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Home My WebLink About1997-zFO~M NO. 4 TOWN OFSOUTHOLD BUILDING D,EPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. CERTIFICATE OF OCCUPANCY No. Z 1757 Date ~overmtoer 4 63 THIS CERTIFIES that the building located at Q~f~.W.Q.~..~. ~..~..~..~.9,.. ~gUt~..0..~..~.. ............. Street Map No. ee Block No. ** Lot No. w* conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................. ..~.~.~.~.....~. ................ , 19..?..~... pursuant to which Building Permit No. .... ~. .......... 1997. dated ....................... ~?.~?..~...,?. ............... , 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 ........ ...................... The certificate is issued to ]~dgar Dot~glas, o~.~ner (owner, lessee or tenant) of the aforesaid building. ~Jilding Inspector 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.° 1997 Z Date ................... /'~eh .......... ~' .............. 1~3 .... Permission is hereby granted to: ~. t~ D~..th.-&. ~;ons...t~e.....t/ii.....F~lg~ ...Douglas ........ Soutt~ol'd ..................................................... to.-.Btr~ id "new "one'"f~.,~i'l~" 'd~eet'tir~ ................................................................................... at premises located at "Oilk'~o'od"'])l"~ ................................................................................ : .......... ............................................. ~o~tho.~d ............................................................................................... pursuant to application dated ...................... l/zl~,~....8 ....................... 19..(~., and approved by the Building Inspector Fee $'"~:O;;OO ........ Building Inspector / TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exom,ned ......... ....... ?....., ........................................ , ~ ........ P~rmff No ................ Disapproved ~/c ........................... ~~~~ ................................................ · z4 ......................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted 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 drown on the diagram which is part of this applica- tion. 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 port for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building~lnspector. APPLICATION IS HEREBY MA,DE to ~he 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, alterations, or for removal or demolition, as herein described. The appticant agrees to comply with all applicable taws, ordinances and regulations. State whether ~applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of~owner of premises .............,~O ~ ~ ~"'~'~'"'~ '"~~ ............................................ ~.J.i'. ..... If~applicant is a corporate, signature of duly a~thor'zed off' . z7 (Name and title of corporate officer) 1. Locotton of land on which proposed work wdl be done. M p No .......................................... Lot No.: ...................... Street and Number ....~~~....~~ ........................................................... i ............ Municipality 2. SfateE~;it;iingu~Sea~]do]]~u:]~cy of~fended use and occupancy of pr]p]sed construction. a. ' ' g e p y ......................... :~ ...................................................................................... b. Intended use and occupancy ....~~ ............................................................................... 3. Nature of work (check which applicable): New Buildhqg .... ,',X~.... ............ Addition Alteration .................. Repair .................. Re, znoval ..................Demolition .................. Olher Work (Describe) .................. .... '~"~ - ~"o~ 4. ~shmatecl Lost .......... ~...~..2, ...N~. ...................................... Fee ............ ¢.. ......................................................................... (to be paid on filJnp 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 of Stories ................................ 8. Dimensions of entire new construction: Front _...4~....~... ................. Rear ..... .~...~... ................ Depth ......~'......~... .............. Height .............................. Number of Stories .............................. · . . ~,-.~ 9. S,ze of lot. Front ..../..,¢,,r~ ................. Rear ....... ~ ........................ Depth ...... .~. ........ ... ........... _ 10. Date of Purchase .......... ...... ~,~ -- __Name of ~Former Own~~.~..~ 11. Zone or use dstrct n whch prem ses are stuated ..... ~'...¢..,.~-~...~.../..~..~...~..Z~'~.(~¢. ..................................... 12. Does proposed construction violate any zoning law ordinance~o~gr regulation? ....... ../~.(....(?. ............................................ p remises~.~.~.¢ Add res¢~~ ....... Phone No.*. ............ ~ .... 13. Name of Owner of Name of Architect .~ ......... ~"-~."-~"";-/'Z" ...... Address ii~i~i~.'.' Phone No ....... : ........... Name of Contracto//~......~....¢?¢¢..~.~.?.~. Address Phone PLOT DIAGRAM Loco.te 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 .according to deed, and show street names and indicate whether interior or corner lot. ~/~ I lyf'l STATE OF NEW YORK, ) c c CqUNTY.OF % ......................... )¢'~5, ., , ~, ...~..~.....~..,....~~..;., ........... being duly sworn, deposes and says that he is the applicant (Name of individual,~'¢_,~; - ,¢/'~~signing application), -,~,r,~,f'~ '' ebove named. He is the ...........,,~...~:.~.~ ............ ..~rT..,J/..~IT:~:~ .......................................... (Contractor, agent, c~rC'orate officer, etc.) of said owner or owners, and is duly authorized to perform or haye 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 appliqation filed therewith. Sworn to before me this ' // .......... .(~ .......... day of ..................... /"~J%"), r-/~,. tar P "~J~*''~' ~~ '~l¢~'"l~IJ~/"'/~'~'""'~""Q"""'"/v7~""~"~"'~" ............. No y ublic ...~ .................................. ~.~t~j°~,, State of ~v¢ 'for,, (Signature of applica.nt)