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Home My WebLink About2551-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ...... 2[- 22.73~ ...... Date ......~:~.~o~a~...:t~l, ...................... , 196~[... THIS CERTIFIES that the building located at -.]~/~..Oe~c..T~ne~...~(~[~l. ......... Street Map No~/(~ ................Block No .... ~ .......... Lot No .............. ~ .............................................. conforms substanhally to the Apphcahon for Building Permit heretofore filed zn th~s office dated ....................... OC~:)]:~te~..~ ............. , 19.64.. pursuant to which Building Permit No. -2..~5~. ~, dated ............... Q~,O~e~'...-~ ~ ............, 19.6.~, was ~ssued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which th~s cerhficate is issued ~s ........ The certificate ~s issued to ..~o~e~:~..~.a~ze~l~.;L ........................................................................... (owner, lessee or tenant) ot: the aforesaid building. Building Inspector \ FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION O1:: THE WORK AUTHORIZED) N? :8551 Z Dote .................... (~I$.~.,, ..... ~ ..................... , 19....~... Permission is hereby granted to: to ..... ~a~l~. 4 .. ma.. ~dd.i~,o~.. ~n..~ .,e~tati~..~w~] ~g .................................................... at premises located at ...~;..,~.t..~,~d~..~er3?.a~ .................................................................... ....................................... ~..C~e~..~.-.~e.~ ............. ~.o~.~h~.~ ................................................... pursuant to application dated ........................... .O~q......~ .......... ]9....~f, and approved by the Building Inspector Fee $.~.IDO ............. Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ......... .(~....~....~.. ....... , 19..~...~.. Approved ........................................ , 19 ........ Permit No .............................. Disapproved a/c ........ ~.:, .......... ~i.. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ....~....~....~.....~.. ................................ , 19.~..~'.. INSTRUCTIONS o. This application must be completely filled in by typewriter or in ~nk and submllted ~n duphcate to the Buildin, Inspector. b. Plot plan showing location of lot and of buildings on premises, relahonsh~p to adlolnlng premises or public streets o areas, and gwing a detailed descriptzon of layout of property must be drawn on the dlogram which is port of th~ applica tion. c. The work covered by this apphcat~on may not be commenced before issuance of Building Permit. d. Upon approval of th~s application, the Building Inspector will issue a Building Permit to the applicant SucJ permit shall be kept on the premises available for inspechon throughout the progress of the work e. No bu~]dmg shall be occupied or used in whole or in pa rt for ony purpose whatever until a Certificate of Occupanc; shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Building Permit pursuant to th--_ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances or Regulations for the construchon of buddings, addmons, alterations, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable laws, ordmonces ond regulations. / ...... (Signature of apphcont, or name, Jf ~ corporation) (Address of applica6t) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ..... ........ Co . ................................................................................................................... Name of owner of premises ...... ..~Z..47....~...~.. ..... /. 4~.~.~A,4. ........................................................................................... If applicant is o. corporate, signature of duly authonzed officer ...... ............. ~'l~e and title of corporate off,cer) 1 Location of land on which proposed work will be done. Map No · . ....................................... Lot No.: ...................... Street and Number ............................................... .~..~.~ ..~7.. ...... ..~../.~..~.T. ..... .~---~.'7~.~...~ax~-~. ...................................... Municipality 2. State ex~st~ng use and occupancy of premises and intended use and occupancy of proposed construct,on. a. Existing use and occupancy ........ ..~-....~..~-n.-~.../.~...~.~4..CLC;r.~. ...................................................................... b Intended use and occupancy ...... -~...~,~.~.. ....... .(~./......~....~.~ ................................................................ 3 Nature of work (check which apphcable) New Budding ........... Addition .................. Alteration ................ Repair .................. Remova! ............... Demolition ........... Other Work (Describe) .................. (to be pa~d on fihng th~s application) 5. If dwelling, number of dwelhng umts ............................ Number of dwelhng umts 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~mens~ons of existing structures, if any Front .-~'~.: ...... Rear ...... ..~.~.~.: ............ Depth ..... ~.Y..~ ............... Height ...... /. .................... Number of Stones Dimensions of same structure with alterations or add~hons, Front ...... ~ ..................... Rear ...;?.~...z~.. .................. Depth ..... ~.~..~ .................... Height ...... ,/.~. '. ........... Number of Stones~ ............../. ................ 8. Dimensions of entire new construction Front .......................... Rear .............................. Depth ............................ He;ght ............................ Number of Stones .......................... 10. Date of Purchase .... ..~./.Y~'x~'~/_.~. ................................ Name of Former Owner ...................................................... 1 I. Zone or use d~strict ~n which premises are situated . ~.4~.¢~.,4~zz=r~.'~,,. ................................................................... 12. Does proposed construction violate any zomng law, ordinance or regulationP ..../~..?. ............................................... Name of Architect ................................................. Address ................................................ Phone No ................. PLOT DIAGRAM Locate clearly and d~st~nctly ali buddings, whether exishng or proposed, and indicate all set-back d~mens~ons fro property lines G~ve street and block numbers or descr,phon .according to deed, and show street names and ind~ca whether interior or corner lot. STATE OF NEW YORK, !./~.....I, COUNTY OF ..~--~.~..~.'.~ S S .... /,~7~.~.~.~-~7~. ....... ~..~z~.....~./.~Z'.. ..................................... being duly sworn, deposes and says that he is the applica~ (Name of md~wdua[ s~gnmg applicahon) above named He ~s the .... ~ ....... ~.~t~ .................................................................................................... (Contractor, agent, corporate officer, etc.) of sa,d owner or owners, and ~s duly authorized to perform or have performed the sa~d work and to make and file th apphcahon, that all statements contained m th~s apphcahon are true to the best of h,s knowledge and belief; an that the work wdl be performed in the manner set forth in the appl,cahon filed therewith Sworn to before me this ......... ......... ............ ' .... ............ C~unt~ ~ ~ture of opplicant) ..... Term Exp~es ~tar~h 30, 19~