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Home My WebLink About2468-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATe OF OCCUPANCY THIS CERTIFIES that the building located at E/¢ ]B~y' A~'e Street Map No ....................... Block No ....................... Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ~'tt. ly 27 19 6b¢ pursuant to which Building Permit No, 2)+68Z dated ~T"o.~.,~' 27 '~ 6)+ s Iss ........................................................ , ~y ........ , wa ' ued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ..... .t. t,.e. . . .o. . .n. . . t. . .:]:. Z . . . ............................................................................. : ............. The certificate is issued to ....~,~,~.~',.?.~;..?...e..~..~...~. ............. ,.(~,.~l.e..~. ................ i .... ~ .... i. .......... (owner, lessee or tenant) of the aforesaid building. FOKM NO. ~ TOWN OF SOUTHOLD 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? 2468 Z Permission is hereby granted to: c re, yin..O,?. ~t.h.~.o..h...L....~..g... AI.~ .~I...~: erz'~. ............. ........ C.~tt~haw~m .................................................. to ...~..a......m.....~.a...a.~.~J,~n..~....~a..mcLatJ~...~:Z~ ..................................................... at premises located at ...~...~.~.....~,..~.,~. ........................................................................................................... ........................................ .g.~.~.o~o~ ~..... l~. Z. .................................................................................. pursuant to application dated .................................... ~ ....... .~...., 19..~'., and approved by the Building Inspector Fee $...~..e...C~.. ............ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ t9 ........ Permit No ............................... Disapproved a/c ................. ................................. APPUC^TION BU DIN PERMIT Application No. c~g ~ ~ INSTRUCTIONS o. 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 drawn on the diagram which is part of this location. c. The work cov, ered 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 shaft 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 Inspe~ctOr. APPLICATION 1S HEREBY MADE to the BuiJding Department for the issuanoe 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 a Iterations, or for removal or demolition, as herein described. Zhe applicant agrees to comply with all applicable laws, ordinances and regulations. ...... ..................................... (Signature of applicant, or nome, if o corporation) ,~ (Address of ..................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................. ................................................................................................ Name of owner of prem ses , . !.~...~-..~., ~...[ Z.-r~.~..~._~..~. 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. Mop No: ............................................Lot No: .................... Street and Number .............~..~..~..~'~.....~6(.~. ........... ~.f~' ,4 ~..'.~.,. ~ .~./,.. .... ~' Muni~pal ty 7' ...................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a, £xisting use and occupancy ................ ~ '; ............................................................................................ b. ntended use and occur~ancv ....... ,~.~,K..~./,,~..'-~4~ 3. Nature of work (check which applicable): New Budding .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ~z; z"~- Fee (to be paid on filing this application) $. If dwelling, number of dwelling units ................................ Number of dwelling units on each floor ............................ garage, number of cars ..................... ............... ~...~,'~;~- .................................................................... If -- fe 6. If business, commercial or mixed occupancy, specify nature and extent o ach 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 ........... f. ............... Rear .............. ~ ........ Depth .....~ ................ Height ............ ~.~ ........Number of Stories ............~ ............. 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated .............. m.. ,~ ........................................ 12. Does proposed construction violate any zoning bw, ordinance or regulation? ....... ~ ..................................... 13. Name of Owner of premises~g~.~ ....... Addres~~.,.~..~.....Phone M,me of Architect ....... 9 ................................ ~ ............ Address ............................. 7 ............. Phone MO ..................... Name of Contrector(~2,,,..L,.~aZ~ ........ Address ~;~.M.,.~x~/~....Phone PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Gfve street and block numbers or description according to deed, and shaw street names and indicate whether interior or corner lot. STATE OF NEW Y, ORI~,/ , z') S q ' .... ,~ COU TY OF ..~....~. ' ': .......................... be ng du y sworn, deposes and says that he is the applicant (Name of individual signing application) /-') , above named. He is the .............................................................. : (Contractor, agent, corlborate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the s~id work ~nd to mqke ~nd file this ~pplic~tion; that ~11 ~tatements contained in thi~ ~pplic~tion ~re true to the be~ of his knowledge and belief; and that the work will be performed in the manner set forth in the applicat~ fi[e~ therewith. Sworn to before me this ~,M¢' ~ ~'/~-~a,, of ~, ~., 19..~.':~ sm~ ~ ~ ~i~nature of apphcant)