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Home My WebLink About1747-zFO~iV[ ~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTJ~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the budding located at .N,~i,~..t~(N!l~.{...~)tl~lt~t,~ ................. Street Map No ..... W.~W ........... Block No..~.W.~'. .............. Lot No .................. ..~.W.~.. ............................................. conforms substantially to the Apphcatlon for Building Permit heretofore filed in this office dated .................. .J~..~....~..~ ................................ , 19....~.~. pursuant to which Build,ng Permit No ......... ..~.....~.'/4'/ doted ......... ~r~y...2~ ............................... , 19...~2, 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 ........ ......... I~Z~/J~...QI~ .. i~Z~..~G ..................................................................................... The certificate is issued to ~r, B,~JI.~I~'~ O~a~ (owner, lessee or tenant) of the aforesaid building. Building Inspector ~OF~I~ 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.° 1747 Z Perm, ission is hereby granted to' ~ez~e~.~tm..~... 'k/~-'"'~,"~.~g':t.e~r. ........ ..... · m~the~[~ ............................................... at premisbs located at ...~.....]/[~L4~.~-e.. ];~o~t ...................................................................... .............. : ..................................... I~Ch~ ................................................................................. pursuant ,to application dated ................................. ~1~ ....... ~ ......... 19.~,., and approved by the Building Inspector Fee $-..~00 ........... Buildtng Inspector FOI~M NO. I TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. " No ....... Approved ................. ~.~: ................... , ]g ........ Permit .................. Application No..../..?...~.....Z ....... Disapproved a/c ........................................................... ate ........................................K .......... ,~...., 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 a detailed description of layout of property must be drown 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 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 po 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 alierations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. 'g pp ' , name, if o corporation) ..... ........... (Address of applicant) State w~her ~pp~J~c].nt is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... ...~..C....~: .......................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work wilt be done. Map No: ............................................ Lot No: .................... Street and Number ........ ~ ........ ~:~.....~ ................................................ /V~uni~ipalif~/ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... ~~ ............................................................................................. 3. Nature of work (check which applicable): New Building .................. Addition ...~. ........... Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ......../..~.~. ........................................... Fee .......................................................................................... (tofbe 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 ..... ~,/.4 ............... Depth ..~.i'~ ..................... 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......~ ........ 9. Size of lot: Front ~O 'f Rear De-th ~20 0 ~ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated.....~.. ...................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............... .../~....~. ............................... 13. Name of Owner of premises ........................................ Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .../~.'~''' "'~..Address .~/-,~...~/.~z~:...''- ~ Phone No ..................... '~PLOT DIAGRAM Locate clearJy and distinctly oil buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block numbers or description according ~ to deed, and show street names and indicate whether interior or corner Jot. //'~O ~ STATE OF NEVt~,YO~K,~ ~,~, ) ~ ~ COUNTY OF. ............... ~..:....~ ...... ~.~ .......... being duly sworn, deposes and says that he is the applicant (Name of individual si~n~ti~,~Q · . above named. He is the ....................... I~.Z...?_~ ....................................................................................... (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 statements contg~.in this application are true to the best of his knowledge and belief; and that the work will be performe~,j~t~[~t forth in the application filed therewith. Sworn to before me this ~52:03449~3, Suffolk Ce ~ Ne~u~°~e~ ........................ ...... t ...... .... Notor of opp co,t> .....................