The URL can be used to link to this page

Home My WebLink About2810-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. CERTIFICATE OF OCCUPANCY No. Z..2,.~21 ............. Dote ....................... ~ecember.....l~..., lc~.6~'.. THiS CEP~TiFI~'S that the building iocated at -~/~...*.ge]: .~i*a.....R~)a~: ...................... Street Map No..~,~(~,~. ........ Block No .......0.~.~.,.A.,... Lot No.~ ......... ~O.~.~O],~,....~.~.., ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................................... ~.U.~.~ ....... .~. .......... , 19~.~... pursuant to which Building Permit No. ~].0.....~ dated .................................. J' .~.~....$...., 19.~.~.., was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ .. P~, ive, t e...one...f.~mily., dwel&$m~ .............................................................................................. The certificate is issued to .~./~.}l.El~.~.~,..~a.~**~(~,~. ............................. 0~*~C*~ ...................................... (owner, lessee or reno*at) of the aforesaid building. H.D. Approval Dee. 13, 196~ by R. Villa ! ....... ................ Buildin~ Inspector FORi~[ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KJ~PT ON THE PREMISES uNTIL FULL COMPLETION,OF THE WORK AUTHORIZED) 2810 z Date 8 19 6~' Permission is hereby grcnted to: ot promises locofed ol ........................ ; ..................................... ~ ...................................................... . . pursuant to application dated ......................................................... , . and approved by the Building Inspector .~0,00 Fee ~ ........................ Build[no InspectOr SUFFOLK COUI~I~ DEPABi?IEh~f OF HEALTH Date ~d~. ~'e~.~ No. ~g/O ~- TO WHOM IT MAY COMCE~ disposal facilities for a structure located at have been inspected by this Department and found to be satisfactory, District -- ~is'trict Engineer FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined 1 Application No ............................. ~)-~ / 0 Approved .Permit No....~......~....~.O...~ Disapproved a/c ............................................................ (Building ~spector) APPLICATION FOR BUILDING PERMIT 7/7/ 4 . Date ............................................................ 19 ............ 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 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 thb 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 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 alterations, or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building ~de and regulatiof~s/x/.. State whether applicant is ow.ncr, lessee, agent, a~~eer, general contractor, electrician, plumber 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 w,6ork w,~l be done..M~ap No.: ....................... ; .......... ,.... I,et 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 ........................................................ ~'7} ...................................................................... b. Intended use and occuponcy ........................................................................................................... 3. Nat4re of work (check which applicable): New Building .................. Addition .................. Alteration Repa~ir .................. Removal .................. Demolition .................. Other Work (Describe) ..................................... 4. EstiMated Cost ..........~.Q..3..3...0....O. ................................. Fee ....................................................................................... (to be paid on filing this application) 5. If d~kelling, number of dwelling units ................ (--4.. ......... Number of dwelling units on each floor If go, rage, number of cars .............................. /. .......................................................................................................... 6. If bJasiness, commercial or mixed occupancy, specify nature and extent of each type of use ........................ 7. Dimsnsions/of existing structures, if any: Front ............................ Rear ................................ Depth .................... Haig.hr ........................ Number of Stories .............................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ........................ Dept.h ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ................................... Rear ........ D..V. .............. Depth ..... ..~...~.. ........ Hei ht ....... ./..q. ........ Number of Stories ................................................................................................................... 10. Dotej of Purchase ............. ..~./..7.~,~..(..6..~.~ ........................ Name of Former Owner ..................................................... 1 1. Zon6 or use district in which premises ore situated ................................ ~. ............................................................. 12. Does proposed construction ~iolole any zoning Iow, ordinance or regulation? ............. ~ .................................... PLOT DIAGRAM LocateI clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-back dimensions fr( property lines. Give street and block number or description according to deed, and show street names and indic( whether inti~rior or corner lot. J r0 ! STATE OF NEW YORK, 1, ¢ e ~, COUNTY OF ................................ ,( .... ,,/j ................. i ............... ~ .......... ~ ............... being duly s)tvorn, deposes and says that he is the applicq~n~ i(Name of individua~Jsigning application) /~ ,.. above named. He is the ...................................................... .*~,m*..~x ..................................................................... ~b... (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 application; that all statements contained in this application are true to the best of his knowledge and belief; that the w~rk will be performed in the manner set forth in the application filed therewith. Sworn to bj~,fore me this ......... · ..day of ....................... , Notorypu .. .. Count of ~ ,/'/ MARION A. REGENT i ~/ ~/OTARY PUBLIC, Slale of Nevi York No. 52-3233120 Suffolk Coul,ty Term Expires M. arch 30,