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Home My WebLink About1861-zFORlli NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ~,/~....~tP,~,~b...~...~ .................................Street ~O~o~...N.?.?..k....'.E...$..~..a.%~o[k Iqo ..... ~ ...........Lot No...~l~..&..~.~ ......... l~c%ll~hol~,.....I/,Z, ..... conforms substantially to the Application for Building I~ermit heretofore filed in this office dated ................................... Al~.l;~t.....21 ...... , 19./:~. pursuant to which Building Permit No. dated ............................. ~1,~ ....... ~?,,~....., 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 ........ ,,.~r.~,~.~e...one,.f.~tmll~,..dwe. l~fin~ ........................................................................................... The certificate is issued to ,.,A~b/~Ic.~**F,,~,(~b. OZ'.t'l ........................ ~t1? ............................................ (owner, lessee or tenant) of the aforesaid buJJding. H.D.Approval Dec 3~ TOWb~ OF $OUYHOLD BUILDING DEPARTMENT TOWN CLERK'S SOUTHOLD, ~. Y. BUILDING PERMIT (THIS PERMIT MUST 13E KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1861' Z Permission is hereby granted to: ............... ~u~.hot~ ............................................. to at premisesL located at "~O'~Et~:~II~r~""E~t,~t,'l;~ ....... ~.~O'~"t~"~"'~"6~': .......... '::ii ........................................... S~. t.h.-~ 1~e-. ~ ~ .......... 8ou.~hot~: ...... : ........ ::.., ~::.~. '....... ~:,.~:, :::. ~" '~' ::~:: ';'' .' .. ~: pursuont, to opplicotion~ ~oted ...... ......:.= ............... ~. ....... ~.. .......] ,~9., ~ FORM NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........................ O. .............. 19 ........ Approved .............................. ~..." ....... 19.,,,).,.Permit No. / Disapproved a/c ........... .~-~ ,.~;..-...~ .............. Application No ............................ APPLICATION FOR BUILDING PERMIT Date ................~......~../ ........... 19..1~......~... 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 cowered by this application.]nay not be commenced before issuance of Building Permit. d. Upon ,g, pproval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall IJe 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 issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of $outhold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordi~es~,~ and regu~tion~ ~ ($ignatur~ oT~ame~, if a corporation) ............................ ':'"'~(Address of ~' ............. State w~e, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ............ ~.~i ........................................................ If applicant is a corporate, signature of duly/authorized ~officer. (Name and title of corporate officer) 1. h.ch r ese war w be one Ma No ~/'~~LotNo ~' ''~'~ Location of land on w h p~)~osed,wor~ w,j)l be~[c . , p : t~f..'....,~c~c.,..,t..;..=.., .................. : ...~..... ........... Street and Number ...... ~..~.~..~.~ii~~__ ~ ................................................... 2. State existing use and occupancy of j;~mises and intended use and occupancy of proposed construction: a. Existing use and occupancy....~~ .............................................................. b. Intended use and occupancy ............ ~-~J~'~&~...'~-~<r....,~z......~..."mm..~..,~rz_-c~....~..~.C. .................................................................. 4. 5. 6. 10. ~1. 12. 13. property lines. Give street and block numbers or description according to deed,I and whether interior or corner lot. Nature of work (check which appliceble): New Building ~" Addition .................... Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... Estimated Cost ............... ~...x~...~ .......................... Fee .......................................................................................... (to be paid on filing this application) If dwelling, number of dwelling units .............. ./.. ............... Number of dwelling units on each floor ............................ If garage, number of cars ................................................................. If business, commercial or mixed occ. upancy, specify nature and extent of each type of use .............................. Dimensions of existing structures, if any: Front ............................ Rear ...... ] ..................... Depth ............................ Height ............................ Number of Stories Dimensions of same structure with alterations or additions: Front ............. J ................... Rear ................................ Depth .............................. Height .............................. Number of Stories ....~ ........................... Dimensions of entire new construction: Front Rear ...... .~...~.. ........... Depth Height ..../.~ ............. Number of Stories ........ ./. ................. Does proposed construction~//.--.~~vi°lc]t~ any z.~n, ing ,Jaw, ordinan~e~ ~_,~..~_ ,,9,r regulation? .... ~ ...................................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from show street names and indicate STATE OF NEW ~/ORK- ...~~..~ .... e'n~ du'y sworn~ deposes ~nd soys thor he ,s the ~pplic~nt (~ome o{ individua~oni~ qpplication) above homed. He is the ............................................................................................................................................................ (Contractor, agent, corhorate officer, etc.) of said owner or owners, and is duly authorized to perform 'or have performed Ithe said work and to make and file this application; that all statements contained in this application are true to t~e best of his knowledge and belief; and that the work will be performed n the manner set f~lh in the application ifiled therewith. Sworn to before me this TH T. ' ~ ~ · ~ ' . ........ ~ .......... t J