The URL can be used to link to this page

Home My WebLink About3228-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ........ ~ .2.?.g.,~ ..... Date ........................ ~13.~i:i~.~ .~ ........ , 19.. THIS CERTIFIES that the building located at ...~&~..A¥~l.e ........................................ Street Map No I~&S~L~.II..g~Z~ock No ...... ~ ......... Lot No ..... ~ ........... ~l~t,~4~OCJ~8., ..~el~...%rl~ conforms substanhally to the Applicahon for Budding Permit heretofore filed in th~s office dated ......................................... IJe~lgDe~19 61~., pursuant to which Budding Permit No.. dated ....'~J~L'~eg"'J.~ ................ , 19 ~6, was ~ssued, and conforms to all of the requirements of the applicable prows~ons of the law The occupancy for which th~s certificate is issued ~s ........ .......... ene...~amJ,~.y.. ~ el, t.~.n~ ......................................................................................... The certificate is issued to .........Jl~tl,..Jf~l~Ll;Jrl,.~7~,'~e~l; ............................................................... (owner, lessee or tenant) of the aforesaid budding FORit~Z 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) No. 3228 Z Perm=ssion is hereby granted to: .................... ~'~t~.~ ....................................... to l~_~.e..altera~utons,,ancl,,hui],&,,an,,a~i.tion,,.~.An.,e.~. ~t lng,,.~w~ll~g .... at premises Iocoted ot ...... /~I~..~e../JB. SS~LI~.~LI~ ....................................................................... ................................. ~.a......~a~...A.=e, ....... 0ut,.ho~ue.~...H ~Y.~ .................................................... pursu~n,~ to application duted ..................... ..~..e.l~..~. ....... .]-..~. ................. , 19.....~..., and approved by the Building Inspector. Fee $....,~, ~.0., ,0. ........... ......... '~"¥~'~"' '"' "Bui Id~ng Inspector FOEI~ NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ............................. Application No ....................... D~sapproved a/~ ...................... ~ ......... ............................... ............................... APPLICATION FOR BUILDING PERMIT Date ....... .~... f..~.. ................... 19.( ~ INSTRUCTIONS a. This apphcat/on must be completely filled in by typewriter or in ink and submitted in duphcate to the BuHdm~ Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to odioming premises or public streets o areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application c. The work covered by this apphcation may not be commenced before ~ssuance of Building Permit d Upon approval of this apphcation, the Building Inspector will ~ssue a Build~ng Permit to the apphcant. Such perm~ 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 o Certificate of Occupancy, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Building Permit pursuant to thc Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances o~ Regulohons, for the construction of buildings, additions or alterations, or for removal or demohhon, as herein described T~e apph~nt ogrees t~ c~m~y wit~ ~ ~pp~icab~e ~ws~ ~rdinances~ bu~in~g c~ an~ regu~t.~ns--~.- "~-'~ ~ ~~' ( .......... . ..: ................... (S~gnature of applicant, or name, if a corporation) ........ .................... (Addre~ of applicant) l State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nome of owner of prem~ses ...~.~w,~.~ ....... ~~ ................. If apphcont ~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 ..................... ~'~ Street and Number ........ ~ .............................. ~.r~..;.:~....,2...)q..'...~...t ............. /V~niclpahty 2.State existing use and occupancy of premises and intended use and occupancy of proposed construction a Existing use and occupancy ............................ ~ .............................................................. b. Intended use and occupancy ...(t4~~..,.~m~, ~' 3. Nature of work (check which applicable) New Building .................. Add~hon .................. A//teration .................. Repair .................. ~,[~emoval .................. Demohtion .................. Other Work (Describe) ...C~/,~¢,~-f.Z%~r.. ..... 4. Estimated Cost ....... /(...~...9~.....~...~ .................... Fee ....... ~...C~.....-. ............................................................. (to be pa~d on filing this apphcation) 5. If dwelling, number of dwelling units ............................ Number of dwelling umts 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~mensions of ex~sting structures, if any: Front ...... ~ .(~. .......... Rear ...... ,~r..~-. ................. Depth .,.~.....c).. ......... Height ...... ~ ........... Number of Stories .... ~. .............................................................................................. Dimensions of same structure with alterations or additions Front ................................... Rear .......................... Depth .....~h~ ............. ~ ..blunt, ,~r-of S'f'67i es ............................... 8. Dimensions of enhre new construchon' Front ...................................Reor ............................ Depth ....................... Height .................... Number of Stories ........................................................................................................ 9. Size of lot' Front ...... ~..~....-~. ........... Rear ..... ~'.D~,/' ........ Depth .... .~?...~ ....... 10 Date of Purchase ...~..~..../....~.i..~....~ .......... Name ~,f Farmer Owner .~...L~,~_.ce,~..J.....~ / -- 11. Zone or use d~strict m which premises are s~tuated .... ~-,,~~~ ................................... 12 Does proposed construchon .~olate any zoning' law, ordinance' or re_gulahon~ ....... ~....'~.. ........... 13. Name of Owner of pram,sas ...~...~...~.w~,,~--~ ress .... ..~. · .. hone No ................... Name of Architect .................................... Address ...................................... Phone No ................ Name of Contractor .~ ~ .s~.-..'. Address ... ~.~.~...~¢~ii~otne NoP.,¢..~. (~..'Z.~.. PLOT DIAGRAM Locate clearly and d~stmctly all buildings, whether ex~sting or proposed, and mdmate all set-back d~mens~ons fron property lines. G~ve street and block number or descriphon according to deed, and show street names and indicat, whether interior or corner lot ( c~v STATE OF NEW YORK, ~ c c COUNTY JDF ................................ ~ .... ..... ~.~.~....~.~ ..~ ......... being duly sworn, deposes and says that he is the apphcar ~ (Name of individual signing apphcot~on) above named He ,s the ........... ~~ ...... ~ ........ ~ ................................................................... c/ (Contractor, agent, corporate officer, etc.) of said owner or owners, and ~s duly authorized to perform or have performed the said work and to make and fd this applicahon, that all statements contained in th~s apphcation are true to the best of his knowledge and behef, an that the work wdl be performed m the manner set forth ,n the app~ic--~fion filed therewith. Sworn to before me this ,~ ~ -- .......... ........ .... Notary Public, .. Count~~' (Signature of applicant) NOTARY PUBLIC, ~[e of l~w York No 52-061811~ Sullolk Count)'