The URL can be used to link to this page

Home My WebLink About2829-zFOH,M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ~,/,l~...~O~ld,...~.~./,t,~.~¢ ...................... Street Map No....X~{ ........... Block No. ~ ............... Lot No ............. XXX ................................................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................. -~tI~IU/t.~,..2, ............. , 19..G.5. pursuant to which Building Permit No. 21~.2g...Z.. dated ....................... ~1~1U~...2 ............. , 19...6.5, 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 ........ ............................... ~dd~.t£on..'to..~.e~l,..es,t~e.. and,. Znsuranue...Off~ce, ....................... The certificate is issued to ~L~iL~:~1~P~``Ge~V~G~~1~P~`~Z~V~&~~ .... (owner, lessee or ten~:nt) of the aforesaid building. FOPoM NO. 2 .TOWN OF SOUTHOLD BUILDING DEPARTI~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHQRI'7ED) N'.° 2829 z Date ............................................................ , 19 ........ Permission is h~reby granted to: ~/ . ...................... .......................... .~.:?...: .................... ~ ......... i ......... at premises Iocoted a~ .................................... .-.~ .................................................................. . ............. pursuont to opplicotlon dotod ....:J~.~.~.,~..~..~: ....... ~ .......2 ....... 19....~, ond o~prov~d by the Building Inspector Fee $ .................... .... Building Inspector FOR~I NO. I TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ..................... ................... ~~'L~;;ri ......................... Application No. ~.L. ~.~ .~, APPLICATION FOR I~UILDING PERMIT ........ 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 this applica- tion. c. The work covered by this application m~y 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 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 of buildings, additions, alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regubtions. (Signatqre of applicant, or name, if o corporation) .... ................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................................................. ~..~./ff.~,..~.~..~, ...... ..~..~.. ~ ..T. ~. ~.e~ ..~.0. f~ .................................................. Name of owner of prem ses ......... ...V./~, ..I,, .~..., ~..~..Y. *~: ........................................................ If applicant is a, corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ...................... Street and Number ..L~..U~I ~ .l.k,.Oeq.~...;>....I......O..................... Municil~6lity " State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Ex~st~n~ .se a~d occupancy ..~/..~.C. ~ ~.ZZ~.~.....~..~..U.~'.~.~..C. ~.: .C~.~.~..~.~ ........ b. Intended use and occupancy . property I!nes. Give street and block numbers or description ~ccor whether iiterior or.corner lot. 3. Nature of work (check which applicable): New Building .................... Addition ...'.~...V ....... Alteration Repdir .................. ..~emoval .................. Demolition .................. Other Work (Describe) 4. Est mated Cost .~ .~. .......... ~ ............................... Fee i (to be paid on filing this application) 5. If d~elling, number of dwelling units .... '~ Number of dwelling units on each floor '~ ' If g rage, number of cars ............................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..~.~,S.i...~...~ 7. Dimensions of existing structures, If any Front ~..~, ................ Rear ...... ..~...~.. Depth Height ....... L.4J ................. Number of Stories ...........!.~..~.~,.~..~h...'~.. ......... Dimensions of same structure with alterations or additions: Front .... ~...'~-..[ .... Rear ...... ~. '2 Depth ........ .~..O. ................. Height ......... !...~. .................. Number of Star es .....J...~...J~4¥,~.~..~,. ~..~..~. 8. D~m~nsions of entire new construction: Front ...... .~.~ .................. Rear ...... .~.~ .................. Depth ~ Heig.ht ....... J...Zj.. .................. Number of Stories ..... L.~..~...~.~.~..~.~n~ 9. Size~of lot: Front .............................. Rear ................................. Depth .............................. 10. Dete of Purchase .......................................................... Nome of Former Owner~.S..~..~.~.ff...~....~,~..~.e..~j 11. Zone or use district in which premises are situated. t2. Doe~ proposed construction violate any zoning law, arc nance or regulation? ....... o ....... ' - ' ..... 13. Narrje of Owner of premises ._..~..hCe..cC.. Address .....~..,~..¢t..I.T..q C~/~, J.~ .~/ Phone Horde of Architect ....... :::...:, .................. :~Z.:-: .......... Address .................... ...-~z....:n. ................. Phone No. No~e of Contractor[.'~.,'~C~.~D..~..~.~.'~,~.~..~,..~...o.~$Address ....l~JJ'k..~-i'~...L~.~.~.l.ff~..l~..r.~..~.' Phone PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and set-back dimensions ' street names and indi~ STATI] OF NEW, YORK, S COUNTY i)F ,'~.g.-/T?., .~.~.~.......~. ,S. .......... ..k:l...~./~.O.k,.'O.....r,~.,....J..~.J~'..~_~.~..~...,J.z'.~., ................. being duly sworn, deposes and says that he is the epplic, ~,lome of individual s~ning application) a.bove nom~d. He is the ....... ! (Contractor, agent, corporate officer, etc.) of said owrler or owners, and is duly authorized to perform or have performed the said work and to make and file applicationl that all statement.s contained in this application are true to the best of his knowledge and belief; that the wgrk will be performed in the manner set forth in the application filed therewith. Sworn tg.~fore me this ~~I ......day/9<~ .../~,..~,.~¢~.u..~.~T~ · , , . ............ ...... , .................. ST' Y~£ ; i 4 ' //)': --'1 8-6 - VY=\ L~ L'i ' /ZL8"X 8'-6"