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Home My WebLink About2831-zFOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...Z...2~81 ........... Date ....................... 0¢tobe~'.....26 ......., 19.6~... THIS CERTIFIES that the building located at ...]t~o~t~...L~e ........................................ Street Eastern Shores Map No ....................... Block No ..... ~ ............. Lot No....8 ......... (~.e~n~4)r.tt...N,.~, ................. conforms substantially to the Application for Building Permit heretofore filed in this office doted ............................... AD.~.! .......... ~,. ............. , 19...~..~. pursuant to which Building Permit No. dated ............................. AUG ....... .] ........... , 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 ........ .... .Lt. ............................................................................................ The certificate is issued to ...~or.~..]~.f~.....~ll~.ct, f~,.~l .................................. ..0~....~.~..~.~ ................. (owner, lessee or tenant) of the aforesaid building. H.D.Approval by R. Villa 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? 2831 Z Date ................................ ~.il~ll.tr....~ ...... , 19..b.~. Permission is hereby granted to: · l~ez~ ~t~e,~ ~-t...~a$.t~ez'~ ................................... .................. ~.~. ........................................ to .. ~tl~J...3 (J....~e~.-ot~e..'~aJ~:~'~3t" ~1¢~ ~-~1'~ .................................................................................... et premises located at .........,~O.~..~ ....... ~S.t,~..~:~Xl..~;.OZ:.g,g..~O...~l. ............................................... ........................................ J~(~atm...[~t ........ ~ez~po~t~ ................................................................... pursuant to application dated ................................... ~lZ~.tZ~Jl...-.C~ .... 19..~., and approved by the Building Inspector Fee $tO, OO' ........... FOEM NO. 1 TOWN OF 5OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ......................................... 19 ........ Approved ......................................... 19 ........ Permit No ................................. Disapproved a/c .............................................................................................. Application No ............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ............................................................ , 19 ............ 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 propertymust be drawn on the diagram which is port of this 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 thr6ughout the progress of the work. e. No building shall be occupied or used in whole or in part I%r 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 th~ issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southgld, 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 h~rein described. The applicant agrees to comply with all applicable laws, ordinances, building code and r~gulations. (Sig~ture o opp ' , n , ' p ' , ............................... i~'~t'~;~"; ~-~';l~i'i'~ ~'r~ti· .............................. State whether applicant is owner, lessee, agent, architect, engineer, 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) I. Location of land on which proposed work will be done. Map No: ............................................ Lot No: ~>~ Street and Number ....~..~....~......~......~ ......... .,.~JZ.~...~ .................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy ,,..;~..! .......................................................................................................... 3. Notpre of wotk (check which ~ ~ ~ ' · Repair .................... Removal .................... Demeht~on ................... Oihe~ Wo~k (Describe) .................................. 4. Estimated Cost ....~.~,~..~..~ ...................................... Fee ~to be paM on filin~ this application) 5. If d~elling, number of dwdlJng units ........ ~. .................. Number of :we~hr~g units on each floor If g~trage, number of cars 6. If b~siness, commerci~J or mixed ~c. cupancy, sp~cffy nature and extenl of each type of use 7. Dimensions of existing structures, if any: Front ......................... Rear ..........................Dep[h Height . ........................... Number of Stories Dimensions of same s~ruc[ure with offecqlions or flad l~o ~ ~ron~ ................................ J~ Dept~ .............................. Height .............................. Number of ~torles 8. Dimqnsions of entire new construction: Front ~ ~ Rear ~O I Depth Height /6 t Number of Stories ..... [ ..................... 9.s~o ~ ~ot: ~o,~ ..,.Ze~,.~ .............. ~ ...... :L~..t ........... ~pt~ .,..L~.R..: ................ ,o. ........................................................ 1 1. Zone or use district in which premises are situoted '~ ~ . 12. Does proposed construction v~olote ony zeroing ~w, ordhmnce or regu~n~ion? ..,~,,~. 13. Nom~ of Architect~~..~ ...... Address Phor,e No,n~ of Contractor ~.~.~ ........ Address .......... ~:~ .............. Phone PLOT DIAGRAM Locote cJeorJy and distinctly ali buiJdings~ wh~t?'mr o~[~th'~g i¢~' fm~po~gtJ+ fred Jrldh',oJo oil whether inte)'ior or corner It0 I I I ......................................... ~i~:~';:.i'¢L" ,. ~U'I~'UBLIC, St~tff of Ndw York v ,., Suffolk Coun~ March 30, 196~ ~,