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Home My WebLink About3274-zFOEi~ 1~O. 4 TOWN OF SOD-'THOLD BUILDING DEPARTMENT 'I'OWN CLERK'S OFFICE SOUTHOLD, N. Y. OEi~.TIFIOATE OF OOOUPANOY iNo.3.0 ~{'. ....... Date ............ Apr/3. .... 1(1 ...... 1968. THIS CERTIFIES that the building located at. ~..~[. ~..~. .... Street Map No .... ~ ...... Block No.. ~ ........ Lot No. ~ ..... ~9~9~..~?~ ...... conforms substantially ~o the Application for Building Permit heretofore f~ed in this office dated .......... ~ .... 1~ ......19.66 pursuant to which Building Permit No..~.~. dated ........... ~¢~ ....~ ..... 19..66, was issued, and conforms to all of the require- ments of the apphcable provisions of the law. The occupancy for which this certificate is issued is . .Aaceaso~. bus.ess .butl~i~. The cert~icate is issued ~o . ~9. Rq~gsk~ ................ ~9~ ................... (owner, lessee or tenant) of the ~oresaid building. Suffolk County Department of Health Approval .................................... Building Inspector FO~V,~ NO. 2 ~ TOW[N oF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 'SOUTHOLD, N. Y. *BUILDING PERMIT ~ ,Cf'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL ~,; ,C.O*/~J~L.,~t-IOI~I, '0F, THE WORK AUTHORIZED) "' P~rmis~ion is hereby grant~l to: ............... , ....................... ....~.*****.~.**~.~..~,.....~.,,~.,,i ..................... i ................... i ......... '. ................................ pursuan¢ to application dated ........... ;....,. ......... .-.~-....~-.-.~-~.-~,-,-.,.J:.~-.....J., 19._.-~.....', ~and oppr, oved by the Building Inspector. Fee * Ir'O0~ Building- Inspector/ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Examined ....... ~.....~.....~... .... 19..~...~. Approved ........................................ , 19....~..Permit No ................................. D~sapproved a/c ~~~ ~ -~c APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. Th~s application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildir Inspector. b Plot plan showing location of lot and of buildings on premises, relationship to adlo~nmg premises or public streets, areas, and giwng a detailed descnption of layout of propertymust be drawn on the d~agram which is part of this applicatio, c. The work covered by th~s applicahon may not be commenced before issuance of Building Permit. d Upon approval of this apphcahon, the Building Inspector will issue a Building Permit to the applicant. Su- 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 ~n pa rt For any purpose whatever until o Certificate of Occupan, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of a Building Permit pursuant to tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances , Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe, The opphcant agrees to comply w,th all apphcable laws, ordinances, building code and regulations. ........................... ........................... (Address of applicant) State whether opphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Locahon of land on which proposed work will be do,ne. Map No' . ...........................................Lot No' . ................ Street and Number ........ ~.....~...~-- ...... ~ ..... .~.....~. ............................................................ Municipality 2. State ex~sting use and occupancy of prem,ses and ~ntended use and occupancy of proposed construction: a. Existing use and occupancy ................ ~...~...~........~...~...~....~.~ b Intended use and occupancy .............................................................................................................. 3 Nature of work (check which apphcable): New Budding ................ Addition ................. Alterahon ................ Repair ' Removal .................... Demohtion .................... Other Work (Describe) .. ,.~.....~....:.. Oo 4. Estimated Cost ................ .¢';~.J.-~......~ .................... Fee ........................................................................................ (to be paid on fihng th~s apphcation) 5. If dwelhng, number of dwelling units ............................ 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, ~f any: Front .......................... Rear .......................... Depth .......................... Hmght ............................ Number of Stories ............................................................................................................. D~mens~ons of same structure w~th alterations or additions' Front ................................ Rear .............................. Depth .............................. Height .............................. Number of Stories ........................................ ent,re new construction: Front Rear ....... ./....~.....,~..... ..... Depth ....,/..~..~.... ......... 8. Dimensions of ........................ Number of Stories Hmght I 0 9 S,ze of lot' Front ....... ...~.....~...: ........ Rear ............................ Depth ..................... .....~.... ~'~ 10. Date of Purchase ...........~...J...O. .......................... Name of Former Owner .................. ~ ~ ~ ............... 11 Zone or use d~stnct m which premises are s~tuated .............................................................................................. 12 Does proposed construction viglate. '~J~L ,) ~.J ~-~.4.~A^'- any zgnmg law, ordinanceq-..cc-(z,J/°r regulation? ............................................ 13 Name of Owner of prem,ses ..~..;..........y....~..~.;,..~.~ddress ..... ..~.-.~..~.'. ............. Phone No ........... Name of Architect ...................................................... Address ............................................ Phone No .................. Name of Contractor .................................................... Address ............................................ Phone No .................. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro property hnes. Give street and block numbers or description according to deed, and show ~es and mdica whether ,nterior or corner lot. ~ ~~ STATE OF NEW-..YOR.K,., ~ 1 ~ c .................... ~'~.~..~....r.'.~.....~....~:.~;..,:',./..c;...'7~. ....... be,ng duly sworn, deposes and says that he ,, the (Name of indw,dual signing application) above named. He is the ................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and is duly authorized to perform or have performed the smd work and to make and th~s apphcat~on, that all statements contained in this application are true to the best of his knowledge and bel and that the work w~ll be performed in the manner set forth ~n the application filed therewith. Sworn to before me th,s~.~day of C~~' , ~ ~~~ ~ ........ ............. Notary Pubhc, ~'~'~ ~"~J[~¥~ ........................ ............................................................ County