The URL can be used to link to this page

Home My WebLink About2968-zFO~H NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERk'S OFFICE SOUTHOLD, N.Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at lil.ol:lll~,..V. IL.ev/..~.V. ellue. ............................ Street Map No ..... ~ .......... Block No....XXX ........... Lot No, ~ ..................... 80,latl~OLcl .................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................ .lD~CI~ll'...3i0, .............. , 19.65... pursuant to which Building Permit No. dated ............ '...lileC-~ll~e~...3,1. .............. , 19..65.., was issued, and conforms to all of the requirements of the applicable provisions of the ~aw. The occupancy for which this certificate is issued is ........ .................... ~¢lclitlo~.. ~.o.. an~,.. ~ml. ly... cl~ ~t 1.lng .................................................................. The certificate is issued to ..~li'~.O~..~.g~U.l~. .............................................................................. (owner, lessee or tena,nt) of the aforesaid building. Building Ins~tor''--~ FORM NO. 2 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? 2968 z Date ............................ B~e~mbe-:¢......~t..., 190.~... Permission is hereby granted to: to ...~Bw. it(~...a.n..edd.i~.mom..cm...an...exi~.~.:[~..ch~.~:~ .............................................. : ....... at premises located at ..... '~'/~'"'~¢>~"V'~I'-A'~e ................................................ ~ ................. : ....... · pursuant to application dated': .......................... Dee ....... ..~.O .............. 19.~.., and approved b~ the Building InspeCtor '-, Fee $.~.,.0.0 ............ , Building inspector. I~OEM NO. 1 Examined ........................................ , t9 .... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Approved ........................ ~..~ .............. , 19 ........ Permit No .................. ................ ......................... Application No. ~/ APPLICATION FOR B'UILDING PERMIT Date ................... , 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 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 pa rt for any purpose whatever until a Certificate o~ Occupancy shall have been granted by the Building Inspector. APPLICATION IS H.EREBY MA,DE 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 oE buildings additions alterations, or for removal or demolition as herein described. The applicant agrees to comply with all applicable lows, ordinances and regulations. / ~-~ (Signat~,fe of applicant, or name, if ~ corporation) .......... ..................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. _ Name of owner of premises ...... ~..~~ ....................................................................... If applicant is-o, corporate, §igna~re of duly~aJthorized officer. (Name and title of corporate atticS'r) 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 and intended use and occupancy of proposed construction. a. Existing use and occupancy ~~ . b. intended use and occupancy ~~ .................................................... . ..... 3. Nature of work (check which applicable): New Building .................... Add,ition ...~.. Alteration .................. Repair .................. Remova! .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost ..... ~..~.O....~ .............................. 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 occupa,ncy, specify nature and extent of each type of use .................................... 7. Dimensions of existing structures, if any: Front ...... .~...~=... ........... Rear ...~....'z~ ................ Depth ~.~,.~. ...................... Height ...~....~.. ................ Number of Stories ....,~...~..~.~ ............................................................................................... Dimensions of same structure with alterations or additions: Front ...... .~..,?-~z... ................ Rear ~.'C..~ ..................... Depth ....~..~. ................... Height ................................ Number of Stories ....~m~-~....~././~.,. 8. Dimensions of entire new construction: Front ........... ~'.......Zm~... ........ R~ar ....... /'...~ ............. Depth ./...O. ......................... Height .............................. Number of Stories ...O;~d--~. ............. 9. Size of lot: Front ..../....-~...$..'~... ........... Rear ..../....'~-..~..~... ............... Depth ....-~.....~..¢ ................. 10. Date o~ Purchase .......................................................... Na,m~ of Former Owner ........................................................ 1 1. Zone or use district in which premises are situated ..... ./.~.~'¢.~ ................................................................................... 12. Does proposed construction violate any zonina law, ordinance or regulation~ ...!...~. ................... 13. Name of Owner of premises~.-~...':~,,~~.... Addres~.~.'.~...~...~, ...... Name of Architect~/~ ~-Z/~- ,~-~ ~r~-~~ ............ '~ ........... ~' .................. Address i:~~iiii:i:iii: Phone No ................... Name of Contract~ ,....,_....~.~ ........ Address Phone No .................. PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, a'nd indicate all set-back dimensions from property lines. Give street and block numbers or descriptlon q,ccording to deed, and show street names and indicate whether interior or corner lot. STATE O~ ~ COUNTY OF ..~ .......... ) °'°'~' ~ ~ ................. ~.~~ ............. being duly sworn, deposes and says that he is he applicant (Name of individuoI~,~nin~~ o.bove homed He's 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 this application; that all statements contained in this application are true to the best of his knowledge a.nd belief; and that the work will be performed in the manner set forth in the application filed therewith. ~ Sworn to before me this ~, .-~ ,~ / ........ '..'~...J....~..-T.~... day of ...~..~~..., 19...~...'~ ~)~~ ............. ...... ............. Notary Pub.._~..,.,.~ .... .... ~ty,:Ec:,T (Signature of applica.nt) " No. 52-3233J20 Suliolk Cou,qty ~^~'~ir~ M,grl:h 30. 19~~7