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Home My WebLink About2239-zFO~M NO. 4 TOWN OF SOUTHO/D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...t~t/~..~a~r..A~e...(p~ut~...i,a.) ............. Street Map No....;X~ ........... Block No .......... = ........Lot No....:F,,~[ ....... (~tt.~OhOg.tle.f...~.,.~r., ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................. ~oveml~e[,..../o ...... , 19..6z3.. pursuant to which Building Permit No ..... ~.~.,~.C)Z, dated .......................... [~O1/.~ ........ ;~. ........ , t96,~..., 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 ........ ....... l~,.~.vat;,~..erte...f.a.m.i.l¥...d~e.l.1..~.n~ .......................................................................................... The certificate is issued to ..... G. 3.~.f..f. O1,4...~f.y.l.e~..j.I~.; ............................. ..0~'11¢~. ........................ ~owner, essee or tenant) of the aforesaid building. ~0TEI Val,~La~3c~e /~I,e,~;ed b~r Bd/Appeal~ FOI~/I NO. 2 . TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUiLDiNG PERMIT N? Permission is hereby granted to: (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED pursuant to application dated ............................. l~embe~......6 ...... ]9..6.3., and approved by the Building Inspector TOWN OF SOUTHOLD 'BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E× m,ned ..... ........ , A . //j/?/],/l ~ ~2---- 19..~....Permit No. ........................................ , ................................ .......................... ....... ....... : ....... ................................. Application No. 2Z.?.~.-...~....? ......... APPLICATION FOR BUILDING PERMIT[ INSTRUCTIONS o. This applicatign must be completely filled in by typewriter or in ink and submitted in duplicete to the Building Inspector. b. Plot plan showing location of lot and of buildings bn premises, relationship to adioining premises or public streets or areas, and giving a detailed description of layout of property must be drown 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 epp~oval 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 o Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment 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 applicant, or nome, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................... .C.o~.~r.~c l:.~r ................................................................................................................................................. Name of owner of premises ....~,'Li£J~z'.d...]]~.~.,.~i~ ........................................................................................................ If applicant is o corporate, signature of duly authorized officer. (Nome and title of corporate officer) 1. Location of land on which proposed work will be done. Mop No: ............. ~']~ ..................... Lot No: .....~ ....... Street and Number ...~...~fs~...A~.~...[.~.~a2...~.t.~hog.~.e .................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~,~.~,i.~ b. Intended use and occupancy ............................. ~,z.~,.a~..~,.tfi&~,o~ .......................... 3. Nature of work (check which applicable): New Building .................. Addition ...~ ..... Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost .........~.~3.~..0...~./.~v~. ............................. Fee ............ ~.. (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... .q..~..~ ................. Number of dwelling units on each floor If garage, number of cars ................. ~. ................... 6. If I~usiness, commercial or mixed occupancy, specify nature,and extent 6f each type of use 7. Dimensions of existing structures, Jf any: Front .............. .;¢.~. ....... Rear ..... ~.~. ................ Depth ....... .~.~ Height ............................ Number of Stories .... ~..~.ff. Dimensions of same structure with a~terations or additions: Front ................................ R, ear Depth ............................ Height ................................ Number of Stories ........................................ 8. Dimensions of entire new construction: Front ........ 3.~. ................... Rear ...... .3?). ................. Depth ..... Height ............................ Number of Stories......o~a ..................... 9, Size of lot: Front ......... ].D.C) ................ Rear ................. .].©.O... Depth .............. ~ ~ O 10. Date of Purchase .............. .~..~,~. ................................ Name of Former Owner 1 t. Zone or use district in which premises are situated, nAu 12. Does proposed construction' violate any zoning law, ordinance or regulation? ....... ~.~. ............................. 13. Name of Owner of premises ....C..:...~.,~.~.c.~?...~?.. .......... Address ............................................ Phone No. Name of Architect ...................................................... Address ............................................ Phone No. Name of Contractor ,~..,~.¢~,.e.,.~...C~;..~.q~ .................... Address ............................................ Phone No. PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set~back dimensions property Pines. Give street and block numbers or description according to deed, and show street names and indic whether interior or corner lot. [ ~ o' / STATE OF NEW YORK, ) COUNTY OF .~.LL~.~.O.~]~ ......... ) S.S. ..................... ~.~.~..~..~..~.~..~.r.¥?.[?,¢ .................................. i ............ bei'ng duly s~vorn, dep'oses and says that he is the (~N,ame of individual signing application) (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 this application are true to the best of his knowledge and and that the work will be performed in th~L~Tdhr~er~:t~l fc;rfh in the-application filed therewith. Sworn to 5efore me this No. 52-0344963, Suffolk County ~ ~ (Signature of applicant)