The URL can be used to link to this page

Home My WebLink About2686-zFORM ~0. 4 TOWN OF SOU?HOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY of the aforesa,d budding H.D. Approval March ~o .Z..~2t~, ............ Oate ................. J~.il ..... .~. .............. 196.6.. THIS CERTIFIES that the building located at ~/~'. ,.-~.-b~,~-,-Ll~':t4~ ............................ Street Map No ..~ ............ Block No~,.~ .............. Lot No ~ .... ~l.t(~OSU$~. .... /t'e.~'e .................. conforms substonhally to the Applicahon for Bu,ldmg Permit heretofore filed m th~s office doted ..................................... ~!~O~... ~ 19~. pursuant to which Budd,ng Permit No .2686..Z doted ........................ j~'~t._~.:.?t ..... , l C~'. , was ,ssued, and conforms to all of the requirements of the applicable prows,ohs of the law The occupancy for which th~s cerhficate is issued is ........ ..~.~&.te o~e...f, aml.~y..~we ~.~ t~g ................................................................................. The cerhf,cate is ~ssued to ..~T~...~D~,~.g]~.. . (owner, lessee or tenant) 28, ].966 by fi. · .. .............................. Budding Inspector FOI~ ~0. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 2686 z Permission is hereby granted to: to ..Out:Ix1...n~.. ~n~.. ~'~t.~... d~l.~. -1~ ..................................................................................... at premises located at .... W~J~.....,~,a.~'bo-3~..Z,n~_~e ................................................................................. .......................................... Gut~hel~ ..... ~-.~-,- ............................................................................. pursuant ~o application doted ................................. ~,~l~q~......~ ......... 19..~., c~nd approved by the Build~ng Inspector Fee $..-1-0..00. ......... SUFFOLK CO~TY DEPAPS~ENT OF N~.ALTH ~g. Permi% No.~ :~ . TO WHOM 1T MAY COMCE~: The sewage disposal facilities for a structure located at ' ~" (Give deed 10cati~ ~ ~/~.~_.-~.',, ~¥,~ ............. ~v~e been inspected by this Department a~d found to be satisfactory. District En~tnee~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19 ........ Permh No ............................ Approved ............................. ~ ......., " ., c~ ~ ~:Z~.. _~- . Application No ............................. APPLICATION FOR BUILDING PERMIT ..... ......... 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 property must be drawn on the diagram which is part of thi.~ applica- tion. 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 M,~DE 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, alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations.~~ (Signature of gpplicant, or name, if o corporation) (Addre~ of applicant) / State whether ~pplicant is owner~lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises .......... ~.~ ........ ~../. ....................... If applicant is a corporate, sig~/ture of duly authorized officer. (Name and title of corporate officer) ,h re ese ark. bedone M No 1. Location of land on wh'c p p d w , · gP .: ':I ......... ~ ........................ Lot No.: ...................... Street and Number ........ .--. ....... (~.....~. ................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy .~.~..~ ~.~. ................................... /C). .............................. 3. Nature of work (check which applicable): New Building ........ .~ ....... Addition Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost ........... /. .. .~7¢ .. ~.. ........................... Fee ~. ~) · f,x%) (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ ~ ............ 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. Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth .............................. Height ............................ Number of Stories Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .......... ~,~...~ ........... Rear ......... .~....~..~.. ........ Depth ......~....~.. ................. / Height ........ /...~. ............... Number of Stories ....... ~ ......... ~ 9. Size of lot: Front ........ /..,,S...Q ........... Rear ...... ,/.~S...~. ................ Depth ~.....~....~.Z ...... 10. Date of Purchase ..... .~.~.....~..../...~..~...~. ........ Nome of Former Owner ~..~ ~, 11. Zone or use district ,n wh.ch prem.ses are situated. '~:'./'.....~.....R..~..~ ................................................. 12. Does proposed construction violate any zon ng ]aw ordinance or re u at on~ ~ *' 13. Name of Owner of prem.s ..[~.~. Address ... ..~...~/:. Phone No ................... Name of Architect ............................................... Address ............ ~. ................ , Phone No ................... Name of Contractor~ i~...~.?~' .Address ....~....~i,~ ~iii.~.'.' Phone PLOT DIAGRAM Locate clearly and distinctly alJ buildings, whether existing or proposed, and indicate all set-back 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. / ?S ! ...~o STATE OF NEW YORK, ) c c COUNTY ~F ................. ~....,~.) ........ ~'~~~:.[[~.,.~ ................. being duly sworn, deposes and says that he is the applicant .g . g pp~' . ) above named. He is the ......... ~r~ ~ (Contractor, agent, corporate officer, etc.) of said owner Or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge a~nd belief; and that the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this ~ ............ ............. ............................. [ ~ ~o. 52-3233120 Suff~!:{