The URL can be used to link to this page

Home My WebLink About2889-zFOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ............... ~.....~3.~ Date ......................... ~]~.i[ .......~, ...... , 19....~6 THIS CERTIFIES that the building located at .~/.~.....!~ij~mat,.t~..~l~'e. ...........................Street Map No .........~, .......... Block No...;I¢~ ............... Lot No....~;~r~ .......... (~,.ee~po~.~t..~,~, .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................................... t01~I~.,. ....... ~...., 1~.... pursuant to which Building Permit No. ~,.~.~.~...~.. dated ................................. .(~.~.....~. ........ , 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 ........ ..Pr.i.v.a.t.e..~n~..~l~..~ell&n.g ............................................................................................... The certificate is issued to .~.~.~ ~.~l 0.~1~. ......................... (owner, lessee or tena,nt) of the aforesaid building. H.D.Approval M~r, 11, 1~66 by ~, ...... .................... Building Inspector 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? 2889 Z Permission is hereby granted to: · .J.~'"Dl'az-'"'A/e"-'-Robert'"~.'~zesk ........ .................. ~eeap~r t. ....................................... to .l~/.14...new.. erie .. ~emi.~F..d,,~e.~t,~ .......................... · '~' "4~. 'd-?2z '~' '~..Z'~...~.' -~'''/'''''7''-'/ at premises Iocoted at ....... ~.-.-.~]LIllnD~h.-.A~ ............................................................................ ...................................................... G~.~en~oz~i...N...Y~ ........................................................................ pursuant to application dated .............................. ~.t, ......... .~.. ............ 19.(i.~.., and approved by the Building Inspector Fee $."10,,j:.~]O. .......... Building Inspector' / S-R SCHD SUFFOLK COUNTT DEPARTMENT OF HEALTH B%dg, Permi% TO WHOM IT MAY CONCERN: The sewage disposal facilities for a stPucture located at have been inspected by %his Department a~d foumd to be satisfactory. ~ ~i.strlot Engin~r~: ,~ :.1 .,~ ........... D-tstr~c% E~gineer FOEM ~0. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×am,ned ...... .............. Approved ......................................... 19 ........ Permit No ........................... Disopproved o/c ........................ :::.: ......................... :,::~,, ......... y .............. ............. - .:;i'.i ..... ~ :r..:.L . . ¢ Application No ............... ~. ............ APPLICATION FOR BUILDING PERMIT Date C~' ~'' 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 par~ 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 pa rt 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 code and regulations. .......... .......................... ~i/gnatu r~ of applicant, or ~n~'m~..~~' a co~Fo~tion) '' (Address of applicant) State whether ap~olicant, 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) 1. Location of land on which proposed work will be done. Map N.o:/~..~.~...j/rT.~J~.4.(~.~Lot No: .....~..../. .......... Street and Number ........... ~'/~.¢~..t~ ./~....../."~.......:~ ......... ~¢:~. f..t;.....~..~.~ ~L c,.c~ ............................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... ..~r...~.~.... ............................................................................................................. b. intended use and occupancy~ ~..(Z,¢ ~ ~-./..~.9'_.~. ................. 3. Na ure of work (check which applicable): New Building .................. Addition .................. Alteration ............. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ................................. 4. Esti'moted Cost ........... ~ .... ..o. ............................ Fee ..................................................................................... (to be paid on filing this application) S. If ~welling, number of dwelling units ...... ~ ........ Number of dwelling units on each floor ....................... If Garage, number of cars ...................................................................................................................................... 6. If ,~usiness, commercial or mixed occupancy, specify nature and extent of each type of use ........................... 7. Din~ensions of existing structures, if any: Front .......................... Rear .......................... Depth ....................... Height ............................ Number of Stories .......................................................................................................... Dimensions of same structure with alterations or aad't'ons Front ................................ Rear ........................... Dep~th .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ........ ..~....'~ ............ Rear ........ (~.....~.. ........... Depth .........~-..?.'...~. ..... Height ......... ~ ................ Number of Stories ....... ~ .......... 10. Datle of Purchase /~ {..~., ~'>" Name of Former Owner~'~-~ 11. Zorle or use district in which premises are situated ............................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ............. ..,~....~. ............................ 13. Narhe of Owner of premis~ ./.~ .~.....~.:..~...Address ............... Phone No.~.~...~..~.~.~., Nar~e of Contractor ............. (. ......... , ................. ~. ......... Address ............................................ Phone No ................ PLOT DIAGRAM I_ocatp clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr property li~es. Give street and block numbers or description according to deed, and show street names and indic, whether interior or corner lot. cou , T , ',. '. _?F .......................... :...../" ...... L/~.~...":.L..,.~J ........... ........................... being duly sworn, deposes and says that he is the applicc ~f'.__._~_~ameu,ame of individua i~g~(n appllca ia ) above nam,ed. He is the ................ ~....a.p~.~. .......................................................................................................... I (Contractor, agent, corporate officer, etc.) of said owher 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 ~re true to the best of his knowledge and and that tl~e work will be performed Jn the manner set forth in the application filed therewith. Sworn to b~fore me this / ~ I ........ ....... ........... ....... Notary P, 'ic,. ............................................ i .............. County fei j (Signature of applico?f)~