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Home My WebLink About3213-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES thor the building Iocoted ot .~$~.~.~;g~. ~.~.V..~ .................................. Street Map No ........ .2..~..~..~.... Block No .... ~ ....... Lot No ......... ~.?. ........... conforms substantially to the Application for Budding Permit heretofore filed in this office dated ............. ..~..~..~.~..~..t,.....3..~. ....................... , 19 ..~..~. pursuant to which Building Perm,t No.~...~.~.3.....~.... dated . .~.~];~=..~ ................... , 19 ...66was issued, and conforms to all of the requirements of the apphcable prowsions of the law. The occupancy for which th~s certificate is ~ssued ~s ........ ............ ~~...~.~. ~.~..gn. e...~m~.z.:~..~.x...x~n~... ................................................. The certificate is issued to ...................... .~.,.O.~.~.~ ..~..:....~...~...~..~..~...~...O..tr..t:..~.....~........~..$..~..~..~..~' .................... (owner, lessee or tenant) of the aforesaid building Buil~l~'ng '~Vd~pector 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°. 3213 Z Date ................... ~.~eJl$]~. ....... ~/. ......... , 1~1~ ..... Permission is hereby granted to: · JBoba~.&..C~ar&c~tte..~e~rc~a~ ................. to · ~ ._'L ~... _~ ~ .. i~,!.~L ~;~'o1~ .-ot~.. er~.. e~S~.~ ..d~-~t~l~ ........................................................ at premises located at .]l~ttr.-~'?'~'"-'~T~lb A~IPe'i~I ..................................................................... ..................................... · ,/ll. · · · ii,villi · .l~,i,~,e .t .......... llioat~t~ ................................................ pursuant to application dated ........................... ~tlil.~ ....... .~.'L ....... I~...., and approved by the Building Inspector Fee $..~,(~ ............ Building Inspector/ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, ~ ¥. Approved ........................................ , 19 ........ Permit No ................................ D~sapproved a/c .............................................................................................. ............................... i§' ;Ji ................................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a Th~s application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin, Inspector. b Plot plan showing location of lot and of buildings on premises, relahonship to adjoining premises or public streets o areas, and gwing a detailed description of layout of propertymust be drawn on the diagram which is part of this applicatior c. The work covered by this apphcatzon may not be commenced before ~ssuance of Building Permit. d. Upon approval of this applicahon, the Building Inspector w~ll issue a Building Permit to the applicant. Sud permit shall be kept on the premises available for znspection throughout the progress of the work. e No building shall be occupied or used in whole or ~n part For any purpose whatever until a Certificate of Occupanc shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the ~ssuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c Regulations, for the censtruction of buddings, addihons or alterations, or for removal or demolition, as herein described The apphcant agrees to comply wzth all applicable laws, ordinances, building code and regulations( ( r'% ........................... · ....................... ~,., ...................................... - (Signature of applicant, or ~.~me, if a corporation) :Dr'1.vet ~outhoid, ~ew York (Address of applicant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde, Name of owner of premises Robert 7. and Charlotte H~ Zieran If applicant ~s 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 ...................................... Lot No: ....J:? .......... Street and Number ........ ~.l~.~.~..0.~.~..~.r;L~.~ .............................................................................................................. Mun,c,pahty 2. State ex,sting use and occupancy of prem,ses and ,ntended use and occupancy of proposed construction: a. Ex,st,ng use and ~cupancy .......................................................................................................................... b Intended use and occupancy ........... ~ ................................................................................................................. 3 Nature of work (check which applicable). New Building .................. Addition.... ......... ~[ ..... Alteration ............... Repair .................... Removal .................... Demolition .................... Other Work (Describe) ..................................... 4. Estimated Cost ~§00,00 ....... Fee (to be pa~d on filing this apphcation) 5. If dwelhng, number of dwelhng un,ts ...... .'...'..'...'..'. .......... Number of dwelling units on each floor ........ .'..~.~.'. ....... If garage, number of cars Olle 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................... 7 D,mens,ons of exist,ng structures, if any: Front ........ ..~..~.....~..~...~..~.. Rear ..... .5...~.....~..e.?...~. .... Depth ......~..~..~...e.?...~. ........ Height .~.4.....~..e..~...~. .......... Number of Stories ................. .o.b.e. .......................................................... j ........................... D,mens,ons of same structure w,th alterations or additions: Front ...~..~.....~..?..e..t...ll~l[IE~l~.ear 6(~ fee~; ~..-24 feet . . 14 feet o~J~ ........................................ L~eprn ............................. Height .............................. Number of Stories ........................................ s.O mensions af ent, re new construction, rro t ....... .... Rear .... ....... Depth ........ Height 8 feet Number of Stories OZ~e 9 S,ze of lot: Front ...~..0...0....~..~.~.~ ....... Rear ..... .~...0..0.....~.?..?..t. .... Depth ~..5..0.....f'...~..e...~. ............ 10 Date of Purchase .... ~.....~.?...6..3......~....~../~[.,...~..~......Nome of Former Owner ....]~....?..P. ........................................... 11 Zone or use d~stnct ~n which premises are situated ............................................................................................... 12 Does proposed construction wolate any zoning law, ordinance or regulat~on~ 13. Name of Owner of premisesl~..O.~.e..~....?,.....~...[..e..Z'...a..n....Address ....~...e.~..W..9.f[.d...~.~.~ ............... Phone No. ~O..~.-..~0.'- Name of Arch,tact ...................................................... Address ............................................ I~hone No ................... Name of Contractor .......... ~.e..l'.. ............................. Address ~.~1E~.0.~I...~)~'~ .................. Phone No. PLOT DIAGRAM Locate clearly and d~st~nctly all buildings, whether existing or proposed, and indicate oll set-back dimensions flor property hnes. Give street and block numbers or descript,on according to deed, and show street names ond indlcat whether ,nter,or or corner lot _~-'W'/~.z~/~Y/~ /~ ~' ~J~/7 / !. STATE OF NEW YORK, COUNTY-OF ................................ f S.S. .......................................................................................... being duly sworn, deposes and says that he is the applica (Name of individual sign,rig app ~cation) above named. He ~s the ...................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and ~s duly authorized to perform or have performed the sa~d work and to make and f th~s application, that all statements contained m th~s application are true to the best of his knowledge and beh~ and that the work wdl be performed ~n the manner set forth in the application filed therewith. Sworn to before me this ......................... dayof ............................................ , 19 ........ ........... ~ .~¢. ...... ,-r-....--~..~w, ,¥,..'-~.. ...... ,< ...... .~,,~....~;,., .~, .~.~.. ~ .."~ ........ Notary Pubhc, . ........................................................... County (S~gnature of applicant)