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Home My WebLink About2471-zFOlt~I NO. 4 TOWN OF$OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..~.....~ar~e~..~ ............................. Street ~astern Shores sec~ I ap No ....................... Block No ......... ~X ......... Lot No..33., ........... ¢l'r.e.~n~..qE.t..,...~:.~: .............. conforms substontioJJy to the Application for Building Permit heretofore flied in this office doted ................................... ,T~J~,~r.....~.~ ............ , t9....~.~ pursuant to which Building Permit No...~.~.?.~..,~. dated ........................... J. LI~Ly .......... 28...., 19....~'..tl; was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ ... ~r £~. at o...one.. ,£ ~,~....~.~:~.ll~P..g .~ ........................................................................................... The certificate is issued to ..]~.l~.~p.~.O~..~O~e~..~ .............................. ~.~..~l..e.~. ................................ (owner, lessee or tenant) of the oforesaid building. Building Inspector/ FOI~H NO. 2 TOWN OF sOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S- OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMLT MUST BE KEPT ON THE PREMISES UNTIL 'FULL COMPLETION OF THE WORK AUTHORIZED) N? 2471 Z Date .......... , .................... ~t~,.....~ ......... , ,y.~'. Permission is hereby granted to: tlmptaa....~eaee...~e....~ ............................... ........ ,...~a~t~m,'-~ .................................. Building Inspecto[': FORM NO. 1 TOWN OF SOUTHOLD DUILDING DEPARTMENT TOWN CLERK'S OFFICE Examined ....... , 10 ..... Approved ........................................ , 19 ....... Permit No .............................. ~ APPLICATION FOR BUILDING PERMIT °ate ............................ 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 adioining premises or public streets or areas, and giving o 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 issuance of o 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, building code and regulations. (Signature of applicant, or name, if a corporation) ,, (Address of applicant) State wheth,e~./~plicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............. ........................................................................................................... Nome of owner of premises ...~...'~........~7..7~.......'~..~...~....~m. .............................................................................................. i~,p/~r, ic~)~/t,~,s a cor~ture of ~,)y ~d 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 ......... ,.. ! ............................................ ~ ........... ~ ............... ~ ....... ~ ........................................ Municipality 2. State existing use and occupancy of' premises end intended use and occupancy of proposed construction: o. Existing use and occupancy ~ ~ .............. b. Intended use and occupancy ~ ~ ~ ......................... 3. Nature of work (check which applicable): New Building .... ~ ........Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Fstimoted Cost .. .~...~...o. .......................................... Fee .......................................................................................... (to be paid on filing this application) / 5. If dwelling, number of dwellino units ............................ ~umber of dweHin~ units on e~ch floor ..~ ....................... If garage, number of cars ....~ ............................................................................... .'. .................................................. 6. if business, commercial or mixed occupancy, specify nature and extent of each type of use ....~.~ .............. 7. Dimensions of existing structures, if any: Front ...~.~ ......... Rear ...... ~ ............ Depth ...;..Z.: .................. Height ............... ~ ............ Number of Stories ~ . ..... ' Dimensions of same structure with alterations or additions: Front ...... ~ ...... .~ ................ Rear ....Z'Z..~ .................... Depth ............... ~ .............. Height ......~.J]~Z ...... ......Number of Stories ....................................... ...~. 8. Dimensions o~ entire n~w construcfian: Front ............... ~ ............ Rear ............. ~ .~ ........... ~t .............................. H~,ht ....~..~..~..~ ...... Number of Stor;~s ..... ~ .................. ~. S[z~ of lot: Fron~ ...... ~.~ ............. R~ar ..... ~.~..~ ............. Depth ....~.~ .................. 10. Date of Purchase ...........~ ........ H.....~...~ ................ N of Farmer .............................................. ~ ................ 11. Zone or use district in which premises are situated ................................................................................................. 12. Does proposed constructian violate any zoning law, ordinance or regulation? ..~ ............................................ Ow.e of Nome of Contractor ............................................................................................. ~ ...... ~hone PLOT DIAG~M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot, STATE OF NEW YORK, COUh~ ,'~/ OF ..................... ~~~~' ben duly sworn, deposes and~says that he is the applicant ...:IZ..:C ................................................................... g (Name of individual signing application) above n,amed. He is the ........................................................... ~.'~'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 application that all statements contained in this application are 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 before me this ,',r . . ...... .............. dayof ........ .................... , ........................................................... Notary Public, . ........... ~ ............... ~¥11~'~u~/~i~','st~te of i~ew ¥orl( (Signature of applicant) ~"~"'~" ' /'~'""'""'"~'~ .... , ,,~ ~ fxpires M~rch 30, 19L~