The URL can be used to link to this page

Home My WebLink About2594-zFOR~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the budding located at . ...~../.~. ..... ~.~..~....~.~.~ .............................. Street Nassau Farms Map No ....................... Block No ..]r~C ............. Lot No !1~., .......... .a...~..~.~..~..o.~.~..e..~.....~.5..~..e. ............ conforms substanhally to the ApplJcahon for Budding Permit heretofore fded in thru office dated ......................................... ~..~...e.~..~...e.~...~, 19 ...~/... pursuant to which Budding Perm,t No ...~...~.?..~.....~. dated .......................... ..N..o..~'...e..~..~...e.?........~..., 19...~.1~., was issued, and conforms to all of the requ,rements of the applicable provisions of the law. The occupancy for which this certificate ~s ~ssued ~s ........ ..Pri~te.. one..£_nmi~...~w~lq l ,~ ............................................................................................. The certificate is issued to ...~..~..d..e..~..~.~.......~.t.~.~..~...~.~...tr~ ............... ~?.?.. ..................................... (owner, lessee or terra,t) of the aforesaid building H.D. approval March 6, by R, Villa Building I nspecto~k. FOR~I 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? 2594 z Permission is hereby granted to: z~.......~..~......~ ..... .~.~.. ~.s.~.....z.~n~ ............ to .... ~..~e~..~e..~...~~ .................................................................................. at premises located at ...... '~t~....~L~.//...Ji~_ .Jl~l~mil ................................................................ ..................................................... ~/Z~.,... ~t:l.a~...:I~+ ....... ~.u~o~ ........................................ pursuant to application dated ................................. ~...~.....1~1..~..~.....~., 19....~..., and approved by the Building Inspector ~O~J~ approved 'by Fee $.. ~.0.~.(~ ......... Building Inspector TOWN OF SOUTHOI.D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.-Y.'~ ........ , ....... ............................................................... (Building Inspector) Application No ............................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. 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 Jn 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 demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code 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 builder. .............................. Co~t~ a~ ~;or ...~..&g~t, ........................................................................................................................ Name of owner of premises ....~.e~,e~'~l.c]¢..[~es3,;l.~ ................................................................................................... If ep~ent is e co~orote, si~eture of duly authorized officer. ........ ..... (Nome and title o~o~rate officer) 1. L~ation of land on which pr~osed work will be done. Map No: ~.~...~.~ ............... Lot No: .~. .......... ~ Strem and Number~..0..~,.~.;~o...~..O~...~/~.....~.~e~.~..~.~ ........ C~ ..................... ~unicipalJ~ 2. State existing use and ~cupancy of premises and intended use and ~cupancy of pr~sed construction: a. ~isting use and ~cuponcy ...~..~ ....................................................................................................... b. Intended use and occupancy ...... D~e..~...~M~ ............................................................................. Repair .................... Removal .................... Demolition ................... ~ Other Work (Describe) ...................................... 4. Estimated Cost ...... ~..br.~0.Q~ ....................................... Fee ....... 3:..0. ............................................................................. (to be paid on filing this application) 5. if dwelling, number of dwelling units ....... .~1~ .............. Number of dwelling units on each floor ............................ If garage, number of cars .............OXle ....................................................................................................................... 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 ...~L~.~. ............. Depth ....~,~ ................... Height ............................ Number of Stories ...OX~ .................. 9. Size of lot: Front ..... ~.0 .................. Rear ........ .~..~). .............. Depth ......~..~ ................... 10. Date of Purchase .................... ~-...~.... .......................... Name of Former Owner ....~.o...s..e.~..~.....~.........]~..~.~...~..~. .............. 11. Zone or use district in which premises are situated ........ ~.~ .................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ................ ~'.~.W ............................... 13. Name of Owner of premises ..~.,~r~s].::LT~ ........... Address ......... ~'.~..A~.q.~; ...........Phone No ..................... ' Name of Architect ...................................................... Address ............................................ Phone No ..................... Nome of Contractor ..... ..~..~..a.~..~.....~..o..m...e..a.....~.~ ......... Address ......... .8. e...~..~...e..~.. .................... Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock 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. N STATE OF NEW ~01~ ) S S ............... ~~ .~ ........................ being du~l~ sworn, deposes and s~¥s that he is the applicant · (Name of ihd[vidual signing apl~fcation) . above named. He is the ................ .~Da~L~,~.~.~;D~. ................................................................................................................ (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 end file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner'set forth in the application filed therewith.^ Sworn to before me this... ]~(~,ellL13e~. · i 9 ' -- / ~ ..................... .......... ........................... Notary PublJc,~.~~nty (Signature of appli~6t)