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Home My WebLink About2667-zFOEi~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located c~p[.e. ~l~.~.~., ..~.q.~-~.~.~ ........................ Street Map No ...~ ........... Block No ...........XZX. ..... Lot No ................... ~ ........................................ conforms substanhally to the Application for Budding Permit heretofore filed in this office dated ................................. ~f~ .,~. ·., 19 ~5.. pursuant to which BuHd,ng Perm.t No..~6..6.7..Z..... dated ............................ ~,lc~,h. 3.2 ...., 19...6,~, was ~ssued, and conforms to all of the requirements of the apphcable prows~ons of the law. The occupancy for which this cerhhcate ~s issued ~s ...... ............................................... .a..~.~.~.o.~....~,.o....~....e.Z...z..~.c~ ..... .(..P.~.!.,...°..~.~.F...*,..~. ,~..~.:~.....l~.~.~.~) The certificate is issued to .......... ~$.~.~.~.~.;~.~..~e~.~'~.~...V..e..~...e.~.~.~.c...~..-.~.~...~..~. ....~....~..~.....~..,....C...o..~.]:le~ (owner, lessee or tenant) of the aforesaid building FORi~ 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°. 2667 Z Date ............... Permission is hereby granted to: ~t. ehr~r.....~me...~e~en.t..ee..A/~......Azma It. Colller .............. G~ee~port; ........................................... to lm~16., eh-. e6d ~.t ~Lon.. ~..n...ezl~ t~Lr~-.-d~e ~.~ ........................................................ at premises lacated at ....~r/411...-.l,~];~]:e...Ln~l~ ............................................................................... ....................... ~ ......................................... I~mtl~oJL~t .................................................................... pursuant to application dated ................................... ]/41.~_~....]~ .... 19.~.~., and approved by the Building Inspector Fee $- .~'~,.00. ............ .... ...................... 1¢'O~,,¢~ ~TO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ~'*~ J/"~- 19 !. Approved ........................................ , ~ ........ ~rmit N~ ................................. D~sap~ro~d a/c .............................................................................................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Dote l~r ch 12 19..~.~.... INSTRUCTIONS o. Th~s application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buitdir Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets, areas, and giving o detailed description of layout of propertymust be drown on the d~ogrom which is port of this opplicotio, c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of th~s application, the Budding Inspector wdl msue o Budding Permit to the applicant. Su, permit shall be kept on the premises available for inspection throughout the progress of the work. e. No budding shall be occupied or used in whole or in port for any purpose whatever untdo Certificate of Occupon, shall hove been granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to ti Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances . Regulations, for the censtruction of buildings, additions or alterabons, or for removal or demolition, as herein describe. The apphcant agrees to comply with all applicable laws, ordinances, budding code and regulations. IJ Rich.t.~r...Home,..Impr:o~zmmez~.t...cc~ ................................ (Signature of opphoant, or nome, if o corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build,- .............................................................. .q ~.t,z'.~.~.J~ ~. ........................................................................................................ Name of owner of premises ....... J~'q~a..~....C~%EJ.e~. ...................................................................................................... If applicant is o 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 ....... ~ ........................ Lot No' ....~.~... Street and Number .... .W/S....~c~D.I~...,C~.e ....... ~c~..~h~],cl ................................................................................... Mumcipality 2. State ex~stmg use and occupancy of premises and ~ntended use and occupancy of proposed construction: a. Existing use and occupancy .... (:].~e:L:L.t~ ......................................................................................................... II b Intended use and occupancy ...................... .'~/....~,,'L~J..Q~ ........................................................................... 3 Nature of work (check which applicable): New Budding .................. Addition ~ ........ Alteration ................ Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................................... 4. Estimated Cost ....... ~.~0...~/,,~ .............................. Fee ........ .~[ ............................................................................. (to be paid on filing this application) 5. If dwelhng, number of dwelling units .......... ~r~. .......... 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. D~mensians of existing structures, if any: Front .......................... Re~r .......................... Depth .......................... Height ............................ Number of Stories ............................................................................................................. D~mens~ons of same structure with alterations or additions: Front ................................ Rear .............................. Depth .............................. Height .............................. Number of Stories ........................................ 8. D~mensions of entire new construction: Front ..... ~(~ ................. Rear ....... )i,(~ ............... Depth ......~]..~ ............ Height ............................ Number of Stories ...~ ................. 9. S~ze of lot: Front .......... ~ ............. Rear ........... ~0 ............ Depth .......]1.~.~ .................. 10 Date of Purchase ........................................................ Name of Former Owner ...................................................... 11. Zone or use district m which premises are situated ........ .".~,."..._~t~l__ ~.~t, ................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? .............. ~¢~ ................................. 13. Name of Owner of premises ...~-tt~..D~...~. e~.~.~.Address ........... ~o:~t,~'~O~C~ ............. Phone No ................... Name of Architect ...................................................... Address ............................................ Phone No ................... Name of Contractor .... ~[~,]?..~.e~...~C:~m.Z~lt~l'.t:....Address ........ ~.e~_n.~.t, .............Phone No ................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fror, property lines. Give street and block numbers or description according to deed, and show street names and ind~cat whether interior ar corner lot. ................................................................................................. being duly sworn, deposes and says that he is the applicon (Name of individual signing application) above named. He ~s thl~.~;~.~*. ......................................................................................................................................... (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and fil th~s application; that all statements contained in this application are true to the best of his knowledge and belie1 and that the work will be performed in the manner set forth m the application filed therewith. Sworn to before me this ....................~"'-~ --/'~~" day of ..................../~ ........... , 19.~.. ~ , ~/~ . ........................ ...... .... - -- ..... ' ....... ~t~:,. (S gnature of apphcant)