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Home My WebLink About2343-zFOI'~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..~.~...~.~t..~O~, .................................. Street Map No ..... ZT~ .......... Block No, ,,,;~117f. ........... Lot No..;~w~f;. ....... .G.~...e..e...~.~3..o.~.).....~.?.]t. ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................................... J[]3~.[Z..~19...~..~. pursuant to which Building Permit No....;~3~3...;~ dated ........................... ~t.]0~'.:[~....~ ....... , 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 ........ ... ~.e~ ~cl. enee...~...~.e~t a'~.~... ~:c~,or~e ~L ............................................................................ The certificate is issued to ..~Gl~t~f].,.~;[,~3T~f,,,~es,t~t~.a.~.,.I~ .............. ~e~,~ ......................... (owner, lessee or tenant) of the aforesaid building. FORM NO. 2 TOWN OF $ouTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, N, Y, BUILDING pERMIy (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WoRK AUTHORIZED) 2343 Z ........ , ........... ~ .................................. · ........ permission is hereby granted tO: .... .~,.e..e..~mr~..~.,.~....,~ .................... i ............. to :~ .e....$.O...~....'e,~.~,~ .. ~,er.l.r~z~,~on~,~ ..~u~e ................. ~ ................................... . .......... ct premises located at ~,i~/~.....~t.'~,.~RO~...t....(O~ ....... ~:..~.; ............................................ .~. ..... ........................................... ~.~0%%~0~.t,.~... ~ L, ................................................................. pursuant to a~plication dated ..;~;, ......................... ...~.:~]~L,-..~.'i ..... 1<~{'....., bnd approved by the Building Inspector ~O~t ~I~ ~O~;L~d.i~:)~ ~0~ 0~ ~.1~'~ ~L~t3e~ Fee $.3,0~.~. .......... TOWN O F S D UTH DLD OFFICE ElF BUILDING INSPECTOR TOWN CLERK'S OFFICE SDUTHDLD~ ~o Y. RECEIVED OEP T, OF PUBLIC WORKS SUFFOLK COUNTY Date ........ Mr. Herman Btshol~ ~omrnissioner o~ Public Works Suffolk ~ounty Yaphank Ave., Yophonk, M. Y. Dear Sir: Middle Road E~t. CR 27A consolidated Lows of the State of New York, this is to notify the Commis- sioner of Public Works of the County of Suffolk that ..... has applied to the Town of Southold for a permit to construct a building on NI~ .. Nor.th .!~o.a~l.~ ...C~?.A.. ~ ....... .G~'.e..eP.1~.or.~.,... ~. ,.Z, ................ os shown on the attached plot plan, ,submitted in triplicate, doted Appall. We shall withhold further action on this application for ten days or as otherwise provided in the aforementioned Section 2391(_ 4/14/64 Approved to the Town o£ Very truly yours, Southold pursuant to Section 2~9K of fha Gen~l Municipal Law; before build-/ ng access to the County Road, a perm./^ · under Sec. 1~6 of the Highway Law wil~ be required. SUFFOLK COD~NTY DEPT ]?IIBLIC WORKS Building Inspector Bishop, Commissioner Town of Southold, N. Y. In accordance with Section 239K of the General Municipal Law of the FOEM NO. I TOWN OF SOUTHOLD BUILDING DEPARTM, ENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y.~ / Approved ..........e~ ................., 19......L.Permit No ................................. .... ...... ....... ........ : ....... ................................. 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 i'ssuance 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 oil applicable laws, ordinances, building code and regulations. (Signature of applicant, or name, if a corporation) ............ ~enpon~...L..L ................................................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contr.a. eto~ ........... Name of owner of premises ...~.Qlllld...~.I.~W..t~.S~&~TIt...Tn~9 ................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name end title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ...~ ....................... Lot No: ..,.~$;;:~ ....... Street and Number ...N/~..~OI'..~..~O.~Ld,..(~'~?~.,i~ ............~]~.~DD~.$.t...~]~ ................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... ~.~.~.~1,12,1~ ................................................................................................. b. Intended use and occupancy s~me w~th residenoe bld& 3. Nature of work (check which applicable): New Building...........,.....~ Addffion .................. Alteration .............. Repgir .................... Removal .................... Demolition .................... Other Work (Describe) 4. Estir~ated Cost .....~....~.~.(~)...~/.~ ............. Fee ....... :~.~. .......................................................................... (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 business, commercial or mixed occupancy, specify nature and extent of each type of use ...~..~..1.~.~.,~. ...... 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 ......... ~,~. .............. Rear ........ ,],~'. .............. Depth ........ ~,.b¢. ........... Height ............................ -Number of Stories ..,...0,,~ ................. 9, Sizeof lot: Front ............. ,,~)~. ....... Rear .....3~.~...~,~ ......... Depth ..Z0.0~.~/.~,-.~. .......... 10. Date of Purchase ........................................................ Name of Former Owner .................................................... 11. Zone or use district in which premises are s~tuated .............. ~...~...~,~.~ ............................................................ I2. Does proposed construction violate any zoning Iow, ordinance or regulation? ...................... ~,~. ....................... 13. Name of Owner of premises ...~otmd,..lI:Le.~....R~.~i~...:[j~.~ .................................. Phone No ................. Name of Architect ...................................................... Address ............................................ Phone No ................. Name of Contractor ..~.~,.~..~....1~..~.~.~. ........................... Address ......(}.~.e..~.~.~.?..~. ................. Phone No ................. 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 indict whether interior or corner lot. SEE ENGIN~I~R'S PLO~ PLAN ATTAC~ STAm COUNW OF ....... ......... / S.S. ............................... ~J::~.l ~,S..1A~mb~,~ ................................ being duly sworn, deposes and says that he is the applicc (Name of individual si~ning application) above narffed. He is the ................. I~.~&~.~l~ ............................................................................................................ (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 file this apptication; that all statements contained in this application ore true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. / Sworn to bbfore me this .................. .~ ..... day of ................ APP.~Z ............... ,19..~. ~ ~ ~ - ~ ~ ~ ,_ /~ I , - / ............. ........................ Notary Public, .~1~:,.~~ ...... ~n~/, /Z (Signature of applicant) ~ ~ 03 ~ .... ~.:e~ York ~~ ~