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Home My WebLink About2288-zFOI~M NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...Z...t9.7)~ ............ Date ...................... 4~-t,O~e~'.....,~O. ...... , 19~... THIS CERTIFIES that the building located at ...~f'~.*...J~/~',W.r..~./~....~.i.~t~-.~BO~,. ]~eet Map No....~:~ ......... Block No .......~ ........ Lot No ......~ ....... ~Oe~t~.:J.~...~.,.~ .................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................................ ~.~.ll,ll~t.~.~r......].l, 19.(~,.. pursuant to which Building Permit No. dated ............................ ~T~I~..~......;~.'i. ........ , 19..(~., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ...... ~r.:i,v~t e. · · e~e. · ..t.'m'mt .,I.y. · ~wet,l.l.n.~ .......................................................................................... The certificate is issued to -..~'.~...~4~..~...0..~....])1~]: ....................... (~/l't~,l* ......................... · ' ~awner, essee or tenant) of the aforesaid building. FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ' BUILDING PERMIT (THIS PERMIT MUS'~ B~ K~P'I"ON TH~ PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 2285 z Permission is hereby granted to: ................... t4~;.~$~ ....................................... pursuan~ to alSplication dated .....< ................ ,....~'~tl;~......'~ .... Building Inspector Fee ~..:.~..0~ .......... 19.~1~, end,approved by the I~UIlOIng inspector ~OP~ NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c~.. .... "" ...... (Building ~ r~,spector) Application No...'.~.....¢~.....~.,.~ .... APPLICATION FOR BUILDING PERMIT Date ...... ........... ..... INSTRUCTIONS a. This application~m'~st 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 detg~!ed description of layout of property must 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 E~uilding 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 in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been g~anted by the Building Inspector. APPLICATION IS HEREBY MADE to the E~uilding 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 ~nd regulations. ..... ................... (Signature of app icant, or name, if a corporation) ........................... .7..,.. .............. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .............................. ............................................................... Name of owner of prem ses ....~....~.-...~.,. ~...,~.~./~.~.,~.,,~ ~ ~).~.. ~Z.., If applicj~nt is a corporate, signature of duly authorized officer. .......... 1. Location of land on which.,,proposed work ,,~ill be done.. Map No' .~..~...~.....~...~..-'~.,,L~,. ...... Lot No: Street and Number . .~.. z~..~./,~.Z~. ,:('J~.~.../,~'......~_,..,~. ~..~_~_ .......................................................... .......... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction' a. Existing use and occupancy b. Intended use and occupancy .'..~J~...~.../.~.~...~'~,'~ 3. Nature of work (check which applicable): New Building .................. Addition ... '.~... ......... Alteration .~ ....... Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ..~l..~x.Z.~..~.....~: ...................... Fee ..................................................................................... (to be paid on filing this application) 5. If d..,welling, number of dwelling units ......~.~.~...: ............. Number of dwelling units on each floor ....................... If garage, number of ears ..... Z-..T-.Z .......................................................................................................................... 6. If business, commercial or mixed occupancy, specify natureand extent of each type of use ...................... .~ ...... 7. Dimensions of existing structures, ~f any: Front..~ .................. Rear ..~ ................... Depth ......................... Height ......... ...~....O..~...~../.. Number of Stories ......... ...~.. .......................................................................................... Dir0ensions of same structure with alterations or additions: Front ....~....~..~,..~ ......... Rear .......--~...~..~..~...". ..... Death .....~.~..~.,.~./.'~.~..~ Height ....... ..~....~...~.~...~ ....... Number of S~ories ...........~ ......................... 8. Dimensions of entire new construction: Front ......... ~..f2...~.4:9 ......... Rear ..... .~..~....-z..~.. ....... Depth . .,~'.i.~....'~/...~.. Height .............. ~..T./.~..~.~. Number of Stories......~.....,~...,~.~.. ................ 9. Size of lot: Front ....~.~.~.~..~...... ..... Rear ...... ~..~.:...~...~.. ...... Depth ..../.~..~..~.:.~.~. ............. / 10. Date of Purchase ...... ~g;./..':4 .~'..~.~..~.. ............ Name of Former Owner A~..,~.4~/,~..~...~..:.~...~.....~....~....' 11. Zor!~e or use district .in which premises are situated ........................................................................................... 12. Doeis proposed construction violate any zoning law, ordinance r regulation:~ ~' 13. Name of Owner of prem s~.~..~...~..~..~.ff..~...~'.,~.....~..~...'~..~..~'..ZAddress Name of Architect ...... .~......~..~.~.~:..< .................. Address ............................................ Phone No ................ Name of Contractor/~.'~zZ~.~,~..'...~...~'.~-~.~.~...~....~..~..4/~..Address ....~.~..ZZ/(.7.~...<..-(.;. ......... Phone'~.~z...~.?..4~..~. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr property li]nes. Give street and block numbers or description according to deed, and show street names and indi< whether in~erior or corner lot. A/~vZ~/'v ~, s ~a~/zo~ - 4~ v " STATE OF' NEW YORK, ) COUNTY DF ............................ ) S.S. ..... Z~,~...~..~.~...~. .............. being du'y sworn, deposes and says that he is the applic, (Name of individual signing opplicotion~ named. He is the ....................................... QBove , (C~ractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized~p~},~performed the said work and to make and of this applic6tion; that all statements containe~sna~jlL~Bn are true to the best of his knowledge and bell and that t~e work will be performed in the ~n~-~,t~ application filed therewith. Sworn to b~fore me tNs . z ~ Re..t g. ~ ~:~6~.~ 30, ~ .~ ~ . ........ .......... cloy f ........................... Notary Public, .~o.~.~ ............ ~C¢.. County (Signature Of ~ic~