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Home My WebLink About2079-zFOH. M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No....~..'~. ~1'~ .......... Date ........................ ~U.]:~.....~'~ ............ , THIS CERTIFIES that the building located at ..~/J~.....~J~-~h~¢~..~,~ ............................. Street Map No. ~ ............ Block No....~,,1C~ ........ Lot No..a¢-_~11; ....... SOU.Ch~ld~......N,.~, .................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................... ,,T,l~te ....... ~ ............ , 19.(~.~.. pursuant to which Building Permit No....g..~)~.c) dated ........................ ~.~e ....... .~ ........... , 19..6..~., 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 ........ ............... F~.ivate..~ne...~t.l¥...dwel. lt~.§ ................................................................................ The certificate is issued to .....J~.i3~llO~d~ ........... ; ............ ,(~4T/.e~. ............ ., ............................. [owner, lessee or tenant) of the aforesoid building. FOI~M 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? 2079 Z Dote ........................ ~lt~e .: ........ ..~ .......... 1c).~3.. Permission is hereby granted to: C~,~ ~ ~f,~h'. 4..~en~,....A/.C-..A.,.~.,~7~o~ ~. .... ................. ~out~o3~ ........................................... to ... Bui.td...a~..a,~eli. t l e n.. ~'..aa .. ex.i.z t~.:[.rtg.. (t~e tt-:[n~ ...................................................... at premises located at .....l~/~f....~tr183-t:~...~.~ ................................................................................. ..................................................... ~o~theld ................................................. : ..................................... pursuant to application dated .................................. ~t~!l~ ...... '~, ........... 19~..., and approved by the Building Inspector Fee $..,;~.00 ........... , Building Inspector NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. APP~CA, TION FOR 5UILDIbIG PER~IT Date .~.....~. ...................... , 1~..~.. INSTRUCTIONS a. This application must be completelv 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 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 o 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 o Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE 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, oF for removal or demoJC~ion, as herein described. The appticant agrees to comply with all applicable laws, ordinances,g~d regulations. /~ ~.._ / · (Sig~'~'Z-.~e'~licant, or name, if a corporation) State whether applicant is_~m~c~er, lessee, agent, architect, engineer, general contractor, electrician, pi[umber or builder. If applicant is a 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.:; .................. .//...: ............. ~kot No.: ...................... Street and Number ..~..~~....~ ................... ~~~ ......................... Municipality 2. State existing use and occupancy at--and, intended use and occupancy of proposed construction. o. Existing use and occupancy.....~----'~~~~/. ............................................................................... b. Intended use and occupono/ ................................................................................................ 3. NatUre of work (check which applicable): New Building .................... Addition ....~.~x,. ....... Alteration Repdr .................. l~moval ................. Demolition .................. Other Work (Describe) .................. 4. Estir~ated Cost ....~..~..~;?...~.~ ............................... Fee ....~,~'.. ~ (to be 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 b~siness, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimbnsions of existing structures, if any: Front ....,~..."~.....~m. ............. Rear ..~.2-z'.. ................. Depth Hei!ht ....././~.... ............... Number of Stories ...... ~ ....................... Dimension~ of same structure with alterations or additions: Front .....~....~ ............. Rear ...~...-...~-=. ................ Depth ..,~....~.. ..................... Height ...../...~... ................... Nu,m, her of Stories ....~ .............. 8. D mens ons of ent re new construct on: ~ront .... ./'..~...."~z ......... Rear .~../....'.~?. ......... Depth ./.~?.... I-lei~ht ...~.. ....................... Number of Stories ..~ .............. 10. Dat~ of Purchase .......................................................... Nome of Former Owner 11. Zon~ or use district in which premises are situated. 12. Does proposed construction wolate any,7_onmg ]ow, ordinance or regulation. 13. Name of Owner of premises ~.,..~.~... Address .~.~.... .............. Phone No. Name of Architect ....... ..,~ ............. ./..C ...................... Address ................................................ Phone No. Name of Contractor,,,<~....~..r..~~..,C~"~t..: Address ................................................ Phone No. PLOT DIAGRAM kocaie clearly and distindly ali 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 whether interior or corner lot. STATE OF NEW )¢'O~. ,~,~ / ) COUNTY ~~ ......................................... being duly ~worn, d~poses and says that he is the applicc (Signature of applica,nt) (Name of individual signin apglication) above nam'ed. 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 application; that all staCements contained in this application are true to the best of his knowledge a.nd belief; that the work will be performed in the manner set forth in the application filed therewith. ~ TOWN OF SOUTHOLD .,x BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. Exam,ned -5 ...... ........ Disapproved a/c .......................................................................................... ...................... 4~ ....... ~.,~..~....:~.~...,~'~ ~ ................. (B~ildi~ I.~t~r~ Application No..~,~..g..)....f ....... INSTRUCTIONS APPLICATION FOR BUILDING PERMIT ote. ..................... , 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 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 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 alterations, or for removal or demoli~on, as herein described. Reguloti°ns f°r the c°nstructi°n °f buildings additi°ns' ordinances~dregubtions. / .] j The applicant agrees to comply with all applicable lows, (Signature of~jSlicont, or nome, if a corporation) ............... ~" "',/' (Address of applicant,'~'''~'~-' ............ State whether applicant is o~wjo~er, lessee, agent, architect, engineer general contractor, electrician, plumber or builder. ................................... ~~' '~'~ ............... :x ................................................................................................. Name of owner of premises ............................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) '~' "~ ~ ' - Mu"f[icipa ity 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. o. [:xisting use and occuponcy ................................................................................... b. Intended use and occuponcy ......... ~~.... ....................................................................................... 3. Nature of work (check which app[icaNe): New Building .................... Addition .....~]~ ....... Alteration Repair ................ ~i~.~i~tova] ..~, .......... Demolition .................. Other Work (Describe) .................. 4. Estimated Cost x (~'c~ ~ -"'"' Fee .....~.... ~ ~ (to be paid on filing this application) 5. If d~velling, number of dwelling units ................................ Number of dwelling units on each floor ..., ....... If g~?rage, number of cars ............................................ 6. If bHsiness, commercial or mixed occupe.ncy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front ...."~..Z...~'.. .............. Rear .....-~'....2~/. ................. Depth ...~....~.. Height ....../'~.... ................ Number of Stories ...... Dimensions of same structure with alterations or additions: Front ....~."...~ ................. Rear ..~...'2,,, ................ Depih ...~.....~... ..................... Height ....?...~... ................... Number of Stories ....~ .............. B. Dim!ensiens of entire new construction: Front ...... ~.,~'...~.~..,~ ...... Rear ,,. ,~.,./'.,..~,~.. ............... Depth ...... Height .,~.~.' . ................... Number of'Std~ries ~-- ' 9. Sizelof lot: t ..../.....'~:....~.. .............. Rear ...../.~.. ..................... Depth./~....~..~ .................... ,\ 10. Date of Purchase .......................................................... Na.m~ oF Former Owner 11. Zone or use district in which premises are situated...~~ 12. Does proposed construction v elate any/zoning law, ordinance or re~qulatJon? ,,,~-~. 13. Na_r~ ~f O.WrcnheirteOcft premises .~.~-..~.~~.... Address ..~.' .............. 'Phone No. Nu~ f A ' .....v.,'~ ............ ¢ ........ :, .......... .;, ...... Address ................................................ Phone No. NerVe of Contractor~.../..¢../.'..'.....'..'~....~...¢'..../..~. Address ................................................ Phone No. P,LOT DIAGRAM Lace,re clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions property lines. Give street and block numbers or description according to deed, and show street names and whether i~terior or corner lot. STATE O~ NEW )FOI~Ig, ~/~ , ) COUNTY ]OF ~...-.6.~.~',~."f.~./.~..),,. (Nome of individual sigr ~ ......... '....~ ....... being duly sworn, deposes and ng application) ? says that he is the (Contractor, ~gent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have perfoi;med the said work and to make and file applic:af[on; that all statements contained in this application are true to the best of his knowledge and belief; that the w,brk will be performed in the manner set forth Jn the application filed therewith. Sworn to ~efor, e me this .................. ./County