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Home My WebLink About2307-zFOP~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ....~....~........~...~..~...~...J?...~...~........~...~..~..? ................... Street Map No ...... ~ ......... Block No ....... ~ ........ Lot No ..... ~ ....... I~.1~. ............................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................... ]~41t~.eJX....J~ ......... , 19.~.... pursuant to which Building Permit No. ,....~..,~...,,~,. dated .............................. ~.~..~.........~......, 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 ........ ......... ~.i.v.a.~.e .. ~m,e...£aa,13,~...~.~ell~ ............................................................................ The certificate is issued to ....~..i~....¥..QJ.~...~. ........................ ~..1~.. ..................................... (owner, lessee or tenant) of the aforesaid building. ~.l>. N~pz'a~ral ~ 20, 196~ Building Inspector FOI~M NO. ~ TOWN OF $OUTHOLD 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? 2307 z Permission is hereby granted to: ........ ~.2.~ ....... ~oata~c..~. .............................. to ...Bull&. haw.. cts.. ,e~m~Ll~..d~e,l,l~ng .................................................................................... ct premises located at ...%//~.....%/&te~.l~®~..DZt. iJ/~ ........................................................................... pursuant to application dated ........................... MIL~.....9 ...............19~))+.., and approved by the Building Inspector Fee $...3~.O..e..Q~... ........ ~'~ ouilaing inspeclo'~ ~ .............. ~..%~.~f ....... ~.:~, .......... SUFFOLK COUNTY DEPARTMENT OF HEALTH Building Permit No.~ c~SJ 7 ~ TO WHOM IT ~Y CONCERN: /~ The sewage disposal facilities for a st~uc~ture located at .... ' .... (GiVe deed locatio~ ' ~ have been inspected by this Department and found to be satisfactory. 'JUL ! ~Z 1~6A FOI~! NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ....... .,~~....!...(.., ~9...~.,.'./ ^ppro ed " " '° ........................................ , 19 ........ Permit No .......................... Disapproved a/c ..~~ ........... ......... (BuHdin~ Inspoctor) APPLICATION FOR BUILDING PERMIT, INSTRUCTIONS o. This application must be completely filled in by typewriter qr 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 o detailed description of layout of property must be drown on the diagram which is port 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 o 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 po rt for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION JS 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. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .............................................. B~ILD~ ........................................................................................ Nome of owner of premises ......... J. Oi'~..V.O.I~¢,,~ ........................................................................................................................ If applicant is o corporate, signature of duly authorized officer. (Nome and title of corporate officer) ]. Location of land on which proposed work will be done. Mop No: ............................................ Lot No: .................... Street and NumberN/.~wa~e~view~D~i.~e..(.~.~..)..~.~{~.~e~...~.7.~3....~.~se~.~e~k~H~gh~..~ /V~unicipaJity £imo 2. State existing use and occupancy of premises and intended use ond occupancy of proposed construction: a. Existing use and occupancy ................................................................................................................................... ' b. Intended use and occupancy ........... ~_fa~t.~r..~z~ .................................................................................. 3. Nature of work (check which app'hcable) New Building ...... I~. ......... Addition .................. Alteration ............... Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estirhaf'ed Cost ....~DI~0,00 ......... : ......................... Fee ....................................................................................... , (to be paid on filing this application) 5. If d~,elhng, number of dwelling un~ts ..... ~ ...................... Number of dwelling units on each floor ......................... If gqrage, number of cars ........................ '~ ...................................................... ' ......................................................... 6. If bj~siness, commercial or mixed occupancy, spec.ify nature.and extent of each type of use ............................. 7. Dim~ensions/ of existing structures, if dna: Front ........ ' .................. Rear ............... ' ....... '.... 'Depth ........................... Heif~ht ............................ NumBer of Stories ....:..~ ......... : ............ : ........ '..:...:.:...:.....~...'...: ........................................ Dimbnsions of same structure with alterations or additions: Front ................................ Rear ............................ Depih ............................ Height ................................ Number of Stories ........................................ 8. Dimensions of entire new construction: Front ....... I~! ................... Rear ............................ Depth ...2~.~. ............... Height .......... ~,.~.? ............ Number of Stories...........~ ............. : ........ 9. Size of lot: Front ..~1,~0! .................... '.. Rear ...~.l. ................. Depth ........ 2(~..~ ......................... 10. Date of Purchase ..... l~..J,..~..~..J~..,~,~ ..................... Name of Former Owner 11. Zone or use district in which premises are situated ....... ~,~l~¢lll~Jli,J.~, ................................................................ 12. Does proposed"const¢Crction vi'olate any zoning law, ordinance or regulation? ... ............ lJll ................................ 13. NonCe of Owner of premises ..... Jlll~l~..~[ll,~. .............. Address ..~,,,~2 ........ ~1~,~.... Phone No .................. Narqe of Architect ...................................................... Address ............................................ Phone No .................. Name of Contractor ~.Ot~..~JI~...lJJ~lmll..l'lCi~,, ......... Address ..~.~j{.JJlm.~l~:~:~.~ll~r~ .~j,.~....~__.,,.~__~ Phone No.~,.-..~,~.l~.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro property lines. Give street and block numbers or description according to deed, and show street names and indic~ whether interior or corner lot. STATFOFiNEV~YO[R~ ,~, )~,. ~J,,?7'~g., //zg/47 ~,.. COUNTY OF ~~.). ~'~,' .......... r,~~...:~.~4~~ ............... L....z:Being 'duly,sworn, depbses and says that he is the applica : (~me of individual signing ap~i~~ above named. He is the .......................... ~.~.~ ......................................................................................... (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 fi this applicdtion; that all statements contained in this application are true to the best of his knowledge and belie and that the work will b~ R~.rform~d.~)p the manner set .fqtth in t~e application filed therewith. , ........................ Notary Public, ../~/~~. County ~(Signature of applicant) .[