The URL can be used to link to this page

Home My WebLink About2280-zFOP,~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY W ' THIS CERTIFIES that the building located at ....~..t.g.?....?....O...~.~...~./,..~.....~.~.~..~.~.....~,.d.. ...... Street Map No,~.~.b...~..O...~..~..~..,... Block No ....... ~ ........ Lot No. ,.~ ........... .~.~ ........................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................................... ~,....~ ..... 19.~,~.. pursuant to which Building Permit No..~.~,q..~. dated ~ 8 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 ........ ~ivate one f~i~ d~g.~.~ The certificate is issued to ..~r.~..~r.~.....~..~.~]~ ......................... ~.~ ......................... (owner, lessee or te~nt) of the aforesaid building. H.D. Approval May al 196F BY U~ev~,a~,..-'~. c~.-~ ~-~ci3~,l&~.,~ FORM NO. ~ · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BEKEPT ON THE PREMISES UNTIL FULL COMPLETION oFTHE WORK ',~UTIZIORIzED)~' 2280 Permission is hereby granted to: . ...'....~ ....... lO~ti~h~lbt ................................. ........... to ...~l,3,.~:..ae~...one..zm, t~...~w~zz~ae~...-i ............. L..: .................. ..... .................................. at premises located a~t ~/~..R~,W.,..~...~/$..~,~,;.~-~e.~,..]~Q~..,.(,Z~8~..~O~*~;) . .~..o.~g.o...z.~, ,~.,i,.,...~.,~ .......... : ......................... ,-..... pursuant to ~pplication dated ....;,.;.,..,i,..,,.~,l~t~'3t~'.~..~ .......... '.~.,.., 19.~.i, 6n~l apprOved by the'' Building inspector Fee . -- Building,'lnsl~ector / . SCHD SOFFOLK COUNTY DEPART~NT OF HEALTH TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at have been inspected by this Department and found to be satisfactory. District Engineer TOWN O.F SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ,. :¢;~.....~,.'-'. ....... , 19 ..... Approved .....~ .................................. , ] 9 ........ Permit No ................................. ............... / t ........ (~uilding Insp clot) .... ........................................... .................................. Application No. 'P- '-)- ~L-tb APPLICATION FOR BUILDING PERMgT Date ..~.......~...M..g ............................. , i9.2t~-'-'~...... 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 property must bedrawn on thediagram 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 opplicont. 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 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 and regulations. (Address of applicant) State whether applicant/is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of prem.se' ::~.~..~.'.,~.~ ~r~~ ' ~~"~'~"~ : f" '~;'~'~ '" ' '6 ....... : ........................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work wilt be done. Map No: .~'9~ ~.~~..-Lot No: .~.. .............. Street and Number .~U'~,~.~.~..'~...~M.:-~ii,~-~}.',J~'rf~.. ............................................................ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~..~/O.~G..~.. ..... b. Intended use and occupancy ........................................... . .~. b~..C~ .......................................................... 3. Nal~ure of work (check which applicable): New Building ..... '..~..... ...... Addition .................. Alteration ............. Rap'air .................... Rempvalfl .................... Demolition......~, ............ Other Work (Describe) ........................ 4. Estimated Cost -- (to be paid on filing this application) 5. If dwelling, number of dwelling units ......./. ..................... Number of dwelling units on each floor ........................ If garage, number of cars ......................................................................................................................................... 6. If I~usiness, commercial or mixed occupancy, specify nature.and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front .......................... Rear .......................... Depth Height ............................ Number of Stories ......................................................................................................... Dimensions of same structure with alterations or additions: Front ................................ Rear ............................ Depth ............................ Height ................................ Number of Stories ........................................ 8. Dimensions of entire new construction: Front.....~L~..~) : ............. Rear ...... '~.~).. .: ....... Depth .~.. : ........ Heif~ht ......... /...-,~ ............. Number of Stories ......~ ............. 9. Siz~ of lot: Front ................................ Rear ............................ Depth ................................. .~..... 4JLt, 10. Dat~ of Purchase.<~.,,~...J.~./.~.a/.~. Name of Former Owner~... Zor~e or use district in which premises are situated ...... 12. Does proposed construction violate any zoning law, ordinance or re§ulation? ~..~ .......................................... .. No(ne of Architect ...................................................... Address ............................................ Phone No ................ JL... Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions property lines. Give street and block numbers or description according to deed, and show street names and indic whether interior or corner lot. STATE OF NEW Yz~.l~///~,/,~ S S ., .............. ~ ....................... being duly sworn, deposes and says that he is the applicc ~Name of indi~'j~'ual signing application) above named. He is the ..................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said o~;ner or owners, and is duly authorized to perform or have performed the said work and to make and ijile this application; that oil statements contained Jo. t~i%0~l~}plication are true to the best of his knowledge and belief; ~rtt~ ~o~e~lisbe perfumed in ~, ~t?t~0~[~ application filed therewith. .............. ........ i,. ~.~.~Z ~. . ~ ~ ~ ~ ......... ~;~'""~'~;?"~':~ ...................... ~'" Nota~ ~?~~..~:~~~ ~ ,~.gnaturo of opphcant)