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Home My WebLink About3236-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the budding located at .~,~,~8...N.~.~.~.~:.~.~ ................ Street conforms substantially to the Apphcat~on for Budding Permtt heretofore filed m this office dated ............................ Stl~.~.eI~,l::~3C.. 2~, 19.6,~ pursuant to which Budding Permit No...~.~.:~t~...~ dated ..........................~.~.~.~]::~.e.~ ~7,, 19...~..~, was ~ssued, and conforms to all of the requirements of the apphcable prows~ons of the law. The occupancy for which th~s cemficate ~s issued ~s ....... ............... ~J.v. ~t;e... cle t;~che cl..g~ ~,~ ...................................................................... The certificate ts issued to .~.,....~.l~.~. ............................................................................................ (owner, lessee or tenant) of the aforesaid building II~OR.~ NO. ~ TO~N O~ .S. QUTHOLD ' tlUILDING ~)~P~RTMENT TOWN CLERK'~ OFFICE ~OUTHOLD, bi. Y. (THIS PERMIT MUST BE KEPT ON THE PR~IS~ UNTIL FULL ~qO~P~i~':~F THE WORK AUTHORIZEDJ ~ ~. ~~.....~ 19..,~ . - , , , :~":: ........................... =..., ......... : ................................ ~ ~:;'~..~,' ~t~.. ~s~J . . ... ... .. .{ ~' a~, s~t, bld~} premises Iocotec~ ot ...~..j~.....~....~.~.~...~..e...~..~.'.~......j~....~...L.~..~.~.~.....~.~.~..s.~.' ............................ ............... , ....... ~. ............ : ......... ~.t..t..~..~...~. .............................................................................. pursu ,,a~' to applicatibn dated ....... '. ............... ~[t..t~..J..~.~.....~. ..... , 19.....~.., and approved by the Buil~ling lnspect6r. ...... i .... Building Inspector FOI~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y~ ........ ........ Approved · { 19 ........ Permit No Application No ............................ D~sopproved a/c ............. :...~~ .......... (Building/inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. Th~s applicahon must be completely filled ~n by typewnter or in ink and submitted in duplicate to the Buildin~ Inspector. b. Plot plan showing location of lot and of buildings on premises, relahonsh~p to adjoining premises or public streets o areas, and g~ving a detailed description of layout of propertymust be drawn on the dmgram which is part of thru application c The work covered by this application may not be commenced before issuance of Building Permit d. Upon approval of th~s application, the Building Inspector will issue a Building Permit to the applicant Sud permit shall be kept on the premises available for ~nspection 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 Occupanc, 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 th- Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances o Regulations, for the construchon of buildings, additions or alterahons, or for removal or demolition, as herein described The apphcant agrees to comply w~th all applicable laws, ordinances, building code and regulations. Joseph Deerkoski (Signature of applicant, or name, if a corporation) Mattituck (Address of applicant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ................................................. g.a~.t rac.t.a~ ................................................................................... Name of owner of premises ...S~...S~ ............................................................................................................................. If applicant ,s a corporate, s~gnature of duly authorized officer. (Name and htle of corporate officer) 1. Location of land on which proposed work will be done. Map No ..~.a...l..t.....L..a...k..e.....V...i..l..l...a.~..e.. Lot No: ................... Street and Number ........ ~.~er.s..~e.e.d.~..~o~.cl,~ ..... ~a.~.~..~.~.~k .................................................................. Mun,cipality 2 State ex,st,ng use and occupancy of prem,ses and intended use and occupancy of proposed construction: a Ex,sting use and occupancy ....... Dw~l.].ir~ ...................................................................................................... b Intended use and occupancy .............. ,ga~e...~:i.th...de.ta,ch~d...§a,~.a~,e .................................................... 3 Nature of work (check which applicable). New Building ..~ ......... Addition .................. Alteration ................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ..................................... 4 Estimated Cost ............................................................ Fee ......................................................................................... (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 ....... ~..O. ............................................................................................................................ 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................... 7. D~mensions of exmting structures, if any: Front ..........................Rear .......................... Depth ........................... Height .......................... Number of Stories .............................................................................................................. D~mens~ons of same structure with alterations or additions Front ................................ Rear ............................... Depth .............................. Height ............................. Number of Stories ........................................ 8. D~mensions of entire new construction' Front ...... ~.~. ................ Rear ........ 2.)+. ............... Depth .....2.l~ ................. Height ............................ Number of Stories .~'te .................... 9. Size of lot: Front ............................ Rear ........................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ...................................................... "A" dist ]1. Zone or use d~stnct m which prem,ses are s~tuated ............................................................................................... 12 Does proposed construction violate any zoning law, oral,nonce or regulation? no 13 Name of Owner of prem,ses ..~,$10a~¢1~ ................ Address .............. ..I~...~.t..$.~...u...q..~. ........ Phone No ................... Name of Arch,tect ...................................................... Address ............................................ Phone No ................... Name of Contractor ...J..:...~..fL~'.~.~'...~O.f~, ................ Address ........Ma.t.~J~lz~.k. ............... Phone No ................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex,sting or proposed, and ,ndicate all set-back dimensions fro~ property hnes. Give street end block numbers or descr,ption according to deed, and show street names and ,ndicat whether interior or corner lot. STATE OF NEW YORK, 1 !¢ / S.S COUNTY OF ....~.~$.O ........ : ...... f ..................... g: ..... D~e.~1~.~k.:L. ............................ : ................ be,ng duly sworn, deposes and says that he is the applica (Name of ~nd~vidual s~gnmg app ication} above named. He ~s the ............. Gol~tr.~.c~eo~. ............................................................................................................... (Contractor, agent, corporate officer, etc.) of sa,d owner or owners, and is duly authorized to perform or have performed the said work and to make and f th~s apphcat~on; that all statements contained m this applicat,on are true to the best of his knowledge and balk and that the work w,II be performed in the manner set forth m the apphcation filed therewith. Sworn to before me th~s .............. .2. Z... day of .............. ..~q.~.D.~.~.~.-9.f~;~....., 19..6.(L......~~ ~, ...... - .........................