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Home My WebLink About2873-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...Z.....2~7.~ ........ Dote Hareh 11 lc)..6.6.. THIS CERTIFIES that the building located at ~'.~.J~' Br. il[g,~J.t,l~e. ~.~...,~.~,e ....... Street M H~rbor Li~htm ~c~ No ...... ~ ...........Lot No. ~1, ~outhold, N.J, ap ixlo .................................................................................... conforms substantially to the Application for Building Permit heretofore filed Jn this office dated ....................................... ~e.~t, ....... la....., 19...6.~. pursuant to which Building Permit No ...... ~.8.~..~.. dated ........................... ~-e~.t ....... ~,~ ....... , 19..6~.., was ~ssued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ....... P~.:I .v.a.t e...or~e .. £amf 1~... ~e.1 li~ ............................. The certificate is issued to Th~.~P~.~ ~.~,~.~ ........... Old'let .................. (owner, lessee or tena,nt) of the aforesaid building. H. D. Approval ~n ~ ,// 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°. 2873 Z Dote ............... JJ/~J:l~,~llJJ~'.....~ ............. , 19..6~. Permission is hereby granted to: I~, B ,... ~tti~ .... ~/~,..~i~ · -. ~'~1~o~ ............... ............. ~ou*,h(~l~l.t..-N~.~-~ ................................. to .Bu.l~d...n~w.. ~ne.. ~'~,~$1~ ..d.we,1.],$.n~ ...................................................................................... at premises located at ........J~)t~..3;J..~.....Jjll~J~j~...'l,.~Jj~t~ ................................................................ .................................................. F,/J~..I~igantirJ....Dr:Lvat ......... Southold .............................. pursuant to application dated ......................... ~o~.tel~be~.....],.O .... t9.6~.., and approved by the Building Inspector Fee $.1~. .......... Building Inspector SUFFOLK COUNTY DEPA~a~iENT OF HEALTH MAR i ~ 1~66 Date TO WHOM IT MAY CONCERN: have been inspected by this Department and found to be satisfactory. District Engineer D sir c ~ Engineer FOEM NO. 1 TOWN OF SOUTHOLD BUILDING DEPA RT,~ENT TOWN GLERK'S OFFIGE SOUTHOLD, N. Y. xom,ned ...... Approved ........................................ , 19...'.:...Permit No...~;~(~.-../.....t~....~.... Disapproved a/c ........ ........... ....... : ................................. (Buildin~,~spector~ APPLICATION FOR. BUILDING PER.MIT Date ................................................... , I9 ............ 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 I(~t 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 part 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 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, ordinaDees, building code and re, gu~ations.~' / (Signature of appli~gnt, or name, if a corporation) ,~ ............................ iX;/;i;;;;";f- ......... r ....... State whether applicanJ' is owne~lessee, gg,e~nt, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Locat'on of and on wh'ch pro osed workw' be done Ma No .. ~ ...... Lot o ~'~x/ 1. :~_p . P .............. ~ ................. N: .................... Street and Number 6x,.~ /~, /i...~./¢'/,AX '~ A?~, ~:~)......~...~.. /~.b.~'. ............... Municipality 2. State existing use and occupancy of/~i~m'ses and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~.~......Cr..../~...../~...../....~'-~ ........................................................................................ b. Intended use and occupancy .~...~..~..d'.~ ........................... 3. NatUre of work (check which appl cable)' New Building ~ Addition 6. Estimated Cost '.oo Fee .... / o ~ (to be paid on filing this application) .5. if d~velling, number of dwelling units ........... ../.. ............. Number of dwelling units on each floor If g,arage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............... 7. Dim!ensions of existing structures, if;any: Front .......................... Rear .......................... Depth Hei~h ............................ Number of Stories Dim,'ensions of same structure with alterations or aaditions. Front ................................Rear Depth .............................. Height ...: ........................... Number of Stories ........................................ 8., Dimensions of entire new construction: Front ..... ~...~.. .............. Rear ....... ..~......~.. .......... Depth 2-- I-lei~ht ...... ./..~. ............... Number of Stories ....... ./.. .................. 9. Size]of lot: Front 11. Zonle or use district in which premises are situated ....... ...."~¢~- 12. Doe's proposed construction violate :any zoning law, ordinance or regulation? 13. Name of Owner of premise ................... .~.A ....... .q ....Address ......... ~..*f~......~.. ............ t .~'.:. Phone No...~... Narpe of Architect .......... ~; .......................................... Address ............................................ Phone No. Narhe of Contractor ........... J I PLOT DIAGRAM I.ocat~ clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-back dimensions fr property lipes. Give street and block numbers or description according to deed, and show street names and indk whether interior or corner lot. I STATE OF! NEW ~ORI~, ,~, ~,/~ ,~ c c COUNTY OF ~/ ............ ~.~.-..~ .......................... being duly sworn, deposes a~ says that (Name of individual signing application) above no~ed. He is the ....~ ....... ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly autho~rized to perform or ~dve performed the said work and to make and this opplicgtion; that all statements contained in this application ore true to the best of his knowledge and bell, and that the work will be performed in the manner set forth in)he application filed therewith. Sworn to ~e~r~me this ~ ~ . // ' /~'~ ./? , ............ ~.dayof .................. ,19 ...... ~ / Z-/ ' ~otory Pu~lic,~~.~~ County ~Um~H I ~OK[a,($i~nature of opplicont)