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Home My WebLink About2062-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located ate/'.S..~,,,~,~],e...R.Cl,,..,...S.Q~.t-~.q.~.~. ............. Street Map No ..........*.?.. ......... Block No ............... .*..*..... Lot No .......... ..*..*.. ..................................................... conforms substantially to the Application for Building Permit heretofore filet) in this office dated .............................. Ma.y.../~ ..................... , 19.6t3.. pursuant to which Building Permit Nc~..~..~..0..~.~ dated ....................... [v/~Y...[.3. .................. , 19....6..3.., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ~ PRIVATE ONE F~M~L¥ DWELLING The certificate is issued to ..... Joha..~,...Ca~.oll.~...o~lte~' ............................................................. (owner, lessee or tenant} of the aforesaid building. Building Inspector FOI~I~I NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2062 Z Dote .......................... t~ ....... l.~ ............ I~.~3.. Permission is hereby granted to: ............ ~et~pe~ .............................................. to ...l~u~..l~l .. an-.-a~..~.t,~, e~'~., on...~ .-e.g,.st i~g...~e-tt~ag .................................................. : .... at premises located at ....$/$.....]~.~1~[:t.e...RO~.~ .................................................................................. ......................................................... ~eu:~ho~ ................................................................................... pursuant to application dated ............................. ~.~l:y~.....~..~. .................. 19~...., and approved by the Building Inspector Fee $....~.,. 0.0 ........... Building Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUT.O .D, E×om ned ....... ....... , Approved ......................................... 19..'/.....Permit No. ......... ~~' '~' ' '~' · ' .: r" '~ Disapproved a/c ...................... ......................... Application No ............................. 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 o detailed description of layout of property must be drown 6n the diagram which is part of thi.~ applica- 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 applicarnt Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shah be occupied or used in whole or in port for any purpose whatever until o 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, alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. R~ohte~ Home ImproV~ent (Signature of applicant, or name, if o corporation) Greenpo~ (Address o~ epplJcont) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pJumber or builder. Contraotc~ Name of owner of premises .............. .~.OJl.,'J..~...l~..~ .................................................................................................... If applicant is o 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.: :~,X Lot No.: ....~ Street and Number E/S Middle Road (C.R.2~A) ~outhold . ................................................................................ ]~ ~ ~ i~'i'l~¥i~" ................................................. 2. State existing use and occupancy of premJses and intended use and occupancy of proposed construction. Dwelli..~., o. Existing use and occupancy ............................................................................................................................... b. Intended use and occupancy It ~/ Additio~ 3. Nature of work (check which applicable): New Building .................... Addition ...... ~.... Alteration Repair .................. Remova! .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost ...~.1..0..0...0.. ~.~.M Fee ...... ~.. ~ (to be paid on filing this application) 5. If d~elling, 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 ............................ Depth Heig, ht ............................ Number of Stories ................ D~mens~ons of same structure with alterations or additions: Front ................................ Rear Depth ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...'10. ...................... Rear ...10 ...................... Depth ........... .~. Height .............................. Number of Stories ~t~ll ...................... 9. Sizeof lot: Front .....]l..~.~. ................. Rear .............. ],.~.¢). ............. Depth .~.~;~/.~l,.b¢.~...~../.~.. 10. Date of Purchase .......................................................... Name of Former Owner 11. Ton9 or use district in which premises are situated ............... 12. Doe} proposed construction violate any zoning law, ordinance or regulation? ....... ~O ..................... 13. Name of Owner of premises ,.~...~'~], .............. Address ................................................ Phone No. Name of Architect .................................................... Address ................................................ Phone No. Name of Contractor~:~.~.~..~.~.~.....~..O...~.~...~.~...~... ......... Address ........... ,~.~..e..~.~..O...~..tf. .............. Phone No. PLOT DIAGRAM Locate clearly and distinctly a~J buildings, whether existing or proposed, and indicate all set-back dimensions fi property I!ines. Give street and block numbers or description according to deed, and show street names and indic corner whether i~terior or lot. ,, STATE OFi NE~' YORK, ) COUNTY OF ~.~.O~ .......... ) S.S. ~',-~ c 'c ~.t' .~.~ ~, being duly sworn, deposes and says that he is the applic( (Name of individual signing application) above named. He is the ....................... ~.~[ ........................................................................................................ : (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 applicatio6; that all statements contained, in this application are true to the best of his knowledge and belief; that the w~rk will be performed in the manner set fort~ in the application filed therewith. Sworn to Before me this ................. .......... .................... , , ...... z -~ ~ ............ ~ ~ounty (Signature of applica,nt) ~ ~dt~ ~ubhc State of New Yor~