~..~...~~.m .... 13. Name of ~ner of premises~..~.~; ...... Address~..~..~hone Name of Architect ................ ~~ ....................................... Address ............................................ Phone NO ..................... Phone PLOT DIAG~M 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. COUN~ OF .,,~ ............ ) ' ' ~ (N~m~ of indi~idum signng ~ppicm 'o ~ of said owner or owne~, and is duly authorized to perform or hove performed the said work and to make end file this application; that all statements contained in this application are true to the ~st of his ~owledge and belief; and that the work will be performed in th~~rth in the application filed therewith.