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Home My WebLink About2608-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWht CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ..... ~,...:2 .l ;18 ......... Date .............................. ,l~p~ ;i, ~k .. ,1,.~. ...... , 19..~.~.. THIS CERTIFIES that the build,ng located at .... ~.ecJ.1,1a~h ..~kV~atl.l.l~l~...C~'%Q~flJ~... Street Map No..~JJ~ ........... Block No...~ ....... Lot No ...... ~ ............................................. conforms substanhally to the Apphcation for Budding Permit heretofore fded in th~s office dated ............................... %~%:'..:L~., 19..~4. pursuant to which Building Permit No 2J~.Cl8~ ... dated ......................... J~t~m]e~...[.~..., 19...~j~, was issued, and conforms to all of the requirements of the apphcable prows~ons of the law. The occupancy for which th~s cerhhcate is issued is ........ ............................................................... One...£amil~..d~e~ ~ ~g. .................................................... The certificate is ~ssued to ............... ~'.,...l~.~...~Zl~J~-; ........................ : .............................. [owner, lessee or tenter) of the aforesaid building 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? 2608 z Permission is hereby granted to. to .... ~tilA.. a~..~d.i.t~en.. ~..a~.. ea~.i~t.l~g..~1~et.l.~ ..................................................... at premises located at "l~/~'"'~'13~I"'A~ .................................................................................... ............................................... g~t~ltog~m ..... l~.'~ ............................................................................ pursuant to application dated ................................. ;D~II~-~ .... ~.t~ ........19..~., and approved by the Budding Inspector Fee $.~'. I~lO .............. Building Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ............ Approved ........................................ , 19' ........ Permit No ............................. (Building I nsp~or) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a Th~s application must be completely filled in by typewriter or in ink and submitted in duphcate to the Buildin, Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets c areas, and g~wng a detailed description of layout of property must be drawn on the diagram which is part of this apphcc tion. c. The work covered by th~s apphcation may not be commenced before ~ssuance of Building Permit. d Upon a,pproval of th~s apphcat~on, the Building Inspector will issue a Building Permit to the apphoant. 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 m whole or m part for any purpose whatever until a Certificate of Occupanc shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to th- Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances o Regulations for the construction of buildings, additions, alterations, or for removal or demohtion, as hereto described The applicant agrees to comply with all apphcable laws, ordinances and regulations. ........ (Address of applicant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ..~en~l...O.o~t r~ ~.~ or. ...................................................................................................................................... Name of owner of premises ....]~...:.....~....A..~,~.O...~..~.~.~..Z'...e. ..... If apphcant is a corporate, signature of duly authorized officer (Name and htle of ~'orpofat~officer) 1. Location of land on which proposed work will be done. Map No ~..~.g~J~..,/~.~.~..q..Lt.~?.... Lot No.: ..................... Street and Number ....~..~.g~.~l,~.~i,...~..y.~., ....................................... .O..~.9..~..9.~.g..e. ................................................. Municipahty 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction. a ~isting use and occupancy~.~.q~ ....................................................................................................... b Intended use and occupancy .~.~.~.~.~.~g~. .................................................................................................... 3 Nature of work (check wh,ch applicable): New Building ............... Addition ......... .~ .....Alteration ............... Repair ................ P, emova! ................. Demolition ............... Other Work (Describe) ................. 4. Eshmoted Cost ~2~000 ...................................... Fee ~5~O.O ................................................................. (to be paid on filing th~s opphcobon) 5 If dweJhng, number of dwelhng umts ..... 1. ................... Number of dwelhng umts on each floor ...... .1, ............... If garage, number of cars ..................................................................................................................................... 6. If business, commeroa[ or m~xed occupancy, specify nature and extent of each type of use ................................. 7 Dlmens,ons of exist,ng structures, ,f any Front. ;~J~' .............. Rear ....... ~.~..t. ............. Depth ...~..~.~.~.t.t. ............ Hmght ...1..~..~. ................... Number of Star,es ............ ~ ........................................................................................ D~mens~ons of same structure w~th alterations or add,hans Front . ..~./~.~. ..................... Rear .~ ......~..~.t. ............... Depth ...3,~.t..~..t! ................. Height ....... .~..~..~ ............... Number of Stones ..~ ........................... 8 D,mens~ons of ent,re new construction Front ...~.Q.~. ................ Rear ......... ~..0..t. .............. Depth ..... ..]...~..t. ............... Height .... .1~3.~. ................ Number of Stones .... .~.. .................... 9 Size of lot' Front ...,~g..0.! ............... Rear ....... .~..0...0..~ ............. Depth ~.6...~..~.....~..9.....]:~..~.].. 10 Date of Purchase ........................................................ Name of Former Owner ...~...1:..e...8:.~..O..~.. .................................. 11 Zone or use d~strict in which premises are s~tuated .~Ifl.~.$~ ....................................................................... 12 Does proposed construchon wolate any zoning law, ordinance or regulation:) ....... ~...O. ............................................... 13. Name of Owner of premises ]~.,~,.~l,q~..n..~.~'~ ...... Address g.~..~..q~.g..e. ......................... Phone No ................. Name of Architect ................................................... Address ............................................... Phone No ................. Name of Contractor ~:J.~.~'..~..T~o~J~gJ:t ........... Address ..... g,.g,.~.g~q~.~l.9. ..................... Phone No.~.~....~...~.6..8. PLOT DIAGRAM Locate clearly and d~stinctly ali buildings, whether existing or proposed, and red,cate oil set-back d~mensions fro~ property lines Gwe street and block numbers or descrtpt~on according to deed, and show street names and indicai whether interior or corner lot ' (Name of mdiwdual slgmng appllc~i~[ ~ above named He is the ..................................... ~~~ ................................................................................. (Contractor, agent, corporate officer, etc ) of sa~d owner or owners, and is duly authorized to perform or have performed the sam work and to make and file thi, application; that all statements contained m this apphcatlon are true to the best of h~s knowledge and belief, ant that the work w~ll be performed in the manner set forth in the apphcabon f~led therewith. Sworn to before me this ~ ......... .............. ................. Notow Publ~'L' .~.X~.t....~... ~ ~g~¢ , ']'r~(S,gnature of opphc~t) / /