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Home My WebLink About2602-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ............Z...2143.. Date .............................,~pZ'.;L.l....22 ...... , 19.65- THIS CERTIFIES that the building located at .~l~a~..J~.er~ie.,...C~fT..cJtDgi, te ............. Street Map No..l~o.~....Jjel~tBIock No...:Jt;X~ ............ Lot No ........ 55..Sk~t,..p~..~£..S4 ........................ conforms substantially to the Apphcahon for Budding Permit heretofore filed in this office doted ................................ ~O~lat:ig~:~...7. ........ , 19..(~j~. pursuant to which Building Permit No. 26~2~ .... doted ....................... .]:)~C _~_m_.l~e~C...'Z ....... , 19...15.z~, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which th~s cerhficate is issued is ........ ........................................... a~.a~..he.~...~S~.~C~g~a ...~.~...O~e...~1~....~/.~.~, ~.~,1~[ .......................... The certificate is issued to ...... W.~.}.[.¥~..i~._...~~ ........ i~/'~'~:'i~'~-~'~"~'t~i .............................. of the aforesaid budding. Building Inspector[ FOF, DI 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°. 2602 Z Date .......................... t)eee,r, ber.....'F ....... , 19.(~.. Permission is hereby granted to: ~om ...lq:a'hee.-..,A/e,.--.'iem :...eoz ............................. ......... t1~1;%~1:~Ic ................................................ to .... Du~ '~8'"arr 'a~di'ti'~'"~ "~'"~I'~ %'i'~'"8~1~ ~ ...................................................... · F ........................................................................ at premises located at ...... J~O%' ~JL ........... ~.J~;~ ......................................................................... ........................................... &/B'""~r~ek'"~ei' ........ OutchoKue .................................................. pursuant to application dated ................................ :Del~' ....... ~ ........... 19..(~1F., and approved by the Budding Inspector Fee $'"'~:*'00 .......... Building Inspector TOWN OF SOUTHOLD BUILDING DEPAI~,TMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ................................. Disapproved o/c ...... Application r~o ........................... (B~ Inspector) APPLIGATION FOR BUILDING PERMIT Dote ................ ~.....C~.. ...... ~ .............. ,19....~'.,~.. INSTRUCTIONS o. This opplicobon must be completely filled in by typewriter or in ink and submitted in duplicate to the BuildinL inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o, areas, and giving o detailed description of layout of propertymust be drawn on the diagram which is part of this applicotion. c. The work covered by this application 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. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No budding shall be occupied or used in whole or m 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 $outhold, 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 apphcont agrees to comply with oil applicable lows, ordinances building code and regulotion~s. (Signature of appl~'~c~nt, or name, if a corporation) ........... ..... ............................ (Address of opptic(~6.t) State whether opp. licont is. owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....................................................................................................................... If applicant is 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: ...... ~....J~.~...~...~.~!.~'. .......... Lot No: ..~.,.~.-~....~...'.~..(. unic~pality 2. State ex~st~ng use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy b. Intended use and occupant ................................................................................................ 3 Nature of work (check which applicable): New Budding .................. Addition .................. Alteration ................. Repair .................... Removal .......... .~, ....... Demolition .................... Other Work (Describe) .................................... 4. Estimated Cost ........... ../....~.....~......~ .......................... Fee ........................................................................................ (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. D~mensions of existing structures, if any: Front ....... .,.'~..,.~. ........... Rear Height ............................ Number of Stories ...........~....~~ .................... 7 ..................................... ;; .......... D~mens~ons of same structure w~th alterations or additions: Front .......... .~....~... ............. Rear ....... Z......~.. .............. Depth .......~......~...~....~....~.. Height .............................. Number of Stories .... .,~...~ ............ / Dimensions of entire new construction: Front ......... ~,.~ .......... Rear ............................ Depth .......................... Height ............................ Number/ of Stories ...... ..~...,:~....~ ~ a.~ / ........ Depth ........ $~ze of lot: Front .......... ,~'., .~,., ......... Rear ........................................ Date of Purchase ........................................................ Name of Former Owner ...................................................... 1 I Zone or use district m which premises are situated ............................................................................................... 12. Does proposed construction violqte any ~ning~law, ordinance~.~~or reg.ula~j3n? .................................................... 13 Name of Owner of prem.ses ~.~..<..' .~...~ ........~....Address ..~~w~. ............ Phone No ................... Name of Architect ......... f__/,' ,,~ ~ ~,-' ............................... ~.z...Address .............. 7Y'~' ....................... Phone No ................... Name of Contractor~ .~...-m....~.~.....~....~.....Address ~.f~..~~..~-. Phone No~..~......~....~.., PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro property hnes. Give street and block numbers or description according to deed, and show street names and in&ca whether interior or corner lot. o 9. ~10. (Name of individual signing application) . /~ /' ~ above r~amed. He is the ............................ ..C~.~...~...~(.../.../.~.~.~.~...~....~. ............................................................................. (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 application; that all statements contained in this application are true to the best of his knowledge and bel and that the work wdl be performed in the manner set forth in the application filed therewith. Sworn to before me th~s -, ~ /~ ~" ............ ......... ............. '"-~I'IO?ARY,rL'~'~,t.,,~ ~,z'~",;~,'Y, or'~ .......................... / '--" T.~.'.......'"'-. ........ .,~'....',...................,....../ ,.~'-"~---<,--t;..~.. . / I" ~ ~ ,,~ ,,, " ~c_.~-~----~ ' ~' ?~C ' ' ' Notary Fubhc,/..~;&~.~,.~,%~..~..~,~.~.'~, .......... County+/~,~,~ /~ (S,gnatu~of apphcant)