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Home My WebLink About2684-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..... H~tF..~:~e-~s..-Ro~d ............................ Street M N~ssau Point Cl~Bb. ap ~o ...................... ~,oc~ ,~o ..................... Lot No .... B67 .............. Cmte~og. ue.t...$,..Y., ........ conforms substant,ally to the Application for Build,ng Permit heretofore filed ~n th~s office dated ............................ ~.~.~h .............. 29 ..... , 19..~t~.. pursuant to which Building Permit No ....... ~'~J' Z dated ............................ ~'. -eJ~ ....... :~..., 19..~.~, was issued, and conforms to all of the requirements of the applicable prowsions of the law. The occupancy for which th~s cemficate ~s issued is ........ ......... ~:~£'~,te...or~ .. ~.~mtl.~.. ~w~]. li.r~ ....................................................................................... The certificate is ~ssued to .......... D0%1~.~8,.,. ~/~gt~e~.., .......... O.t~e~ ...... .......... : .............................. Lowner, lessee or of the aforesaid building H.D. Approval July 20 196~ by R. Villa Budding Inspector FO~,M NO, 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2684 z Date ........................... ~e~t.....m~9 ........... , 19.~ Permission is hereby granted to: to ...~t~..~ew..o~ze...fmni~r..~wel.l. li~ ................................................................................... premises located at ...].e~..3~/.t ......N&'~a~ll'"]~o4-~$,"{]'~; "]:~o~' ......................... ~ ...... , .......... ................................. W/.S.....l~r~a~..l~ ..... ~,~a~..ro~.~ ............................... i' ...... ."i ...... .......................................................... ¢~~ ...................................................... : .................. ~ , ~', ..... b,y the pursuant to application dated ............................... ~;r'g~"'";~l ........ 19..~, and ,approved Budding Inspector Fee $"'].Ow 00 ......... SCHD SUFFOLK COUNTY D£PARTi~ OF TO '~t0H IT itlY CONCEPJI: have bcen insoected by this Department and found to be satisfactory. JUL 2 0 ~ District Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ..~/~. ~...~.. ............ 19.,~..,~T Approved ' \ 19 ........ Permit No. ................................ i' ;i .......................... ^ppl catlo. No. '/ APPLICATION FOR BUILDING PERMIT Dote ....................... 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 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, ordinances, building code and regulations. ~. (Signature of applicant, or name, if a corporation) .............. (Address of applicant)/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 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 No: ....~...~..~..~..~...~.d....~.'..~z-L.ot Street and Number Municipality State existing use and occupancy of premises and in'~nded ~use and occupancy of proposed construction: a. Existing use and occupancy ......... ...~....~ ....... '~-~ ,,~L~,,:...9..~ ................................................................................. b. Intended use and occupancy ........... -J. .......... ' '-~'..~...~ ....... I~.~~~ ............................................... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost ....... /....~/,,...O....O...~. .................................. Fee .......................................................................................... (to be paid on filing this application) .5. If dwelling, number of dwelling units ....... --/. .................. Number of dwelling units on each floor ...... --.~... ................. If §ore§e, number of cars ........................................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature end extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front ..........................Rear .......................... Depth ............................ Height ............................ Number of Stories ............................................................................................................... Dimensions of some structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ....... ~ .............................. 8. Dmensons of entire new construction: Front ...... ...... Rear ....... .......... Depth · ........ Height ...... ~/...~.. .............. Number of Stories .......... /. ............... 9. Size of lot: Front ...... j..~,q:;~ ........... Rear ....... ~/...~....cb. ........... Depth .....?3..~...C?........t. ..... 10. Date of Purchase .......... ./iL:~,~...~./.~....~..,~'.. ................ Name of Former Owner ..~.....~.,........~.....:~.~w.. 11. Zone or use d str ct in which remises are situated 12. Does proposed construction violate any zoning law, ordinance,~r.~.r~gJ.l.!~ion? ..................................................... premises ...... ~ ............ ..... .. Phone No..1.~...?.~.7..~..~, 13. Name of Owner of Name of Architect ...................................................... Address ............................ · ................ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-bock dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, .............. .~...~.../;z>~,~ ............................... being duly sworn, deposes and says that he is the applicant (Name of individual sig~in~ application) above ~med. He is the .................................................... ~.~. .................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this application; that all statements contained in this application ~re true to the best of his knowledge and belief; and that the work will be performed in th~ge~z~trforth in ~ application filed therewith. Sworn to before me this ........................