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HomeMy WebLinkAbout2231-zFOI~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 ..... Jc~lt.~...R.~.0*.t~.~..'.~/.-~..:[~..~..~.....H.~.~.b...o..~. ~eet Map No...g...~,~ ..........Block No ......~T~ ......... Lot No .....~. .......... .~...o..~...~..~.P.~.~..~......?.~.*.i.~.... ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................................... 0~.~o.l~e~......~[.0..., 19...~..~t. pursuant to which Building Permit No ...... ~.~.~..]r..~ dated ........................... 0.a.~Qb~.~......~.., 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 ........ ~.r.i~.t,.e..o.b.e. ~:~1~..~.~f~.~k~ .................................. The certificate is issued to ......~..O.f.~'..e,.~.~....?..*.....H..O...~.,y... .................................... .0...~..~..e.?. .............................. (owner, lessee or tenant) of the aforesaid building. H.D. Approval ~arch 196~ FO~ NO. 2 TO~N OF $OUT8OLD 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) Permission is hereby granted to: ~, t~, S~t~..&..~o~..~....~.O..,T~ePl~..~.,..~oe~t .............. I~i~)~ .............................................. to ....]~1~1 .~,~.~..~'~e,..£~m-~l~..,~e3~a8 ................................................................................... at premises located at ...~,~,..~:~.,.,.~,,,-O.-.~---,-O~,-.J~...~l~.l~,.JJ~t~]~J~t-..~P~e~ ................. ....................................... . .s.g.,.4~.h~.~.~,... ~,~ ~.,. ........................................................................................ pursuant .tQ application dated .........~.~ ......... ~13~e:E:......~{~ ........ , 19o~.~.., and approved by the BuiJding Inspector Fee ..... ~;ildlng Inspector '" F' ' SCHD SUFFOLK COUNTY ~OER%~TUE~T OF HEALTH Date March 19, 1 96~4 _ Building Permit No. 2231g. TO ~OM IT MAY CONCERN: The sewage disposal facilities for a structure located at Privte Rd., off Town Harbo~ Road_L~Southold (H%ey~) "~e d-~e~ocatio~) - have been inspected by this Department and found to be satisfactory. ~~ ~. ~ District Engineer FOR~ NO. 1 TOWN OF SOUTHOLD .BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y.~' Examined .....~ ....... (..~ ........ , 19 Approved ......... ~'~q..~.........~.....~..~....., 19....~....Permit No.....~....'.~...,~.~.....~... ..... ............................. ...................................... v (Building lnsptctor) APPLICATION FOR BUILDING PERMIT INSTRUCT~0NS a. This application must be completely filled in by typewriter or Inspector. ink and submitted in duplicate to the Buitding b. Plot plan showing location of lot and of buildings on premises, relationship to adioining premises or public streets or areas, and giving a detailed description of layout of property must bedrown on thediagram 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 [nspectbr wiH 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 whatever until c~ Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION ~S 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, a'nd other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Zhe opplicantagrees to ,co. mply with all applicable laws, ordina~,c s and re~ulati~t~. ~/ ~ (S'~gnatur,,e of applicant, or name, if o corporation) (Address of applic State whether applicant is owner, lessee, agent,, archi~tect,,engineer, general cont"actor, electrician, plumber or builder. Nome of owner of promiseufi~<~/.~,__~.-~/r,~..//p2 , .............. '"~"~ ................... ' .............................................................. (Name and title of corporate officer) t ' 1. Location of land on which proposed w~be ~orfe. Map No: ...2,....~,~ ................... ::..'.......~L~t No: .................... Street and Number~.~.~.....~.~.~...~~.,~.' ./-~'~r~ ......................... '~:....i .......................... Municipality State existing use and occupancy of p/~emises and intended use and occupancy of proposed construction: a E× t ng on occ anc .................................................................. b ntended use and occupancy 3. NatL~re of work (check which applicable!: New Building .................. Addition .................. Alteration ............... Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost .,.~:~.,~?.~2~9.~...~ ........................ Fee ....... ./.z~...~ ............................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling ,units ......~ .......... Number of c~welling units on each floor .......................... If garage, 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 .......................... 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 .._~5,,~..~.. ............... Depth . .~....~.. ............... , Height ...~. ................. Number of Stories.....'~..~ .................... 9, Size of lot: Front ....~....~.. .................. Rear .....~.../..':...~...'~. ....... Depth ....~....~....~.. ...................... 10. Date of Purchase .........~ ............ ................................ Name//) --at Former Owner,_......~.~----~.,..i 11. Zone or use district in which premises are situated......./..[....~'~-~,...x.'4}.~',.,,f-X'...r~.../..~...Z'.. 12. Does proposed construction violate a:ny zoning law, ordinance or regulation? ......~... ......................................... 13. Name of Owner of premise/s-~...~.-...~.....Address~.,~/~.../~..,~-~-_~~" -- Phone No N'ame of Architect ..................................................... Address ............................................ Phone No ................. Name of Contractor /~./.. ~ ................ · Address ............................................ Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock'dimensions fr~ property lines. Give street and block numbers or description according to deed, and show street names and indic~ whether interior or corner lot. STATE OF NE~ O ) ~ ..................... ~~tbeing duly sworn, deposes a that he is the applicc (Name of individual signin~ application) ~ ~¢_ ~ above named, He is the .................. ~.....~T.....~ ................................................................. ~. ...... / ~ (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 this application; that all statements contained ij~t~is~a~l~ation are true to the best of his knowledge and bel and that the work will be performed in th~a,j~r,~e,s~i~fclrt~i~?he application filed therewith~ S om to ef me this ~o. 52-03~r~963, Suffolk CO~ Y /.C" /;r ............ ....................