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Home My WebLink About2045-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ~ 3.720 Date ~ovem]~e~ 4 ]~63 THIS CERTIFIES that the building located at ...~.~.,~.~, ,~[q.~.~...~.f~ ~.[~ ......... Street M~p No. ~ Block No. *~ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................ ~e~,~.~.,.~ ................... , 19.~.~.. pursuant fo which Building Permit No.~...~9~... doted .................. ~.~...~. .................. , 19.,~., was issued, and conforms to all of the requiremen~ of the applicable provisions of the law. The occupancy for which this certificate js issued is ........ ...................................... ~A~..,~[.,~y..~e .............................. , ............................ The certificate is issued to ~.~..~.~,~, (owner, ~essee or tenant) of the aforesaid building, Building Inspector FOI~M NO. 2 .TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S aFl:ICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETI~ON OF THE WORK AUTHORIZED) N? 2045 Z Date ................ A!~r.~t. ......... ~5. ............... 19.....(~3 Permission is hereby granted to: Chas · .Bu~. b.!.e.. · ..~..~..... A.~.th~ .~....~v.~.~ .................. ............. ~G~.een~r..~ ............................................ to ...... ~Bt~ild..e~..add.l~;io~..on..~n...esl~tt.nff...d:/tel.ll.~ff ................................................... at premises Iocoted at .l~/~.....~t~b~:~-.-~e ..................................................................................... ............................................... F~ s%.. ~c~ ...................................................................................... pursuant to application dated ............................ A~-~- .......~ .......... ~.19.(~.~..., and approved by the · BuHdJrlg Inspector Fee $ .. ~.~..0.0. ............ Building Inspecto~ ~ TOWN OF SOUTHOLD BUILDING I~PARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......~.......~...~., 19...~..?. Approved ........................................ , 19..3....Permit No .............................. Diseppmved o/c ......................... Application No. ~-O APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. This opplication must b~ completely filled in by typewriter or in ink ond submitted in duplicate to the Building Inspector. b. Plot plon showing Iocotion of lot and of buildings on premises, relationship to odioining premises or public streets or oreos, ond giving o detailed description of layout of property must be drown on the diogram which is part of thi.~ opplica- tion. 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 th~ work. e. No building shall be occupied or used in whole or in pa rt for any purpose whaCever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY N~DE to the Building Department for the issuance of o 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, 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 a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor Name of owner of premises ......A~/...t..h....l~......D...aV..i...s. ................................................................................................................... If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of lan~d on which proposed work will be done. Map No.: ........ ~ .................... Lot No.: ..... .x..~ ....... Street and Number ..... ,~,~,~]~1,.t....L.~n, fi.~ ........ F~.t....~.i~n ................................................................................ Municipality 2. State existing use and occupancy of prerr~ses and intended use and occupancy of proposed construction. a. Existing use and occupancy ........ (~.w..9~..1.~,D~ ..................................................................................................... b. Intended use and occupancy il W/ addition property lines. Give street and block whether interiOr or corner lot. 3. Nature of work (check which applicable): New Buitding .: .................. Addition ...... ;~T~Alteration .................. Repair .................. Remova! .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost .........~....0..0...~../..~.. .......................... ~.. ...... i~. Fee ~' (to be paid on filing this application) 5. If dwelling, number of dwelling units .....qD, f~ ..................... 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 ...~.c). .................... 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 ...QT~ .................... 9. Size of lot: Front ......... 2.~ ................ Rear .................................. Depth ...].~.(~ ................... 10. Date of Purchase .......................................................... N~me of Former Owner ........................................................ 1 I. Zone or use district in which premises are situated, t~A~ 12. DOes proposed construction violate any zoning ]aw, ordinance or regulation:~ TJ.O 13. Name of Owner Of premises .....~........D...~..~..~..~ ............... Address ................................................ Phone No ................... Name of Architect .................................................... Address ................................................ Phone No ................... Name of Contractor ...~.~..~.'L~,~..e. ...... Address ................................................ Phone No .................. PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, end indicate all set-back dimensions from numbers or desa~tJon~according to deed, and show street names and indicate S*A*E OF k ) COUNTY OF .... ..~.~.$. ) S.S. .................... ~..-~.~-~.~. ................................................. being duly sworn, deposes end says thor he is the opplicont (Nome of individuo! sianing opplicotion) above named. He is the ........ .~.~.~Z'.~O.~? .......................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said wore and to make and file this c~plJcatJon; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the applicatk~n filed therewith. Sworn to before me this .................. of ................... ............ , fl,. ,. ....... ('/ ~'_~ ~ue~n~'~f~' ~ ........... .~4~'-~.[~.......x..~..~..~..~ ................................ ~lotary r'uoHc ,~)~'~Y.~f,~.,.P..u~,:~ ....... ~o~pty,~,¢ (Signature of applicant) ~,' I~o. 52-0344963, Suffolk County ~ ~ Commission Expires March 30, ~.g~ z/ · ·