The URL can be used to link to this page

Home My WebLink About1980-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No..;~..~[~.~. ............ Date ...................... Al~.l~.S.t....;~9. ......... , 19...~.3. THIS CERTIFIES that the building located at ...S~.8...NO.~.~Ch..Rd..&..~.S...~,.[.,,~.,~... Street Map No ...... ~ ....... Block No .......~ ........ Lot No.....~_n~ ............ ~e~tO~:[¢1...}~.,.~, ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................... ~.e~a~,.~'......~.~....., 19.(~..~.. pursuant to which Building Permit No....~.~.0. dated ......................... .~Te.~tta. r~.....~.[...., 19..1~., 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 ........ .... B.usine.ss...b.uilding.~... s.tor, a~e~...wa3t ~ko. us.e...e .¢.0. .......................................................... The certificate is issued to ..~r~..%,$~..~;&%10;~O~T&:[ ..................... Q%Pm. e3~ ..................................... (owner, lessee or tenant) of the aforesaid building. FORM NO. 2 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.o 1980r 7 Date ..................... ~I~B~l~.~.....3], .........19..~3. Permission is hereby granted to: ~.t e.~.e.. ~¢....8.~epno~ki ...................................... ..... 2.e~oni~ ......................................................... to ...gov...~n..~x~st~tr~..husin~s~..hul~n~...(.lo~d~n~..pl~t~z~..~to~.a&e..&. Offiee) ...to..ne.~..~oc~.tion ......................................................................................................................... at premises located at ..il/~..L..~..l~...R.....&..l~/&.lio~.th...l~oad..w~t..~£...l~oon;~o..Z~ue. ...................................... ~.e~oni~.. r,, Z. .......................................................................................... pursuant to application dated ...................... ,T, ari3;~.y. ....... .~3, ............. 19~.~..., and approved by the Building Inspector Fee TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ................. ~ ................... 19..'~.....Permit No. ,Z,-I ~ ~ Disapproved a/c ......................... . ........................ i§~'i'l'~'i'~"i~ .......................... Application No.../.....~..~ ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and sui~mitted 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 a detailed description of layout of property must be drawn on the diagram which is part of this location. c. The work cov. ered 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 Buildln_q Department for the issuanoe 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 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 name, if a corporation) (Address of ~pplic~nt) State wheth.er 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. Mop No:~-,/"~'"'"'~"; ....................... Lot No: ..:.....:.x. ......... Street and Number .................................................................................................................................................... ~.. ....... Municipality 2. State existing use and occupancy of pr. emises and intended use and .o~:cupancy of proposed construction: Existing use and occupancy ~ ....... "~'"~/,~]'/'.,L4"~ ........................................................ b. Intended use and occupancy ................................................................... .v.~z./.._~k'..'.~......~.... ...... ~,.I ............... 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition ........ ..~ ........ Other Work (Describe) ....~ 4. Estimated Cost ........... ~..!.. ................................ Fee ..~.~....O. ................................................................................ (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 ......... ~....~..'~..~.j~1 ............................................ : ..................................... Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth ............. : ................ Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ........ ~,...~'.~.....~..~.~.. Rear ....... ..~;....~..:~.t..}.~... Depth ....~.....~...~....../~....?...~ 10. Date of Purchase ......... .]...~.....~...~ ........................... Nc~m/~o~, ~Owne r ...... /..~. J.~.: ...................... 11. Zone or use district in which premises are situated.....].~ ..................................................................................... 12. Does proposed construction violate .a/?y zoning ~a,w, ordinance~l; regulation? .... ~ ...................................... · ~ ~'~/~~ /~/-~"~' ~"- '~ ~ Pon 13. Name of Owner of prem,ses....'~.....'~r..mpr..~..'r.=::........Address ...~..... .................................. h e NO ..................... Name of Architect ........................................................ FO, .~. o.~-~c.~ Address .......................... ..~....~ 2 ................ Phone NO ..................... Name of Contractor ............................................... Address .............................. Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description occording to deed, and show street names and indicate whether interio4' L., t ,t~ or corner STATE OF COUNTY OF (Name of individual signing abave named. He is the .......... of said owner or owners, and is duly authorized to perform or have performed the sai, this application; that all statements contained in this application are true to the and that the work w be performed in th~f~,a,,r}~'~e,~ f~ in the application Sworn to before me this , '~(=. St;lt~ ~ New York Notary Public, ~'...t~(.....?.~~.....being d~y sworn, deposes and says that he is th, applicont ~e of individuol signi~ ap¢cation) ~e s the ................... ~ .......................................................... ~ ..................................... (Controctor, agent, cor~orote officer, or owners, ond is duly outhorized to perform or have performed the saiCw~ ond~o moke and file n; that all statements contoined in this opplication are true to the ~his k~ledge ond belief; /ork will be performed in th,,~gn~'~ ~ in the application~~i~