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Home My WebLink About2098-zFOEM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at "E'/~'""Jf~'"O~"~/ooc~'"D:t .......................... Street ~o~..~.".~ ........... B~ock No ...... x~ ......... Lot No...~1 .................... ~Z.,...~.,.~., .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................... ~,T~ ....... ~),j, ............. , ]9~.~.... pursuant to which Building Permit No. '.'~098~. dated ...................... LT~g-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 ........ ......... .Pr.t'V~ t e" o'ne" '£a~i']zy.. 'dwe ~'tln~ ....................................................................................... The certificate is issued to ......~ha~.l. es.....Gi.~.d, er. Sleve ......: ................... ~wner ........................ towner, lessee or tenant) of the aforesaid building. FORI~I 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? 2098' Z Date ............................. ~ ....... ,~,~. ...... 19..~.~. Permission is hereby granted to: Ch~.le~..~.i. tcle~Z.~ve ....................... : .............. ................ ~s~-et' ................................................. to ... ]~t~l..l~ .- ~.. ed c~.~.~o~ .. en..-e~...ese~. ~b.~...~e~.~.~ ...................................................... at premises located at ..... ']:0~"~'~ .......... .~'t~'~"'~'~Z*]~ .................................................................... ............................. ~'~.....l~.,...O~oo~..m~ ....... ~e~.. ............................................................... pursuant to application dated .................................. ~T~E[~'""~ ..........19~..., and approved by the Building Inspector Fee $...~,~.00 ............ Building Inspector FOR. lVI NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N..Y. Ex.amined.~. ~D- X'(, t9..(?...~.. Approved .................... ~/ ~.,k. ................. , 19...~...Permit No,, .~......~.?...~..~..... Disapproved a/c ............................................................................................ ............ , .................. i-i~'~.i.l~i'~-...~ .'"-. ~;;;ig /nSpe ................................ APPLICATION FOR BUILDING PERMIT Date .......... ............ ....... 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 p remises, 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 occupi'ed 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, 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. .............. ................................................................................................................................................... Name of owner of premises .............................................................................. 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. MapANo: .: ............................ M.... Lot No: ................... c~/~- //'~ .... .~. ~ ~,!) . ' Street and Number ....~',..;'. ........ ..1( .(.~.~'...,.::'~..~(~ ....... ~S..: ........................................................ ' ....................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........... L~'......:....: ......... ~ ........................................ , ..................................................... b. Intended use and occupancy .......................~.~ ................. ~....... ......................... ; ................................................. 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .............. Repair .................... Removal ................... Demolition .......... .~, ...... Other Work (Describe) ........................ 4. Estimated Cost (to be paid on filing this application) 5. If d~velling, number of dwelling units .............................. Number of dwelling units on each floor If g~lrage, 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 ............ ..'~.......~m~.... Rear ......... .~.....'~:.. ........ Depth .....~....~. ................. Height ............................ Number of Stories ..... ~ .............................................................................................. DJm'ensions of same structure with alterations or additions: Front ................................ Rear ............................ Depth ............................ Height ................................ Number of Stories ........................................ 8. Dimbnsions of entire new construction: Front ................................ Rear ....... ~.'.~ ..........Depth ....................... Height ............................ Number of Stories .......... ~ ......... 9. Size of lot: Front ....... ~..O..~ .............. Rear ........... ~..~ ...... Depth ............ ~..~ ................. ~0. Date of Purchase ........................................................ Name of Former Owner .................................................... 11. Zon~ or use district in which premises ore situated .................................................... %_.~.%. .......................... 12. Doe~ proposed construction vie at~ flny~ ~onJn~ law, etd nance~gu arian? ............................................ 13. Name of Owner of premises .~..~~Address ..~~...' ................... Phone No ........... Name of Architect ........................ ~~~~ ....................... ~...Address ......... ~....~ .... Phone No ................. Name of Contractor ................................ Address ........ ~.~.~.~.~ Phone No. PLOT DIAG~M L_ocat~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions er, property lipes. Give street and block numbers or description according to deed, and show street names and indic, whether inferior or corner lot. cou w ................. ~~~'.~~: ............ being duly sworn, deposes and says that he is the applic~ (Name of individual sign~ appH~ti~) above named. He is the ............... ~~ ........................................................................................................... (Contractor, agent, corporate officer, etc.) of said owper or owners, and is duly authorized to perform or have performed the said work and to make and · this applicDtion; that all statements contaiD~d i.~.~sZa~[~atio~ are true to the best of his knowledge and bell and that t~e work will be performed in th~~t~[~[~e ~plication filed therewith. Sworn to b~fore me this ~ ~Ofliltl,~[[0n Expires ~30, ................ ...................................... , ...... Notary Public, .~~:....~......~C~t~ (Signature of applicant) FORI~I NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , ]9 ........ Permit No ..................... Application No.....~.....~..?...~.. ...... Disapproved a/c ................................................................................................... ............. ............................................. (Building I~spector) APPLICATION FOR BUILDING PERMIT~-/ uate .......... ~,./. .................................... , ................ 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 bui)dings 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. ~cl of this application, the Building Inspector will issue o Building Permit to the applicant. Such /,l¢~rmit shall b'~~ premises available for inspection throughout the progress of the work. e. No building shall be"~upied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Bui~Ln..~ !nspector. ~.~<~,~'~'{~,~J,~J,S. HEREBY MADE to the Budding Department for the ~ssuance of a Budding Permit pursuant to the Building Zone Or~q~,~of the Town of Southold, Suffolk County, New York, and other applicable Lows, 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, ordinances and regulations. ......... ~gn.a~ure o? appuc~nL or name, iT a 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. 1. Locat on of and on wh ~c? proposed wo~r ¢ w II be done Map ~o ~';~C,~. Lot No' ~S--)[ .......................................... Street and Number ........................................ .~. ..................................................................................... Municipality 2. State existing use and occupancy o~ntended use end occupancy of proposed construction: a. Existing use and occupancy ................................... .................................. ten e an ~ ~ c~,'/ ~,r ~ , .... b. n d d use and occup cy ............................................ .v./... ............................................................................... 3. Nature of work (check which applicable): New Building .................. Addition .................. a~on Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Esti[nated Cost ...... ~) .................................................... Fee ..................................................................................... ~ (to be paid on filing this application) 5. If d~velling, 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 (]nd extent of each type of use 7. Dimensions of existing structures, if any: Front ............ ..~....~. Rear ......... .~..)m'.. ........ Depth ...,~..:~ ............... Height ............................ Number of Stories ......(~... ............................................................................................... Dirriens OhS of same structure with alterations or additions'. Front ................................ Rear ........................... Dep:th ............................ Height ................................ Number of Stories ........................................ ! 8~ Dirdensions of entire new construction: Front ........... .~.'.~m... .......... Rear ......... ~.z'~ .........Depth ..../..~.. ............ Height ............................ Number of Stories ......... ~ ......... 9. Size of lot: Front / O O Rear /r CpO j' ............................................................ Depth ........................................ 10. Date of Purchase ........................................................ Nam~ of. Former Owner ................................................... 11~ Zor~e or use district in which premises are situated......'...:~ ................................................ 12. Does proposed construction ~olat~j~n~o~nij~.~ la,~w, ord,nance,~gul_aJi, on ................................................... 13. Narhe of Owner of premises ..~..'..~..~.'..~..~_~.~Address ..~....~:'.....'. ................... Phone No ................. Name of Architect .................. ~'.....o~ .............. ~...Address ........ .k~.....~.~........?hone No ................ "on' ' Name of ~ ~racror ...... d ......... ~ ................................ Address ........ IxL; "/"/;(~/'/~"~'I-'-:..X..Y ~..~.T~ ....... ~ ...... Phone No ................. PLOT DIAGRA,M kocat~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr. property I[nes. Give street and block numbers or description according to deed, and show street names and indic, whether in~erior or corner lot. STATE OH NE _W~-,~OR~/(C ) S~ above named.tNamee°tisl~H ' . .............. ~.7:: ..................................................................................................... ~ (Contractor, agent, corporate officer, etc.) of said ow:ncr or owners, and is duly authorized to perform or have perfon-ned the said work and to make and th s app cation; that all statements containd~lir~l ~i!}0~Dlicq~tion are true to the best of his knowledge and bel and that the work w be performed n/~, ~r~J~t~gg}~o~Y~l,,:~in the application filed therewith. Sworn to ~efore me this ~~,, ~u:~i~s~:~'~~ _ J ,y ' ~'. .................. ~ ................... r.: ................y pp'