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Home My WebLink About2208-zFO~ NO. 4 TOWN OFSOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ~/~......~.~,~..~..$_Ft...e....~ .............................. .... Street MopNo ....... ~ ........ Block No ......~ ......... Lot No..:F,~XZ,~ ....... ~0,.~.~J,.~g.0~ ............................ conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................... · 0C.~;O~r......~....., 19...~'. pursuant to which Building Permit No. ~.~..0..8..... dated ..i ........................ .0..~...~..O...~..~...~.......~......, 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 ........ ............... ~.i.v.a~o..one..~mil.y...d.~elling. ................................................................................. The certificate is issued to ......~{al~.~'...I~10.,~l~.,~e~. ...................... O!l/l~f~lrl. ............................................... (owner, lessee or tenant) of the 'aforesaid building. 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°. 2208, Z Dote ...................... O~.toher.,...~ ........... 19..6.3. Permission is hereby granted to: Geo...A~le.~....~'C.....~.:ey...~ze, A~.~ey .................. ............. Cu. teheg.~e ............................................. to ... ~Bu~. 1~1.. ~n.. ~dd;~ t,~.e~., eh...a~...e,~ng...d~e.l.l ~ ...................................................... at premises located at ...~.~.....~.]~"~e...~i~.rla ................................................................................. ...................................................... ~,~;.~l.t.uck .................................................................................... pursuant to application dated ........................... 0~;-*.......~' .................... 19..~.3., and approved by the Building Inspector Fee $ ..~,.*.C)~. ............ Building Inspector '! TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ("ff~'~,,~ 5 19~> Approved ........................................ ~ 19 ........ Permit No ................................. APPLICATION FOR BUILDING PERMIT Date ....................... ~ ...... ~ ...... ,] 9...~.....~.. ....... 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 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 port 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 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 pa rt for any purpose whateYer until 'a Certificate of 0ccuponcy shall have 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 or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ....................... .............................. (Signature of oppl~ont, or nome, if o corp~oration) (Name and title of corporate officer) Street and Number ............... ~.:.:z.~.~.zrz.-rx-.. ........ ,~...~. ...................................................................................................... Municipality State existing use and occupancy of premises a,n,d,,ij~)t,t~e~d use and occupancy of proposed construction: a. Exis,n, u,e and occupancy .................. ................................................................................... b. Intended use and occupancy ................... :..~...~..~.~_~. .................................................................................... V 3. Nature of work (check which applicabl~): New Building .................. Addition ~ Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ................. ..z~...O...O..O. ................................ 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 business, commercial or mixed occupancy, specify notureand extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............ 3. f~ ......... Rear ........ 3/* .............. Depth ..~..q....~' .............. Height ......... ,/..~. .............. Number of Stories ......... /. ............................................................................................... Dimensions of same structure with alterations or additions: Front ............. ~..~. ............. Rear ....... ~..~'. ............... Depth ....... 5'..,,~..~. ............ Height ................. (.,~ ........... Number of Stories ........................................ 8. Dimensions of entire new construction: Front ................................ Rear ............................ Depth ........................ Height ............................ Number of Stories .................................. 9. Size of lot: Front ................................ Rear ............................ Depth ........................................ 10. Date of Purchase ........................................................ Name of Former Owner .................................................... 11. Zone or use district in which premises are situated ............................................................................................. 12. Does proposed construction violate any zoning., law, ordinance o,r,r~gulation?__,~__/?.,~,*z~z.. 7,.- //-~z ~/~',,-//~ ....................... Name of Owner of premises../~....c~.....~c.~ ........ Address .:~.~.¢-4<..'~..~m¢.......,~......r(~t~'hone No ................. 13. NameName of°f ArchiteCtcontractor .......~'...~¢4'...y._~'g~~li~'~'~ .....................................~' .................... AddressAddress~:: -¢)-,9~...~.~PhonePh°ne No.N° ................. PLOT DIAGRA,M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fn property lines. Give street and block numbers or description according to deed, and show street names and indic, whether interior or corner lot. 17 STATE OF NEW ¥OR~I~, ~/ ) S S ................... ~ ...... ~ ....................................... being duly sworn, deposes ond says that he is the applico above no (rr~d.mHe_sthie,_.__..._i~..,...~.._~....[.i.._~ .~...No eof~lndvidua/ s~nin~ app cation) ~ /1 ............................................................................................ (Contractor, agent, corporate officer, etc.) of said owher or owners, and is duly authorized to perform or have performed the said work and to make and f this application; that all statements contained in~'[~i~l qpF~rf;~tion are true to the best of his knowledge and beli, and that t,he work will be performed in the /~,,~r~bl,~,e~taf¢~'l~'~¥f01~'~e application flied therewith. no 52-0344963, Suffolk Cou~ Sworn to before me this - C0m~ · y ,, ~ z~ ,.4 ,/(1 ,,_ ss~o~ £xp~re.s ~,Irch 30, 19/~ I~. /]// ............ 7.~.. day of .................. /~..~ ....... 19..~.:~'. ./7,.,,H.., f~/,u