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Home My WebLink About2136-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE: OF OCCUPANCY No. Z..1,929 ............. Date ......................... ~e. pt;.,.,.e~hel'...22., 19.~..~.., THiS CERTIFIES that the building located at .,l~/~..~ii~b~ez'...F,,e:L..Co~ze. ...................... Street Map No. XXX ...............Block No. LV0~ .............. Lot No. ,X/g( .......... E:Lshe~'.s.../isl,~.tqd ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................................... J.1/ly, ....... 30. ....... , 19..~,~. pursuant to which Building Permit No...~,],3.~,~.. dated ............................. ~.I/~T~.....,~][, ....... , 19.~.., 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 ........ Bu~lne s.~.. ~u~,ld&ng...w.....o£f&oe..&..£~.e~ght...te~,1,nal .................................................. The certificate is issued to ....~lsher.$..Island..Eerl~.~..~l.$]br. tc.t ............................. (owner, lessee or tenant) of the aforesaid building. Building Inspe~ FORM NO. :B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2136' Z Dote ...... Permission is hereby granted to: .............. .~i.sher ~.--~ia.z~J ................................ to ·. ~ut.ld...a~, .-a~di.~ien...on .. a~-.exi, eq~.~ng .. bu~tr~e ~.~.- b~.idf~g ................................. at premises Jocoted at ..j~i.l.~,l~ai~t..~)~i-~.½...~.]:.ve~...]~e$..~o~-~ ................................................ .Fi.s~zer z pu?suant to opplication dated ................................... ~'~1~'""'~(~ ......... 1~....., and approved by the Building Inspector Fee $ ·..~0~'~ ............ -- ~uHa~ng inspector j NO. 1 TOWN OF SOUTHOLD BUILDING DEPART/~tENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved .-Z ........................................ , 19 ........ Permit' No ........................... Application No. ~'l 3 (o Disapproved a/c .................. (Building Inspe~)" .............. APPLICATION FOR I~UILDING PERMIT Date ....... . .?....c~......~....~....~.. ...................... , 19....~ 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 o detailed description of layout of property must be drown on the diagram which is part of this applica- tion. c. The work covered by this application m~y not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the opplico,nt. 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 hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, NeW YO~, ar~ other applicable Laws, Ordinances or Regulations for the construction al buildings, additions, alterations, or ?'or/'r~gff~val/or ,~r!~litior~, as herein described. The applicant agrees to comply with all applicable lows, ordinances l//////~ ///k/I//~ (Sfgnature of applic,,~flt,'~or name, if a corporation) ..... ........ (Address of applicant) State whether applicator is owner ~lessee ~gent architect engineer, general contractor, electrician, plumber or bu der 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. Map No.: ........................................ Lot No.: ...................... Street and Number ...... .~'. ;~.~........~/..~ ..~.~.'...~../.?...~..... ~.~.f...~....~.. ...................... ... ~' Municipality ..... 2. State e?<isting use and occupancy of R~r~em~s~s and intended use and occupancy of proposed construction. a. Existing use and occupancy ......... .,~.~,..,~..Z~..~..¥.~./~..~.. .................................................... b. Intended use and occupancy ............ ~....~.......~...~., ...................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition .......... ~. ....... Alteration Repair .................. Remova! .................. Demolition .................. Other Work (Describe) .................. Estimated 4. Cost ./~/..~....~.. ~ ................................. Fee ........ : (to be paid on filing this application) 5. If dwelling, number of dwellinfl units ................................ Number of dwelling units on each floor If g~rage, number of cars ............................................ 6. If business, commercial or mlxed occupancy, specify nature .and extent of each type of use 7. Dimensions of existing structures, if any: Front .......... q.. ............... Rear ...... .~....u.. ............... Depth .......-~...~....~ ........ / Height ............ ~ ............ Number of Stories .......... Dim;ensions 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 .............................. 9. Size of lot: Front ........................... '-1"7"- y, ~,~Rear .................................. Depth ............................. 7'/ ,-~ ,-- --,--, / 10. Date of Purchase .../.S'~/?..~../..~./...~f.~.....,~.. ................... Na,m~ of Former Owner ......... 1 1. zonb ar use district---- tin which premises are situated ........ ~.."7~..~ .... 12. Doei proposed construction violate rice regulc or 13, Nam," e of Owner of premis Phone No. Name of Architect Address Phone No. Name of Contractor .y. Address Phone No. PLOT DIAGRAM Locqte clearly and distinctly ail buildings, whether existing or proposed, a.nd indicate all set-back dimensions property ines. Give street and block numbers or description ~occording to deed, and show street names and whether pter or or corner lot. /_ STATE O~ NEW COUNTY OF (.Name of individual abow; named. He is the ......... ...~¢-~ tion) ......... being duly sworn, deposes and says that he is the (Contractor, agent corporate officer, etc.) . ' of said owner or owners, and is duly authorized to perform or have perf6rmed the said work and to make and file application; that all statements contained in this application are .tj~ J',t~ the best o,f his knowledge and belief; that the work will be performed in the manner set forth in the appli,96)4o~//f, i4ed/~h~rev~'th.,/ Sworn to before me this ..... . ..... .... T~ Notary Public ...~...~.~~... ~u~ .......