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Home My WebLink About2623-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .Beebe-..D~..&..Aat,.].~'...~. .................... Street Ma~.....~..O...~.?.. ........ Block No ....................... Lot No .~.~f. ....... (]~;~h~'~"'N'~'~ ................. conforms substantially to the Apphcat~on for Building Permit heretofore filed m this office dated ................................... ,~ec..~_]~e~.....~?/., 1~¢ .... pursuant to which Building Permit No...2~,.~.. dated ............................... D~.O~..~.O ........ , 19~R-..., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which th~s certificate is issued is ........ Pz'.iva~e..one...~.aat.ly..~t~e.l.l~g ............................................................................................... The certificate is issued to ~O~a:Qd..,~.]Jaa~t ........ 01~1e3¢. ............................................................ (owner, lessee or tenant) of the aforesaid budding. H.D. Approval April 26, 196% by R.Villa ........ .'.:4 .............................. Budding InspeCtor TOWN OF SOIJTHOLD BUILDING DI:pART/v~ENT 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? 2623 Z Date .......................... .]Deee~t]~F ....... .~0., 19.(~1~.. Permission is hereby granted to: ~ .. ~b.l:~s.....&/~...-l~o.l.~-~.. Bo.~mm ............ .............. C~teh~ue .......................................... to Bu~L~..~ew..~tw.£~m~..1~.. ~wei.~r~ ..................................................................................... c~t premmes located at .... ~..,,~y .... ~o~e..Gove.... ~i~ ................................................................ .......................... l~ee~e.. ~. &. '/ua~'l~'. '~ i"'" 'Cutehcrgu~ ¥" '~'; 'If; .......................................... pursuant to apphcation dated .......................... X~O, .......... ~ .......... , ]96~ .... and approved by the Building Inspector Fee $~O.00 ............ Building Insl~ctor SCHD SUFFOLK COUNTY DEPAST~NT OF HEALTH TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at · - (Giv® deed 16cation)' ' have been inspected by this Department and found to be satisfactory. " ' District Engineer FOR~! NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Examined ..................... ~.....~...r..., 19 ...... Approved ........................................ , 19 ........ Permit No. ~ ~ 3 ~ ~ ~sa~roved a/c .............................. ~ .............. ~ ......................... ~. ............... ................................. INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buitdir Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giwng o detailed description of layout of propertymust be drawn on the d~ogram which is part of this applicatio c The work covered by th~s application may not be commenced before zssuance of Building Permit. d. Upon approval of this application, the Budding Inspector will issue o Building Permit to the applicant. Su, permit shall be kept on the premises available for inspect,on 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 Occupon, shall have been granted by the Building Inspector APPLICATION IS HERE. BY MADE to the Building Department for the issuance of o Budding Permit pursuant to ti Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances . Regulatmns, for the construction of buddings, additions or alterat,ons, or for removal or demolition, os herein describe. The apphcant agrees to comply wzth oil applicable laws, ordinances, building code and~ns. ......... · ....... ................. ............... State whether applicant is owner, lessee, agent, architec,~pngineer, general contractor, electrician, plumber or builde Name of owner of premises ............ ~...~ ......... ..~......~ ......................................................................... If applicant ~s a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on wh ch proposed work will be done. Map No: ..~L~t~....~ Lot No' ~' x(~ Street and Number .... ~....~....~.~.....~..~..~ ................. iiiiii iiii............i iiiiiiiiiiiiiiiii.. Munic~pahty 2. State ex~sting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....................................... ..._.._......_~.... ................................................................ b. Intended use and occupancy ................................~ ................ ..., 3 Nature of work (check which applicable): New Building .................. Addition .................. Alteration ................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ..................................... Estimated Cost ..................... ~..?~.~..0. .......................... Fee ......................................................................................... 4. (to be pa~d on filing this application) 5. If dwelhng, number of dwelling units ............... ........... Number of dwelling units on each floor ....~...'~.../.~.~., .......... If garage, number of cars 1 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 .......................... Depth ........................... Height ........................... Number of Stories .............................................................................................................. D~mens~ons of same structure with alterations or addmons: Front ................................ Rear ............................... Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front .............. .~..~.~. ...... Rear ........... ~.....~.. ......... Depth ....... .'Z...~.. ............. Height ............ ./.~. ............ Number of Stories ........ ./...~...~. ............ 9. Size of lot: Front ......... /...~.. ............. Rear ............................ Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ...................................................... ] 1. Zone or use district in which premises are situated ............................... ~ ............................................................ 12.Does proposed construction violate ,anw zonina~aw, ordinance or reg/~lation .................................................... ,3.Name of Owner of pram,sas Phone ................... Name of Architect .......................... ,, ........................ Address Phone No ................... Name of Contractor ..~ ...... ~ .................... Address ii~'.~~iii Phone No.../~..~...?.....~..~../. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions trot property hnes. Give street and block numbers or description according to deed, and show street names and indicat whether mnterior or corner lot. .too STATE OF NE%'V YORK, ~ ~ ~ COUNTY OF ...........................r~..~'~'~' ..................... ~....~.....,~..(?,~r)~ ................................... being duly sworn, d~ooses and says that he is the appllc~ (Nome of irf~l~viduol signing application) above named. He is the ................................................................. .-~..~:.,~......'rz..~" ............................................................... (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 th~s apphcat~on, that all statements contained in th~s application are true to the best of his knowledge and bali and that the work w~ll be performed in the manner set forth in the application filed therewith. ........................ r