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Home My WebLink About2253-zFOR~ NO. t TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..E/8.....B~[ffdhol'~...F,~.d ......................... Street ~%f?.~...'?...~.~?~o~°~o.~...~.~ .......... Lot ~o. ,~.~ ......... ~o~.~.,...~.,.~.. ................. conforms substantially to the Application for Building Permit heretofore filed in this office doted .................................... ,l~v. emhbl'...~Lc)..., 196.~.... pursuant to which Building Permit No...2~.~3..?. dated ~l'.O.V.~...[.~.~h..],c~,~...&..~e~f~9 ......... was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ...P.z'J,at'at e... one.. £ ~mi].y....d~.e 1 ].~ng .............................................................................................. The certificate is issued to ....Th.ot~8.f~..I~i~/~J[S ............... 0yitlel: ....................................................... (owner, lessee or tenant) of the oforesoid builc~ing. FOI~M NO. 2 ?OW~ o~ $OOT~O~ BUILDING DEP.ARTMENT TOWN CLERK'S OFFICE , SOUTHOLD~_,~,N. Y. 'BUILDING pERMIT'~, (THIS PERMIT MUST BE ~KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 2253 Z Permission is hereby granted to: ........... ..:..: .......... ~?..~.~ .......................................... ~$uild new one family to at premises Jocated at. ~,.O,t. 6.0...;~.~oni~..Ba~...Es.~tes.,~me~e~.) .......... ].: ................ ........................... . .............. ~.(E..~t.~m~..~.,~,...~en~. ................................................. pursuont to ~pplicafion dated .................................. ~...~.~19...~, Ond'o~ovod by the dwelling be In line ~lth O~ho~ dwe!lin~ ,~d. have ~nim~ Fee $.~9~.~ ...... ~ .... ~ido ~e '' ~uildln~ Inspector ,/ 3. Nature of work (check which applicable): New Building ...ff.... ......... Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. [stimated Cost ..... ~j~.~.~...t...~. ............................... 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 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 6f Stories ........................................ 8. Dimensions of entire new construction: Front ...........~..0.....' ........... Rear .......... .'~...~. .......... Depth .....~..~. ............... Height ....... .~. .................. Number of Stories ........... (. ..................... 9. Size of lot: Front ........ ~..~...... ............ Rear ......... ~...~ ............ Depth ~. 10. Date of Purchose~..~..~...../...~..~...../..~..~'~ .............. Name of Former Owner~--~'~..~...~ ...... ] 1. Zone or use district in which premises ore situated ........................................................... 12. Does proposed construction vi~late any :~o,.ning low, ordinance or regulation? ................. Y..~...~.,..~. ..... ~...~. ........... 13. Name of Owner of premises-~__~-m........~/.fJ~....Address .Z/.~..~,.:'.~...~.,. Phone~.~...~/..~ Name of Architect ..................................................... Address ............. ~,/.~ ........................ Phone ~,x/o~ .~ ................. Name of Contractor ..~. '~,....~ ....... Address~..J..~....~J.....~ ......... Phone PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and indicate ali set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE~/ Y~,,~K,h ) S S ........................... ..~~......~.~.~.~ .............. being duly sworn, deposes and says that he is the applicant (Name of individual signing application) (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 file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this kl~ ~, ' /~~~ ~ ~ ~ .'~n0 (S,gnature of appl,cant) FOI~I NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exarained ..................................... ~, '19 ........ Application No. Approved~, ....................................... , 19 ........ Permit No ................................. D,sopproved ...... ......................... ...................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date~ .......... ./....~. ...................... , INSTRUCTIONS a. Thls application must be completely filled in by typewriter or in ink and submitted in duplicate to the I nsp~,~ctor. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this applicat 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. 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 Occul: shall have been g~anted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance~ Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descri~ed~ The applicant agrees to comply with all applicable laws, ordinances and regulations. (S'gnature of applicant, or name, f a corporation) ....... ...... '"i,~'~'~ of ~'~'l~licont) ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 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 ...... ~.~J~....~.....~ ............................................. Municipality ......... 2. Stale existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............................................................................................................................. b. Intended use and occuponcy .......................................................................................