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Home My WebLink About2550-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. CERTIFICATE OF OCCUPANCY No ...~.,...~ ....... Date .................. .~. ......... !.3~.em1~e~...19 19..6.~. THIS CERTIFIES that the budding located at ~e~..S~'~;[k..~&~re~ ................................. Street Map No "~l~ .............. Block No ........ ~ ........ Lot No. ~ ........... ~j4t, j~t~,~l~t..~,.~, ............. conforms substantially to the Apphcahon for Budding Permit heretofore filed in this office dated ..................................... ~)a~ot~ez'"'"~0", 19'6tl-" pursuant to which Building Permit No..~Q..~ dated ............................ O~,'~ ........ ~.CI ...... , 19..~., was msued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this ~:~rtihcate is issued is ........ ............. · P~-£~te"oae'"£a~i'ty'"d~ee~'l'.~,~ ................................................................................... The certificate is issued to ..... ~)~eF.~..~a~tt.~he~ .................... O~e~. ....................................... (owner, lessee orxter~nt) of the aforesaid building. FOENI NO. ~ TOWN OF $OIJTHO/D 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 2550 Z Date .......................... O~ ~;,~ol~r.....~LO ....... , 19.~. Permission is hereby granted to: ~eme..l~o~.~on. '~q:~'"R~bez- t-' ~eu-~ tt~e~ ..... .............. ~..~ ............................................ to .~u, ild..a~..a~t~tt, t,s. oa..ea..~s.e~,,a~..dve~.:t. '~,~ ........................................................ at premises located at ..... ~-.~g~-f~-~..A~t'~ .................................................................................... .............................................. Cuteheg~e .......................................................................................... pursuant to application doted ......................... ~;C~l~eF. ....... /~ ........ 19...~.~ and approved by the Building Inspector Fee $....~'~,.~. .......... FO~ NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×am,ned ........ ............. Approved ........................................ , 19 ........ Permit No O Disapproved a/c ..... ~ ...................... ................................. Application No..,.~.~....~.,...~...~ ...... APPLICATION FOR BUILDING PERMIT ............... , ...... INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildir Inspector. b. Plot plan showing location of lot and of buildings on prem,ses, relationship to adjoining premises or public streets areas, and giwng a detailed description of layout of propertymust be drawn on the diagram which is port of this opplicatio c The work covered by this apphcation may not be commenced before ~ssuance of Building Permit. d. Upon approval of this applicahon, 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 m part for any purpose whatever until o Certificate of Occupan shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE 1o the Budding Department for the issuance of a Building Permit pursuant to tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The apphcant agrees to comply with all applicable lows, ordinances, building code and regulations. .............. ............ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build. If applicant ~s 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 2. State existing use and occupancy/~J'~ ' ~__ (~) _,~ ~°f-4~remts'es and mt~4Jed use and occupancy of proposed construction: a. 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 .... ..~....~..~,,,.g...c..¢,.-~. ........................... Fee ........................................................................................ (to be paid on filing this application) 5. If dwelhng, 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. D,mensio~of ex,stin,~g structures, if any: Front ........ .-~...~., ......... Rear ....~:,~..~. ............ Depth ,~,~..~.. ................. Height .~... ................. Number of Stor~es ........../.. ................................................................................................ Dimensions of ~ame structure w,th alterat,ons or additions: Front ......... .~.....~.. .............. Rear ..~..,.~ Depth ...... ..--~...~,-Sw/'- ............. Height ........ ./..~......'~.. ........... Number of Stories .... Z'.. ................................. 8. D mens ons of en, re new construction: ront ............ ........ Rear ....... ............. Depth Height ............ J,~.'~.. ........ Number of Stories ..... ]. ..................... 9. Size of lot: Front .......... /......~..?. ....... Rear ........ Z....'~.. ........... Depth .....,,~..~..~...d__J ............. 10. Date of Purchase ........................................................ Name of Former Owner ..................................................... ] I. Zone or use d~strict in which premises are situated .............................................................................................. 12. Does proposed construction vi~olate any zoning lay, ordinance~.r regulation? ......... ~ ................................. 13. Name of Owner of premises ~~..~.:~~ddress ..~ ......... Phone No Name of Architect ..................................................... Address Phone No .................. PLOT DIAGRAM Locate clearly end distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions ftc property lines. Give street and block numbers or description according to deed, and show street names and indica whether interior or corner lot. 50 STATE OF NEW Y~RK~,, COUNTY OF .,~.J ~'~,, i~l~..~r;~..~. ....... being duly sworn,__d~eposes and says that he is the appli, above named. He is the ..................~~~~ ....................................................... 6/ · (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and is duly authorized to perform or have performed the said work and to make and this apphcation; that all statements contained in this application are true to the best of his knowledge and be and that the work w~ll be performed in the manner set forth in the apphcation filed therewith. Sworn to/~r~e this .............. of. ............... lO~m~mss~on Expires Ma~ch 30, 19