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Home My WebLink About2511-zFOI~[ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTJ~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No . Z .20.~. ........... Date ....................... I~ecem~e~.....'/.9...-, 19.(~.. THIS CERTIFIES that the building located at . .,S./L~.....P,'v.~,I't..Roac!,. ................................ Street Map No .... ~ ........... Block No ..;JF,,~X. ............ Lot No ~ ....... [/e,.~.t:[.t,l~Jl:t...N.,.~', ................. conforms substantially to the Apphcation for Building Permit heretofore filed in this office dated ........................................... ~Lejlt.../.~..., 19..~.~.. pursuant to which Building Permit No ..... ~l.]:,..Z dated ................................... ~.eD~.....8..., 19.6.~., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for whmh this certificate ~s ~ssued is ........ ............ ~.~.v. ate..en~../'~.i.Z~r..d.we.l.I/.~g .................................................................................. The certificate is issued to ...~Okl~l..~O~e~'.tS~3D, ................... OhlZle~. ............................................... (owner, lessee or tenant) of the aforesaid building H.g.Approval Nov. 17, ~96~ b7 R,Vllla/ Building 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) 2511 Z Date .......................... ~t, elll~e~ ....... 9", 19.. Permission is hereby granted to: ~-eent...Iteiee.....A/C..~To~m...Itebe~t~e~ ....... ....... ~-]~--~a~ed.t ~,n...Ave .................................. .............. ~'l~,..-,T~memm~...N-,4[~ .............................. to · .. JBx~2A.. ~ae~. · e~e..~'em~]~y~..d,~e-ii-'f ~,t, sg ................................................................................... at premises located at ..-J/~.-]lJl~h..P, oe~ ....................................................................................... ...................................................... 3ea-%t~t~tek.~ ..... N.,.Y~ .................................................................... pursuant to application dated(~,OlF~.~t~.).....tjl~pt~ ......... 8 ......... 19.~¥., and approved by the Building Inspector Fee $. 10...0~ .......... s-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Building Permit TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at , ~/~ //,, 7, ,~ ':- (Give deed '10cati~) ................. ..... kn~:: ,~,/~ ......... have been inspected by this Department and found to be satisfactory. ~~.& ~. 7.:::, District Engineer Exomined ....~......~.. ........ , Approved ........................................ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No. ~.../ ......... 19..:.~...Permit No. c~ ~' / [ ~ Disapproved O~~ .............. ........................ APPLICATION FOR BUILDING PERMIT ot. ............................... .......................... , INSTRUCTIONS o. 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 propertymust be drawn 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 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 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 or alterations, or for removal or d~q~lition, as herein described. The appl cant agrees to comply with all applicable laws, ordinance/s, building code and/~gu, I/ations. -~ (Sigr~c~ture of 9pplic~nt, or nam~e~"if'a~corporat'o ) ............................... ............... State whether apglic~ant ij owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) 'L~ · ~ ,~/ ~ .~ ! ~:~ ~,.~ . 1. Location of land on whmh~rk w Mop No: ...... ~ ................. ~t No ..................... Street and Number ..................................... ,, ....................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy ................ ~ .............................................. ~ ........................... 3. Nature of work (check which applicable): New Building ...../,~............ Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost ,/..,.~.,.~,.,.-~,....~.. v ....................... , ............................. Pee .......................................................................................... (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 of Stories. ....................................... 8. Dimensions of entire new construction: Front ..... ~ ................... Rear ......~...~. ................. Depth ......-~.?...../.. ............ Height ............................ Number of Stories 9. Size of lot: Front ..... .~&~....~...O...../. ....... Rear ..... ...~...~....~.. .......... Depth ......./....~.~..~...~'~.. .......... 10, Date of Purchase .~...~.....~.~....../.~...~....~?. ...........Name.of,~.Forme,r,~._.~ - ~ ~- ~ ~~Own~ .....~. ................................................. 11. Zone or use district in which premises are situated ....... ~....~~...~ 12. Does proposed construction vi~ ate any~onin law ordinance or reau at on:~ ~ . . 13. Name of Owner of prem sesame.......~...~.Address ..~..i.~..~. ........ ~-( -- ~.~nn~_ Kin Name of Architect ........................... ~ ..................... Address ............................................. Phone No ..................... Name of Contractor ~.~ ................ Address~.~...~...~..~.~ ....... Phone No.~.......~.-....~...~..~ 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 according to deed, and show street names and indicate whether interior or corner lot. I /2..¢/ STATE OF NEW YORK, ~_ COUNTY OF ................................ ~ S.S. ................................................................................................. being duly sworn, deposes and says that he is the applicont (Name of individual signing application) abov~ named. He is the ......................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sam work and to make and file this;~pplication; that all statements contained in this application are true to the best of his knowledge and be ef; and that the work will be performed Jn the manner set forth in the application filed therewitJ~ Sworn to before me this ~ .~ / ry , ~~~¢¢'~t~...'C~....'-.7.. ...... y~ 'g pp' ) No..SZ-O6iStOO I~ommlsslon Expires March ¢JO, ~.~ ~_~.~ -'3 o " /_3-' 0 /o: 0 //-2 il I r