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Home My WebLink About2766-zFOlh'~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z.... ~.2.~.0. .......... Date ................................ THIS CERTIFIES that the building located at .~/~,....G~.O~t~,..R~)~iX]. ................................ Street Map No ....... ;~ ........ Block No ........... ~_~ .....Lot No .......~r,~. ............ J~oll.t, ho~l,dl.....~,~, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................. ~ .............. .~.~......, 196.~.... pursuant to which Building Permit No. ~7~"~.. dated ................................ J~a~'"'"2~' ....... , 19.6.~.., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ..... ~.~..~.~.a.te.. one..~m./,l¥...d.we~l$~g ............................................................................................ The certificate is issued to ...A~bez'.~..&.ge,'L~..C~.e~a.~ ................... O~z~ez'.~ ........................ (owner, lessee or tenant) of the aforesaid building. Building Inspector 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? 2766 z Permission is hereby granted to: .C..e.~J,~...~.~.el.~.~.~ .............................................. ~ro~e Rd ................... J5 ~u~ho:Izl ......................................... to ... · ~u~ ld · · an.. &ddt.t,'- ~t~.. ~il.. ~1~..®r~ ~t ~r~.. 4~®1.1 .:~n~ ...................................................... ct premises located at ...... .~:~.C/~..ROIi.d~.....J~I.]..1...C.o]JDI~K ............................................................. Southold pursuant to application dated ........................ ..~. ~. ......... ~,~ ................ 19..~'., and approved by the Building Inspector Fee $ ........................ FO~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×om ned .......... , 19 ........ Permit No ............................. Approved ........................... ~.~. ......... "~ c~ ~ 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 pa:rt of this application. c. The work covered by this application may not be commenced before issuo,nce 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 whol~ 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 a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or P, egu~ations, for the construction of buildings, additions or a~terations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. Albe:2t C ze tatka../.C~l&a · ~ ~latt~a ................................... (Signature of applicant, or nome, if a corporation) (Address of applicant) State whether oppiicont is owner, lessee, agent, orchltect/ ngineer, general contractor, electrician, p[umber or builder. ......................................... a. ~..e..n.&...~..f ~.~' ................................................. Name of owner of premises .......... C~].ia..~ze~tka ........................................................................................................ 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.: ..... Z~...~...~. ......................... Lot No.: ....?~ ............. Street and Number ....... .G:~...L~oa~.....[v[l~...C.o[lmn.y.~......~u2.hoJ. d ......................................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........... d.~e3~3.,'L.~(% ..................................................................................................... b. Intended use and occupancy ............ '.'q..a..~?.'...~.Jr..t.~...~.~...~...cl:~-.~-.~.i...O..~.. .................................................................. 3. NatUre of work (check which applicable): New Building .................. Addition .....~... Alteration Repair .................. Removal .................. Demoht~an .................. Other Work (Describe) .................................... 4. Estimated Cost ........... .~....~...-~.. ........................... Fee i ~' (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... ~ ...... Number of dwelling units on each floor If g6rage, number of cars 6. If I~usiness, commercial or mixed occupancy, specify nature end extent of each type of use 7. Dir~ensions of existing structures, if any: Front ............. ~...~. ....... Rear .......~....~. .................... Depth Hei~lht ........................ Number of Stories D~mens~ons of same structure with a.lterations or additions: Front .................................... Rear Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .......... C.~.. .................. Rear....[....~.. ................ Depth ....'~...~..~...~. .... Height .................... Number of Stories 9. Size] of lot: Front ............... .~......~..... Rear ...... ?......'~.. .................... Depth .....r~.~ ........... Former 10. Datb of Purchase ........................................................ Name of ~Owner 11. Zor~e~ or use district in which premises are situated ............ 12. Doer proposed construction violate any zoning law, ordinance or regulation? · 13. Name of Owner of premises ..~....~m.....~..~...~i~ddress ....... ~..~ ......................Phone No. Name of Architect ...................................................... Address ............................................ Phone No. NoTe of Contractor ...~....~?~;:..~....Address ..... ~...~. .......................... Phone No. ] PLOT DIAGRAM Locatb clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions property lines. Give street and block number or description according to deed, and show street names and whether interior or corner lot. STATE O~ NEW~ .S.S. COUNTY ..c'~......being duly sworn, deposes and soys that he is the appliC (Name of individual sig ' obow; na~ed. He is the ~ ~ (Contractor, agent, corporate officer, etc.) of said o~ner or owners, and is duly authorized to perform or have performed the said work and to make and this applidatJon; that oil statements contained Jn this application ore true 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 before me this .............. o: .......