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Home My WebLink About2577-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the build,ng located at .... Hay~wate~.s..H([ .................................... Street Nassau Point Cl, ,P. rop( Alonzo, .J~¥s]r sec] ....... Map No ....................... Block P, IO ..................... LOT I',lO ........ J,'~.~ ..... .J~'J.1~o~og.%J.e.l....J~.,.Y., ............ conforms substantially to the Apphcatlon for Bu,ld,ng Perm,t heretofore filed m thru office dated ............................... .N..~..?. ....... ~ ............ , 19....(q..~.. pursuant to wh,ch Bu,lding Perm,t No. p~['~.~'...Z. dated .............................. ..Jr..o_?. ....... .1...0......, 19.....~.., was ,ssued, and conforms to all of the requ,rements of the applicable provis,ons of the law. The occupancy for which this cert,ficate is msued is ........ .................................................................................... The certificate ~s issued to ..~...ghD...~.$.~]~ ..................................... .1[~ .............................. (owner, lessee or tenant) of the aforesaid building. H.D. Approval ~une 8, 196% FORM NO. 2 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? 2577 Z Date ....................... ~:rg'J~Jt:~F'"'"~O ........ , 19..61t~ Permission ts hereby granted to: tleorl~e..Ahle~....4/C.....Jcha.~.tet~koalct ........ ............. C~tehog.xu~ ............................................ to ...tau~.~d...ae~.. one.. ~aat.~.. ave:i:.1. -~g .................................................................................... at premises located at .... lla~ $~u.. ,~r~t .. e~Lub.. ~eepe~ t,y ~ ................... tla~ete~s...~oad ..................................... pursuant to opphcotion dated ........................... ~OTeaiblaZ' ....... '8 ..... 19.tr:~.., and approved by the Budding Inspector Fee $.~L0,.0I~ .......... uuilding ~lhspector/ SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH ~ldg. Permit No.~.~'7 The sewage disposal facilities fo~a structure located at ] (Give deed location) - ~---~ -,~' /~/~/~ .... have been inspected by this Department and found to be satisfactory. District Engineer NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...... ~....~...0.. ........... 19.G...c[. Approved ........................................ , 19 ........ Permit No ................................. Disapl::roved a/c ........ ~~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildln Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giving a detailed description of layout of propertymust be drawn on the diagram which is part of this appl/catior 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. Suc 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 Occupan~ 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 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~ applicant agrees to comply all applicable laws, ~na~n~co The with ordinances, buildin code and regulati ......... '~'i'~'~'~t u re ~'~ '~"~ ~',' ~; '~~ ~-~;~]~i ....... ................. ................. State whether applicant is owner, lessee, agent, archit.e.c/tr engineer, general contractor, electrician, plumber or buildc ...................................................................,~ l)~[z~""~""~'Ir )~ ~) i) ................ ; ............................................................................... Name of owner of premises ............ ~ .......... ~~ ......................................................................... // If applicant is a corporate, signatu/~ of duly authorized off,car. 76> .................... ................... Street and Number ......... ~..F..p.~ .... ..~..'.~ ......................... ~ ...................................... ex/ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a Ex~sting use and occupancy ................................~ .............................................................................. b. Intended use and occupancy .............. -~~ ....... ~ .............................................................................. 3. Nature of work (check which applicable): New Building .... .~5....... ..... Addibon .................. Alteration ................ Repair .................... Removal .................... Demohdon .................... Other Work (Describe) .................................... 4. Estimated Cost .......¢,,.~..,~...0..0.. .................................... 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. Dm~ens~ons of ex~sting structures, ii: 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. S,ze of lot: Front ..........~..¢.'Z.~. ........ Rear ........... .?'.~.. ........... Depth ...... .~.,~.¢t .................. 10. Date of Purchase ....,~-~ .......... /.~.~..O. ......................... Name of Former Owner I ~ Zone or use d~strictb'in which premises are s~tuoted ...................................... .4~;'.. .................................................... 12. Does proposed construction v~,ol~te any~c~.niog Ij~w., ord,nance or ~,~gulation?,,~ . ~"'/J~'0~i?~'~.~ .......................... 13. Name of Owner of prem,ses ~...~~..Address ...A.. !.~w~......~--~..(..~l~Eone No ................... Name of Architect ........ ,4~'~ ''J~'''~''''--- ........... ~)~,~ .......... Address iii..._...-...._i~~iiii.~ ~ Phone No ................... Name of Contractor .... ~r..C~fv:..~. ..... ..~.~ .......... Address Phone No .................. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro property lines. Give street and block numbers or description according to deed, and show street names and ~ndica whether interior or corner lot. STATE OF NEW YORK, ~ q ~ (Contractor, agent, corporate officer, etc ) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and this appltcat~on, that all statements contained m this application are true to the best of his knowledge and beJ and that the work will be performed in the manner set forth in the apphcation filed therewith. Sworn to before me th,s .......................... day of ............................................ , 19 ........ Notary ublic,. ........................................................... County