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Home My WebLink About2219-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .... B~.~be...~)~.~k.~.e ....................................... Street Map ~o ....................... ~,oc~ ~o ....................... Lot ~o..2. ......... .C..~.e.~.9.gp..e. ................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................................ 0~.1~.,0.~..~.~...~,~ 19...~.3. pursuant to which Building Permit No..2...2..~.~.g. .... dated ............................. ..Q~.t;...O..~.~......~...~., ] 9..~.3...i 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 ........ ..... P~. i.v.a.te...on~., f. ami] ,~... ~we.'~. li ng ........................................................................................... The certificate is issued to ....~T~..~i.~].~,~}l~ .......................................... 0.~¢~f~. ............................ (owner, lessee or tenant) of the aforesaid building. Building Inspector FOEi~I NO. 2 TOWN 0~ $OUTHO~D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS F~ERMIT MUST BE KEpT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 2219' Z Permission is hereby granted to: : c~e~:...~Lo.w.~.~.s......~.q.....T...o...~.....~!~.s..~ ........... ...... .q~che~ue ........................................ : ........... to .,l~.~l],¢Lz~e~..oz~e...,Ca~,~....~.~;LLl~ ........................................................... ......................... at premises located at ....L~.t~..~...~ ....... J~I~Z~'~...J~.JtlD~.~. ..................................... ~ ........................... ................................................. .~.e...e.~..e...~&..v.e., ......... .C..~.~.~..~...e. ................................... i ............... pursuant to application dated ..................................... .0~.~Q];).~:~.....~,19...~,~, and approved by the Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×amined ........ ...... Approved ........................................ 19 ........ Permit ~o ............................... Disapproved a/c ......... .................................. ' '~ p to~) Application No.....~..&.!...~ ........... APPLICATION FOR BUILDING PERMIT Da t e..~...../....'~.. ............................... ,9..6~...'~ .... INSTRUCTIONS a. This application mast be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plat plan showing location of Jot 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 location. 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 part 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with o[I applicable laws, ordinances (]nd regulations. ............................. ~nature of applicant, or name, if a corporation) ........ .......................... (Al:tdress of opplicont) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises....>,r,~...~.~ ...... .~.~~-.~ .............................................................................................. If applicant is a corporate, si(gr)ature of duly authorized officer. (Name and title of corporate officer) 2. State existing use and occupancy of pr, emises and intended use and occupancy of proposed construction: b. Intended use and occupancy ...... /.~.....~. ,,.~.../.~..~...~..~--.-. .................................... 3. Nafure of work (check which applicable): New Building .............. Addition .................... Alteration ReF~air .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost .............. /... .4 .... ~ ..................... Fee ............. ~ ' (to be paid on filing this application) 5. if dwelling, number of dwelling units ........./ ...................... Number of dwelling units on eoch floor .... If garage, number of cars ................ 6. If ,business, commercial or mixed occupancy, specify nature and extent of each type of use .... 7. Dirflensions of existing structures, if any: Front ............................ Rear ............................ Depth ............ Height ............................ Number of Stories Dimensions of same structure with alterations or additions: Front ................................ Rear Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front ......... .~.....~,~... ...... Rear ..... . .~....6..,,~,. ........ Depth .,...~.....~.. ......... Height ...... ~,~...4,.../. ......... Number of Stories ~ 9. Size of lot: Front ...,/...,';Z...~.. ........... Rear .,.."Z..'...~....,' .......... Depth ~...Z.~.....~..,/.~......~.t "'~ ~'/ Name of Former Owner ....~..~ 10, Dante of Purchase ..~..~..¢/..~/.../,..~ ......................... ............. 11. Zone or use district in which premises are s~tuated .... ~49.~...~.....~..,. ~.., .... 12. Does proposed construction violate any zoning law, ordinance or regulation? ..... 13, Nome of Owner of premises..~,c~r~,...~.~.~~ ~ ' ....... Address .~....~,:./.~'-'~ ...... Phone NO, H Name of Architect ................. ¥. .................................... Address ............................................ Phone NO. Nc~me of Contractor..~.~: .......... Address. ,t ......... Phone NO. PLOT DIAGRAM Loca:te clearly and distinctly oil buildings, whether existing or proposed, and indicate alt set-back dimensions fdom property lines. Give street and block numbers or description occording to deed, and show street names and indidate whether interior or corner lot. .~,_~ ,~ $' ~7 STATE OF NEW ¥OR,~, m~ ) SS COUNT~ OF ..~...) ' .(Name of individual signing application) above hashed. He is the ......... · ...... (Contractor, agent, corporate officer, etc.) of said o.~'ner or owners, and is duly authorized to perform or have performed the said work and to make and this application; that all statements contained in ~i~application are true to the best of his knowledge and be f ~ t ~D ~I h n the a hcat~on file th rew'th and that the work will be per ormed, 'n, h~ .,,,~c.~ ~'~ ft~t ' p~' '~ i~, ~ . Notary ~ublic, ~f~y.~.....~ff....~...~~.....:.~o~y