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Home My WebLink About1824-zNO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No .....~,t.~Lr~ ........... Date ................ ~o.V. el~Ll~e~'......~. ............. , 19..~.?-... THIS CERTIFIES that the building located at .~r~.J~t//.O.Q~:~..~'.[.v..~ ................................ Street Ma~..~..1.....P.~.k.. ..... Block No .... ~ ........... Lot No..~'P-..&..53, ..... ~l~2~V.~ .~.~....N..,...Y.:. ................ conforms substantially to the Applicahon for Building Permit heretofore filed in this office dated .............................. E~I.~.....'I~ ................. , 19~... pursuant to which Building Permit No ...... .~...~..8..~.~ dated ............................. .]'~.....,~. ...... , 19...~.2..., was ~ssued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ....... ~.~t~"-~"T~!'ly-'~'l'!r~ ....................................................................................... The certificate is ~ssued to ..... (]~,Or'gS"'H~'~El~i~ ...... ;..~I~o~' ............ : ......... : ............................. [owner, lessee or tenant) of the aforesaid building. FORI~ NO. 2 TOWN OF $OUTHOLD 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.° 1824, Z Dote .......................... ,V,~ ........ 'I'7 ..... 19.~... Permission is hereby granted to. to .... ~,~.Id...a~ ..a~d.~.~.~em. eR.. a~.. ex.~.s ~.i~g.. ~etl4J~ ............................................. at premises located ot ..~L,O~,..~...~i~t.~b..~l~;il[; ............................................................................. .............. ~ ......................... ~..08_~od...Dr.~ve .......... z~met ................................................... pursuar~t ~o application doted ......................................... ~.~.~.. ~.~.19.~., °nd opproved by the Building ~nspector Fee $ .~'. ~)0 ............. NO. ! TO~VN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Approved ........................................ , 1~ ........ Permif Na ................................. Applicotion No ..... /...~......~T...~. ...... Disapproved a/c ...................................................... APPLICATION FOR BUILDING PERMIT Date ....................................... , 19...~.....~... ..... 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 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 pa 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 alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, or~'na~s and regulate/ // (S'gnat.~e of appllcar~/~J name, ifa corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...... ~...'~.~ .................................................................................. If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) 1. Cocotion of land on which proposed work will be done. Map No: ..... ~....~...~..3 ..... Lot No: ..~.. .............. Municipality 2. State existing use and occupancy of premises and. intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~ .................................................................................................... b. Intended use and occupancy ................................................................................................................................. 3. Nature of work (check which applicable): New Build ing ~.~.. ....... 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 flor ........ ~ .................. If garage, number of cars ......... ~.~.~ ............................................................................................................................ 6. If business, com~rcial or mixed ~cupancy, specify nature and extent of each t~e of use ................................ ~J / J 7. Dimensions of existing structures, if any: Front ....... ~ ................ Rear ...... }..~ .............. ~pth ...,~.~ .................. Height ...... .~.~ .............. Number of Stories ............ ~ ....................... : ....................................................................... Dimensions of same structure with alterations or additions: Front .......... ~..........~ ............ Rear ....... ~.~. ................... / Depth ..... ~ ................. Height ........ ~ ...................Number of Stories .............. / ....................... Front 8. Dimensions of entire n~ construction: ................................ Rear .... .,..~ ............ ~ / ,... .... D~th ...... ~ ................ Height ........ ~.~ ............... Number of Stories ........ ~.~ ..................... 9. Size of lot: Front ............. .~ ................ Rear ........ .~.~ .............. ~pth ....~.~.~....,~..~ ]0. Date of Purchase ~.Y. [~ ~ .... ~ome o' Former ~ner~ ~'q ~..~ Zono or e strct in~ ............................. ~ ....... 1 ]. us d' ' ' wh'ch premises ore s'tuoted ................................................................................................. 12. Ooes proposed construct on ~oote onE zonn~ ow, ordnonce or re~uoton? ..... ~.~ ........................................... 13. Name of ~ner of premises ~ ~ddress ...~ ~.~ ' · .~.. hone No ..................... Name of Architect ........... . .......................................... Address ........................ , ................. Phone No ..................... Nam~ o~ ~ontractor ....... ~~L...Address .... ~..~J... Phone No~.~..~ ~ PLOT DIAG~ Locate clearly end distinctly ~11 buildings, whether existing or proposed, end indicote ell set-~ck dimensions from p~er~ lines. Give street ~nd bilk numbers or description eccordin~ to deed, end show street n~mes ~nd indicete .~ther interior or corner lot. ~ Ot~ ~0,0~ ~OoD ~ ' STATE OF NEW~~ S S COUN~ OF ~~ - . above name~s the ........... ;,~ ........................... ; ...................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have perform~ the said work and to make and file this ~lication; that all stotements contained in this application are true to the best of his knowl~ge and belief; and that the wore will be performed in ~e manner set fo~h in the application filed therewith. Sworn to before me this .~~ N;2, ' ';'. ........... ;J J;... =========================;.. Coun~ .............................. ~'i;;;;~';;';~";;;~;;;;~' .............................