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Home My WebLink About2507-zF~I~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 ..1~./~..C~/~.~..~.~ ................................. Street Map ~.~y.o..o.~ ....... Bbck No ...... ~ ..... Lot No ~,. ....... f~.~t~.~..Z.~. .................................. conforms substantially to the Application for Budding Permit heretofore filed m thru office dated ...................................... At~ ........ 3~L..., 19.~.. pursuant to which Bu,lding Permit No ..... ..~..~....0~.... Z dated .......................... ~....,~1, ......... , 19...~..~.., was ~ssued, and conforms to oil of the requirements of the applicable prows~ons of the law. The occupancy for which thru certificate is ~ssued is ........ ...... I~t.v~te..o~e...£am~].~'.. dwelling ........................................................................................ The certificate is issued to $O~,-rt..~ll~,e/ ..................... O'dlle~. ............................................................. (owner, lessee or tenc~t) of the aforesaid building. H.D.App~oval ~ov 19, 196~ FOP,~ NO. ~ 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? 2507 z Permission ~s hereby granted to: ............... _J-~.~,~_~ ................................... to ~a~,I~,..~..~m .- g.a~t-.:ly. · awt.t .~u~ ...................................................................................... at premises located at ..... ]J~;'"f;~! ........ JJt:fliJ~Jl.'al~O~ ........................................................................... ........................................... ~/&'~'~t~"i~a.ri .......... lto~t~ ................................................ pursuant to application dated ............................... &Jtlgt~'"']t ...... 19~,.., and approved by the Budding Inspector Fee $...'LO~,O0 ......... FO~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .... ............... · e ........ : ......... ....... Approved ................... t. ................... 19 ........ Permit No. -' ................... ' ...... "~di~ ~/¢~p;;;i;;;i ................................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stree or areas, and g~wng a detailed description of layout of property must be drawn on the diagram which is part of this locotioi c. Zhe work covered by this application may not be commenced before issuance of Budding Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant Su, 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 Jn p art for any purpose whatever until o Certificate of Occupant shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Building Permit pursuant to tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances . Regulations, for the construction of buildings, additions or a Iterations, or for removal or demolition, os herein describe The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, ..... ~....c=:~...~-~ f~L ........ .~.~;,~:~:~r~'~.~: ........................................................................................................................... Name of owner of premises ......... ~..~ ...... ~.ff.t~ ................................................................................................. If applicant is a corporate, signature of duly authorized officer. ........ ..... .......... ~ (Nome and title of corporate officer) 1. Locobon of land on which proposed work will be done. Map No: .~.~)~....~&~. Lot No' ....~ ....... Street and Number .... ~:~...~.~,...~ ...... ~J~f.¢~ ........ .~.~ ............................................................ Municipality 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction. a. ~isting use and occupancy .................................................................................................................................. b. Intended use and occupancy .......... ~¢~.~.~.~,~ ........................................................................................ 3. Nature of work (check which apphcable)' New Budding ...... Z.....Addition .................... Alteration .................... Repair .................. Removal .................... Demolition ................... Other Work (Describe) .................... 4. Est,mated Cost......~...~.~..~ ....................................... Fee ..... .¢'.,Z.~r....~.. ..................................................................... (to be paid on filing this apphcation) 5. If dwelhng, number of dwelhng umts .............. ../. .............. Number of dwelhng umts on each floor ......................... If garage, number of cars ............. /...~9,f¢ ...... ZC..ZZ'..4~..¢~;;:~. .............................................................................. 6 If business, commercial or mixed occupancy, speci~ nature and extent of each type of use .......................... 7. Dimensions of existing structures, if any Frent ............................ Rear ............................ Depth ........................... Height ........................... Number of Stones ................................................................................................. Dimensions of same structure w~th alterations or additions: Front ................................ Rear .............................. Depth ............................. Height ............................. Number of Stories ............................... 8 Dimensions of entire new construct.on' Front .... ~.~.~7. ..........Rear ........ ~ ............... Depth ~' Height ....... ../~...~ ........... Number of Stories ........................... 9 Size of lot' Front ......../.~.~ ....... Rear .~crf~ ..... Z.~.~... Depth ~.~...~.~.'.~...~'~, ~)%~ I0 Date of Purchase ...................................................... Name of Former Owner ....................................................... 11 Zone or use district in which premises are situated ............................................................................................... 12. Does proposed construction wolate any zoning law, ordinance or regulation~ ...~: ........................................ 13. Name of Owner of premises.~.....~.~ ......... Address .~Z~..~}~.....&~ ..... Phone NO.~.?.~.~."~. Name of Architect ...................................................... Address .......................................... Phone NO .................. Name of Contractor.~.~.~...~.~ ...... Address ~¢~'~ ~ ~ ' Phone ................... ........... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex~shng or proposed, and indicate all set-back dimensions fron property hnes Gwe street and block numbers or description according to deed, and show street names and in&cat whether interior or corner lot ,o' STATE OF NEW YORK, ) S S COUNTY OF ............................ ) ......... ~.?,~.~.(~Z) ....... ~-~..&/.2~¢.,~,~/~. ................................... being duly sworn, deposes and says that he is the apphcar (Name of individual s~gning application) above named. He is the ..... .~..¢...*~,.,~7,~.$~,~ .......................................................................................................................... (Contractor, agent, corporate officer, etc ) of said owner or owners, and ~s duly authorized to perform or have performed the said work and to make and fil this apphcation, that all statements contained in this apphcation are true to the best of his knowledge and behe and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ................... ~ ...... ~..,_~/~_n._.~;~ ......... '7"l~rr~R¥ Puj¢ e , , ~,-.'~'- or app,icant) Notary PubJ,e., ~H~ T~O0~