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Home My WebLink About3227-zFOI~M N'O. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ~: 2689 Date A~,~:i! 24 19...6.,~. THIS CERTIFIES that the budding located at ~e~..~ ...................................... Street ~tt. Pa~k P~op. M~p No ....................Block No ....... ~... Lot No ........ .~ ....................... ~~,.. conforms subst~nholly to the Applicahon for Budding Permit heretofore filed in th~s office d~ted .................... ~~..~.~, 19 .~. pursuant to wh,ch Budd,ng Permit No..~.~..~. doted .......................... ~~.~..A~, 19 .~.., was .ssued, and conforms to all of the requirements of the apphcable prows~ons of the law The occupancy for which th~s certificate is issued ~s ........ .......................... .~.~$~.~...~p ..~...~m$~ .~Z~.~ .................................................. The certificate ~s ~ssued to .~.~....~.~...~.~.~ ............................................................................... (owner, lessee or te~nt) of the aforesaid building FOI~I NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 3227 Z v~te ...................... ~,ep.~e~b~.....:~.9.., 1 Permission is hereby granted to: 8~,~n3,e~.. Sepl~o.....A~.O.,...)t~.-J.o.,.K~n~ ..... .............. ltai;ti~.uok ........................................... to ..~ll~l..m~,. ad~lt.tlon..a.a..e, xi~t;Ir,§.. ~l,'~,ett..~.~ ..................................................... ot premises located at ~.D.~...~8,~ ..... 14a.tl;.£t~uolf..I~.a~l~...p~p ........................................................ ................................ ~.$g..s}X..E~.~.~ ~ ....... ~.~i~;~ck ...................................................................... pursuan% to apphcation dated ......................... ~]~ .......... .~1 ........... , 19.~.., and approved by the Building Inspector. Fee ~i[.OQ ............... Building Inspectort FORI~ NO. 1 TOWN OF SOUTHOLD BU!LDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ..... ...... Approved I x 19 ........ Permit No D~sapproved a~ ............................ (Building In/~ector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o This application must be completely filled m by typewriter or m ink and submitted in duplicate to the Buildin, Inspector. b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or public streets c areas, and g~vmg a detailed descnption of layout of propertymust be drawn on the diagram which is part of this applicatio, c The work covered by this application may not be commenced before issuance of Building Permit d. Upon approval of thru applicahon, the Budding Inspector wdl ~ssue a Building Permit to the applicant. Suc 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 m part i~or 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 issuance of o Building Permit pursuant to th Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other opphcable Laws, Ordinances c Regulations, for the construchon of buddings, additions or alterations, or for removal or demolition, as herein describe, The applicant agrees to comply w~th 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 builde ................................................... Co~t~.ta~ ................................................................................................................... Name of owner of premises .... ~S...~T.,...~,%~tlZ .................................................................................................................... If applicant ~s a corporate, signature of duly authorized officer (Name and t,tle of corporate officer) 1. Location of land on wh,ch proposed work will be done. Mop No Matt Park Prop Lot No: 98 Street and Number ...... ,,,q.i~}z~f..~oa~.~ .......... M~t.i.tuck .................................................................................. Mumcipolity 2. State exmtmg use and occupancy of premises and ~ntended use and occupancy of proposed construction: a. Existing use and occupancy ......... dW~l.1..iz~g .................................................................................................. b. Intended use and occupancy ......... ~.~.~.~...¥.~?..~...a..z!..,a.~,cl:..L..~.9.,z7 ................................................................ 3 Nature of work (check which applicable): New Building .................. Add~hon .~:~r,~;: ....... Alteration ................. Repair .................... Removal .................... Demolmon .................... Other Work (Describe) ..................................... 4. Estimated Cost ...'l~,~O0 ............................................. Fee .... ~,~ ........................................................................... (to be paid on filing th~s apphcation) 5. if dwelling, number of dwelling units ........ ~:t'~ ............ Number of dwelling units on each floor ........................... If garage, number of cars .......................................................................................................................................... 6 If bus~ness, commercial or mixed occupancy, specify nature and extent of each type of use ............................... 7 D~mensions of existing structures, if any' Front .......................... Rear .......................... Depth ........................... Height ............................ Number of Stones ............................................................................................................. Dimensions of same structure with alterations or additions' Front ................................ Rear ............................... Depth .............................. Height ............................. Number of Stories ........................................ 8 D~mensions of entire new construction: Front ...... ~,6 ................. Rear ...... ;~f~ ................. Depth ....10 ................... Height ........................... Number of Stories O~ft ...................... 9. Size of lot: Front ...... ~.0. ................. Rear ............................ Depth ................................ 10. Date of Purchase ....................................................... Name of Former Owner ...................................................... 11. Zone or use district in which premises are s~tuated ....... ?J~!!...c].~$.t ..................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulahon? ....... tCC~ ........................................ 13. Name of Owner of premises ..~Z'.s,..~l'.....~l.~"~ ........ Address ....... ?.t~.~;.t:l..~¢.~ ............... Phone No ................... Name of Architect ...................................................... Address ............................................ Phone No ................... Name of Contractor ...q .... 13e~pkO .............................. Address ....... ~.¢.t,:i.C,.,~e~. ............... Phone No ................... PLOT DIAGRAM Locate clearly and d~stinctly all buildings, whether ex~st~ng or proposed, and indicate all set-back dimensions fro~ property hnes. Give street and block numbers or description according to deed, and show street names and indicat whether interior or corner lot. STATE OF NEV~."(~j~K~,~. 1 COUNTY OF ..~...~..~..u.~.~ ............ / S S. .............................. ~.~3.~r...Re.~c~:;:~ .................. : ................ be,rig duly sworn, deposes and says that he ~s the applic~ (Name of individual signing application) above named He is the ......... C~o,~.J;.~.ae,¢~ .................................................................................................................... (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and ~s duly authorized to perform or have performed the said work and to make and f th~s application; that all statements contained ~n this application are true to the best of his knowledge and beh. and that the work w~ll be performed in the manner set forth m the apphcat~on filed therewith. Sworn to before me this ................... '1~. day of ....................... ~,~]~.t, ........... , 19..6~. Notary Pubhc, . ........................................................... County (Signature of applicant)