HomeMy WebLinkAbout2380-zFOlt~l NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE: OF OCCUPANCY
THIS CERTIFIES that the building located at .... .BeaQ~..(~ou,~.~; ....................................... Street
MG~rdiner~ Bay. E,st~TM
ap I'qo ....................... Block ~1o ....................... Lot No...~.~,t, .............. ~]a.~.t..~e~.~(;~ ..................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
................................... A,~L~. ......... ,,~Q,..., 19~... pursuant to which Building Permit No.
dated .............................. }/~r......l. ........... , 19.4~br.., 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 ........
.... p.~J,.v..~.t.e....~p,...~,ly.....~.v.e.~l~j~ .............................................................................................
The certificate is issued to ..~"3~[C,.~'SJ~e~,,~,.~'L~.~ ................... 0~3.e~.S ......................................
(owner, lessee or tenant)
of the aforesaid building.
FOItM NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE K£PT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 2380 z
Date ......................... JJJ~Jr .......... ~, ............... , 19~ ....
Permission is hereby granted to:
Joseph D t aJ.....A~.~ ..J~u~..~z~ · &..W~l~e .............
..... .~.~W~h..Av~ ...................................
.................... G~o~t ......................................
to ,..t~..bu~L~d..~a~..a~d.~.~.t~n...o~ ..a~.. ex.S -s ~.~1~ .-d~e-l.:~ ~t~ ................................................
of premises located at ..~ll~;[~¢~'.lB..J~J~t..~ll~4~eJl ........ l~m...~.(~i.v*..[~l~.ll- ..............................
.................... : ....................... JBeach..CLo~m f.~ ....... Eaat...,.~ar~[on .......................................................
pursuant to application dated ........................ &J;l~,.t.~......30 ............... 1~......, and approved by the
Building Inspector
Fee $5,.~ ..............
Building Inspector
;~ r' :' ar ~ ~ ~OWt~ OF $OUTHOLD
~' . ::":"~'" "~J'II~DING DEPARTMENT
TOWN CLERK'S OFFICE
~/~ .~.. SOUTHOLD, N. Y.
Examined .........
.
Approved
......... ~.Pormi~ Mo. ~..~.~...~...~
Dis*pprovod, o/c ........................
................. .......................
Application No. ~' ~ o~
APPLICATION FOR ~UILDIHG PERMIT
I NSTRU C'FI ONS
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 be drown on the diagram which is part of thi,~ applica-
tion.
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 applico,nt. 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 pui'pose whatever until a Certificate of Occupancy'"
shall have been granted by the Building Inspector.
APPLICATION IS H.EREBY 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, alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances and regulations.
........................... : .........
i~,/~ne¥~'~e o~ c~p~ii~'~'~t,'~'~'~or~, if a corporation)
............................. --
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pJumber or builder.
............. ......................................................................................................................................................
Name of owner of premises
If applicant is a, 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.: ../....(...~.. ..........
Street and Number ...... ~..~L ......... ~...q.~.,/ ............... .~...~...~..~.J.~.~'.. ~.~...~..~..'/.~..~.~,~' ........
Municipa{itf .....
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction.
a. Existing use and occupancy ... /~r..~-~ ~'..~...~. ...................................... . .....
b. Intended use and occupancy
3. Nature of work (check which applicable): New Buitdihg .................... Addition /'"'/ Alteration
Repair .................. Remova! .................. Demolition .................. Other Work (Describe) ..................
(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 ..............A/.¢.~V.'~. ............................................................................................................
6. If b~siness, commercial or mixed occupancy, specify nature a,nd extent of each type of use ...............................
7. Dimensions of existing structures, if any: Front ........ .~,..q..~ ............. Rear ......... .~..~.'. ............ Depth ...... ..~...~.~ ...........
Height ...../..~. .................. Number of Stories ....~ .............................................................................................
Dimensions of same structure with alterations or additions: Front .......... ¢..~. ................. Rear ......... E.E. ............
Depth ...... ~..Z,. .................... Height ......... /...~.../. ............... Number of Stories .......cz'e~. ..................
8. Dimensions of entire new construction: Front ......... .~ ................... Rear ....... 2..~ .................. Depth ......~.'Z'.. .............
Height ........ /.5.: ................ Number of Stories ..... ~x.~ ................
11.
Zone
12. Does proposed construction violate any zoning ]aw, ordinance or regulation? ........ ~/.¢!.x~.~ ....................................
Name of Architect .................................................... Address ................................................ Phone No ..............
PLOT DIAGRAM
koaaCe clearly and distinctly a!i buildings, whether existing or proposed, o'nd indicate all set-back dimensions fi ~m
property lines. Give street and block numbers or description a,ccording to deed, and show street names and indicate
whether interior or corner lot.
STAtuE OF~ NEW Y~R~! .,~) SS
COUNTY OF ..~) ,' '
....;~7~~~;..x~,~ ,' .~ ...................................... being duly swo,r~, deposes and says that he is the applio
(/ ' (,J~ame of individual si~(j~hg application)
a,bow; 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 file
application; that all sta,tements contained in this application are t'rue to the best of his knowledge and belief;
that the work will be performed in the manner set forth in the application filed therewith.
Sworn to me this
Notary Pdblic
(Signature of applic~