The URL can be used to link to this page

Home My WebLink About2292-zFO~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ..... Z..18~.1 ......... Date ......................... ,-~,F.....13 .............. , '~9..0.~.. THIS CERTIFIES that the building located ot .B/J] ........ ~[~..J~.~.~ ................................ Street Map No. ~ Block No. ~ .... Lot No. ~ 80~¢~O[d conforms substantially to the Application for Building Permit heretofore filed in this office dated ......................................... ~ ....... ~ ........ , 1~.... pursuant to which Building Permit No ..... ~ dated ............................. Ee~l~.....~., 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 ........ .... ~s~e~s...~Z4[~ ............. ~.....e~.~e.e...e[~ ........................................................................ The certificate is issued to ...~ee...~8 ......................... O~e~. .................................................. (owner, lessee or tenant) of the aforesaid building. Building Inspector FOEM NO. 2 TOWN OF SOU~HOI. D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING ~ERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2292 z Permission is hereby granted to: ........... ~h~l~ ......................... : ....................... to ... ~BG~:I~ ..~e~ ..~&.n~s $...~)~t. t4t~ ............... ~. .................... : .......................... ; ....... .~ ............... at premises located at, ..... J~J.J~..J~t~..JJ~d9 ........ .'..-'~....".~tl...~,l~ ........................... : .............. ; ....... ................................................... ~.~h~l~,,.....~,z,..,..L ............. ....... ......................... ~ ........................ pursuant to application dated ....... ,., ................................................ :.., 19 ........ , and approved by the NOTE. ~ermit ~u~e~ ~O. ~la~ a~p~oVe~ by ~abe~ De~t. Building Inspector Fee $....~..0.,....~. ........ Bu!ldlng- nspector ~ FOI~ NO. 1 TOWN aP SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exemined ............ ...... , 19 .. Approved ,~,. ~/~,3~-~ ~ . ............................... ...................................... 9 ........ Permit No. c~ Disapproved a/c .............................................................................................. (Building I~s'~ector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must 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 detailed description of layout of propertymust 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 Building 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 granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Perrnit'l~u'rsuant 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, es herein described. The applicant agrees to comply with all applicable laws, ordinances, b~?ing code and regulations. ~,~hature of applicant, or name, if a corporation) ....... .o...z_a.' ........................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................................... :...'.....O~e~. ........................................................................................................................................ Name of owner of premises ............ .(~&~...~*...~..~,Jl ....................................................................................................... if applicant is o 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: ............................................ Lot No: .................... 3~0' Eas~ of Town Harbor Lane on Main Road Street end ~umber ........................................................................... J... .......... .'.,: .................................................. ~ ....... Municipality 2. State existing use and occupancy of premises and intended use 'and occupancy of propbsed construction: e. Existing use and occupancy .......................................................... ; ........................................................................ ~eal Ectate Office i b. intended use and occupancy .......................................................................................................... ; ...................... property lipes. Give street and block numbers or description according to deed, and si)ow street names whether inferior or corner lot. .~, /,,, 3. Nature of work (check which applicable): New Building ...... .~ ......... Addition .................. Alteration .............. Rep.air .................... Removal .................... Demol t on .................... Other Work (Describe) .................................. 4. ' Estimated. Cost .......... ~400';'0~ .............................. Fee ........... ¢~.~.n...0Oo ............................................................ ..... I ~t"5~e pa d on filing th~s oppl cation) 5. If dwelling, number of dwelling units ............................ Number of dweiling units on each floor ........................ If gl, aroge, number of cars ....................................................................................................................................... 6. If business, commercial or mixed occupancy, sp~t~ nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ""~O~ ............ Rear .......................... Depth ........................ Height ............................ Number of Stories ........................................................................................................... Dim, ensions of same structure with alterations or additions: Front ................................Rear ............................ Dap;th .............................. Height .............................. Number of Stories ....................................... 8. Dir~ensions of entire new construction: Front '"~.'"~'N~ ....... Rear ,,.~,,,,~t~ ........ Depth ,,~1,,,~"~,~, .... Height ,....~O..,~.N~ .......Numbe~ of Stories ,,,~11~ ................. 9. Size of lot: Front ..... J~.'~'"'~lli'~'" Rear.'"'~l.'~'O"'~, ..... Depth "~GO'"~ ........... 10. Date of Purchase ................. ~ ..................... :.].~.~ ...... Name of Former Owner 11. Zone or use district in which premises are situated ...... i~ ....... ~111~.~111...]~.11~S~,~ ................... . ................. 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? .............. i~ .............................. 13. Na~e of Owner of premises (i~'~.~®'"R'~'"~.'II ...... Address ..~.~..~1..~.i. 1~,a.~%~.I1.8. Phone Narhe of Architect ...................................................... Address ............................................ Phone No. ' Name of Contractor (],~.~1~...~....~,~.~,11 .................. Address ~l~,l~..~i~,~,~3~,~]:u~lJI... Phone PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-ba~k dimensi'ons fr 'and indic STATE OFI NEW YORK, COUNTY pF ....... ~.~.~]~ ........ / S,S. --- be nn duly deposes and says that~he is the applk ................. ~ ............ ;~"~.~.~,'"]~i" '~I~'"';:" ". '"~ ............... ~ sworn, (Name o?~na~waua~ s~gnmg opp ~cat~om above named,~He is the ........................ ~ontractor, 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 applicbtion;_ that ail statements contained, in this application .... are true to the best of his knowledge and and that t,be work will be pe,r,f~ormed m the manner set forth ~n the apphcahon filed therewith. Sworn to bt~foze me this / / ~ ~-~ ~7 ~. day of ~ .~.~.~'~, 19 ,~Z'~,' fl),, /::,j .~' - ................. . .......... Notary Pu$1ic,//./..qzn'z~....~..~.~.l~....r...-/.~. -Coun-fy ~pi~^ ~. ~^l.k~tignature of applicant) ' / // z k~OTARY{~rqlC, State of New York ~, // ~,"o, b~13,~2900, Suffolk County -- Tarot Expires March 30, RIVERHEAD BUILDING SUPPLY CD. 303 DSTI~A"IDER AVENUE P, tVEVHFAD, N. Y. /