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Home My WebLink About2615-zFOPoM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ....Z._22,48. ......... Date . THIS CERTIFIES that the building located at ~V~,. ~a~r..Ga,~cl~e;~.s..~a.~...F,8:lc,. Street Map No ..... ~ ......... Block No ..... ~ ........ Lot No ...... 3.~5 ..anc~.J.l[6 ................................. conforms substantially to the Apphcohon for Building Permit heretofore filed ~n this office dated ..................... I;)ecem:hea~....~.~ ........ , 19 6.5 pursuant to which Building Permit No .2~,5..~ dated ............... Dec-ent~e~'"'.l,~ ......... , 19 ..... 6,.~,as issued, and conforms to all of the requirements of the apphcable provisions of the law The occupancy for which th,s cerhficate ~s issued ,s ........ .......................... l~s4.den~e ................................................................................................ The certificate is issued to ..~:t..~..,l.ant..l~,...t~l~l.~.~-~t ....... .,a./~.....~,~.l,~u~'..-K.,....~1:la.~n .............. towner, lessee or tenant) of the aforesaid building FO~ NO. 2 TOWN O~ SO~TNOLD 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? 2615 z Permfssion is hereby granted to: .............. ~.h~],d .............................................. to ....... ]~.~.d..-m~..add.t.t~Ler~-~,~ .~n..~4.s~.[~..d,~e.~-t~Lnl~ ................................................... at premises located at .... .~Lo~,.~I~..~,.ll-.~*..~,.~]4~ .... Ge~zt.d,:l,t'~i~l~..]g~l,~r...~ll.~;~.~;el~. ...................... pursuant to application dated .......................... I~ei~... ~ ................. , 19..(~., and approved by the Building Inspector Fee $...~..130. ........... mUllalng fnspec~r FO~ NO, 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN C, LERK'S OFFICE SOUTHOLD, N. Y. Application No. ',,~,..,~..',,~.,..~.. ........ Approved ........................................ , 19 ........ Permit No ................................. Disapproved a/c ................... jj:zz~ ...................... ~.,.-.:.-T..7..~..~,..~.. .......... ~.~ --- Z/ ................ ....................................... ~ (Building I7~ector) API~LICATION FOP, BUILDING P£RMIT .......................... INSTRUCTIONS a. Th~s application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin~ Inspector. b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or public streets o~ areas, and gwing a detailed description of layout of propertymust be drawn on the diagram which is part of this application. c. The work covered by this apphcation may not be commenced before .ssuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permzt 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 Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Buil&ng Department for the issuance of a Building Permit pursuant to the Budding 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 apphcant agrees to comply with all applicable laws, ordinaries, building code and regulations. / (A dress of ;'pS'l'J~anu ,',Z~ State wheth,9~applicant is o~wne~lesse~tect, engineer, general contractor, electrician, plumber or builder. ............ ;,,...,..,- ............. Lz- cz. zzc, ................... .................................................................... Name of owner of prem.ses ............... ~~/~:....~.~ ................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) i 1. Location of land on whicht(~~ ~ ~z--~ /,/,b)~ ~ffpr°p°sed work will be done. Mop No: ............................. '"~""L' ....... Lot/~ .................... Street and Number ..ki~..~...~~....~...~. · .~......'I...~-~ .................. a. Existing use and occupancy ...... ~-~ .-¢.m .r.~ .................................................................................... b Intended use and occupancy .... ~,~ ....................................................................................... 3. Nature of work (check which applicable) New Building .................. Addition ....~ ........ Alteration ................. Repair .................... Remo?~ ................... Demoht~on .................. Other Work (Describe) ................................ .~-'~ ~./~.~ ~.0~ ........................................................................................ 4 Eshmated Cost .................... ~..~... ......... ~ .................. Fee (to be pa~d on fihng th~s apphcahon) 5 If dwelhng, number of dwelling umts ......... ~.. .............. Number of dwelling umts on each floor ........................... If garage, number of cars ..................................................................................................................................... 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use ............................... 7 D,mens,ons of ex,sting structures, ,f any. Front .... ~..~.~.~.~.~.~.~.~.~... ........... Rear ...... .~....'q...'~... ........ Depth ...~r....~.....~... ....... Height .... /./~...'. ............ Number of Stories ........... /.. ........................... ~.. ..... ~...._ ........................................... D~mens~ons of same structure w~th alterations or aad~hons-- Front ..... ~... Rear ............................... Depth .............................. Height ............................. Number of Stones ........................................ 8 D~mens~ons of entire new construction Front ~.. Rear .......................... Depth ........................... Height .......................... Number of Stor~es ............................ / 9 S,ze of lot. Front..../.~....~.....~. ....... Rear ........ !...'~.....7......~... Depth ..... /.....)~....~.. ............... 10. Date of Purchase ........................................................ Name of Former Owner .............. ~. ...................................... 1 1. Zone or use district m which premises are s~tuated ....... ~.. ............................................................................... Does proposed construction wolate any zom~g law, ordinance or regulation~ / 12 /~. ~/'~"~ ~ ,--'~ ~'~ ~ ~-,, ~:~,/~//'? ' ' ......... ! .......................................... t3 Name of Owner of prem,se~zx~....'.z.../~¢~...~.4:.~,ddress-~-.~..~~.~ Phone Name of Arch,tect ............................................. .v;...~ddress .................................... ~;...;a Phone No ................... Name of Contractor ddres ' Phone kl~ PLOT DIAGRAM Locate clearly and d~stmctly all buildings, whether ex~shng or proposed, and ~ndicate all set-back d~mensions fror property hnes' Give street and block numbers or description according to deed, and show street names and ~nd~cat whether ~nter~or or corner lot STATE OF NEW YORK, ~ S S COUNTY OF .............................. ~ ............................................................................................... being duly .sworn, deposes and says that he is the applicar (Name of individual s~gmng apphcat~on) above named. He ~s the .................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and fil th~s apphcat~on; that all statements contained in this apphcat~on are true to the best of h~s knowledge and behe and that the work wdl be performed m the manner set forth ~n t.he apphcation fded therewith Sworn to before me this ............. Z (~ ...... day of ............./'~:~...'~..~...., 19 ........ ~ I~J~ 1 ~ 1) r.' ~<? (~ ~-//~ -,~ ~ ' ~- --~ z.~ ........ :...v~..~ ~..LL~.,....~../~/~....:.:~ .............. Notary Pub',c /..)...~....~....q.~'..~.....~. ...... ./...%~...~: ....C~p0~?~y';'-':, ." "---'~ , .,cr?gnature of applicant) Term Expm,s ~',~arch