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Home My WebLink About2804-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. CERTIFICATE OF OCCUPANCY No. "Z'""~'~']~ ......... Date ..................... ,Tan.ua~'y.....6 ........... , THIS CERTIFIES that the building located at '"'l~'~'O~'l~i...~./..We.8~ha.]:.i~..~ .......... Street w~g!~o~...!?.z..~.a..~}. B~oek ~o ....................... ~ot ~o ....... ~at:~i.~l~,.....t¢,.~., ....................... conforms substantially to the Application for Building Permit heretofore filed in this office doted .................................. ~.~ ......... .9 .......... , 19(~... pursuant to which Building Permit No. ~C~......Z dated ................................ ~T~t~.~ ....... ~....., 19.~.., 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 ........ ..... .I~i.v a.t e...o~e ...f. amtl.~. · c~wet~,lnt~ ....................... : ......................................................... , ......... The certificate is issued to ...... ~'~['l~"{}i~l~,~FiS.'~ ..................... ~et'. .......................................... (owner, lessee or tenant) of the aforesaid building. 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) NO, 280~J z Date .............................. ~'ll~,.]r.....~.. ............ , 19~,.~... Permission is hereby granted to: A. Reill~..&..$ons...Ine....~/C.....J.....~t~be~t. ...J~tti-tuek ...................................................... to ..... ~t-tO..em..~..elit.~o~ .. on" m~ '-exi~ci,,~'' d-~t~ir~ .................................................... at premises located at ....... ~....~8~,phl~t.i.~..J;J~J ........................................................................... ................................................... $ia.~ti.~uek. t...-..N¥.~f~ ........................................................................ pursuant to application dated ................................ ~[tl~r..~ ............... 19~.~.., and approved by the Building Inspector Fee $.~,~)~ ............. Building Inspector TOWN OF ~OUTHOt~D BUILDING DEPARTMENT TOWN GLER~('S OFFICE SOUTHOLD, N. Y., Approved ...................... t.~. .............. , 19 ........ Permit No ............................. Application No.....~......°C~..~....~. ....... (Buildin~ Inspector) .................. APPLICATION FOR BUILDING PERMIT Date ........................ . .J..u..1. Z .......... .2. .............. , 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 premi.ses or public streets or areas, and giving a deCailed description of layout of property must be drawn on the diagram which is part of thi.s 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 HEP, EBY 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 code and regulations. · &.....Rei.l.l.y..~..S oz~s...Zzza .............................................. (Signature of applicant, or name, if a corporation) l~a.t ~i.t~.ck .................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................. q.o.~..¢..~ ~..q ~..o.~ ....................................................................................................................... Name of owner of premises ...~,~....lg.'i~bez'.n~.t; ................................ 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..Map No.: ...... ~OJ.Z~.~,...~]l.~f~.$.~D~ Lot No.: ........................ Street and Number ....~.~..~¢,.~...~.....~.~.~.~.~.~..A~.9.~ ....... ]~.~.~.~q~ ................................................. Municipality 2. State existing use and occupancy of premises and intended use and ~cupancy of proposed construction: a. Existing use and occupancy ............ ~.~ff~.~=~ .................................................................................................... b. Intended use and occupancy ............... ~D~...~...~d~.~.%~ ........................................................................... 3. Nature of work (check which applicable): New Building .................. Addition ....~ ....... Alteration Rep6ir .................. Removal .................. Demolition .................. Other Work (Describe) 4. Estimated Cost .~.Q,...O..O..O.. ........................................ :,..Fee ..... ~ ~ (to be paid on filing this application) 5. If d~elling, number of dwelling units ...... f~x"le ............... Number of dwelling units on each 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, Jf any: Front ............................ Rear ................................ Depth Height ........................ Number of Stories Dimensionsl of same structure wffh alterations or additions: Front .................................... Rear Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensionsk of entire new construction: Front ...... ].B ......................... Rear ......... ,!-..~ .............. Depth ...... ~.~ ........ Height .................... Number of Stones ..... Q~ ..................................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Datb of Purchase ........................................................ Name of Former Owner 1 1. Zon'~e or use district in which premises are situated ...... !!,6..~!......ql,$~.l~ ............. 12. DoepI proposed construction violate any zoning law, ordinance or regulation? ............. ,ZlQ.. 13. Nar~e of Owner of premises ....~..,....~..~.~.'p..e~,,.til..~ ........ Address ............... ~.~...~..%..~..tl:..o.~ ....... Phone No. ] Naqne of Architect ...................................................... Address ............................................ Phone No. Narpe of Contractor .~....]~,ei3ZZ.~...&..S .................... Address ...Lvis.~.t,.$.t;.~,f:~ ................... Phone No. PLOT DIAGRAM Locatj~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr property lines. Give street end block number or description according to deed, and show street names and whether i.nferior or corner lot. STATE O1~ NEW Y~,P,K, 1. S S COUNTY~OF .~11:k.~c~].lg .............,f ' ' ~ ~O~C] ~e~]~ being duly sworn, deposes and says that he is the app~k ~(Name of individual signing application) above na~ed. He is the .......... ~o~¢~.~.¢o~ .................. (Contractor, agent, corporate officer, etc.) of said o~ner or owners, and is duly authorized to perform or have performed the said w6rk 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 ~ork wiU be performed in the manner set forth in the application filed therewith. Sworn to ~efore me this { ...... Notary Pdblic, ~te ~ ~County ~SJgnature of applicant)