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Home My WebLink About3287-zF~Ri~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ~.~I~..~J~I.~;..~:D.I~ ................................... Street Map No ....................... Block No ....................... Lot No...J~lt~t~J~],l~u...~...~.G:l¢~ ........................ conform~s substantially to the Application for Building Permit heretofore filed in this office dated ..................... t]~.~1~,~..~.~, .................... 19..~.. pursuant to which Building Permit No 3~,8.?...Z.. dated .......... ..(~....~.~.~.~¢...:~.u ................. , 19.~.6 .... was issued, and conforms to all of the requirements of the applicable provisions of the law The occupancy for which this certificate is issued is ........ ..... ~..=..~ .v. ~.e....g.~..a..~....(.~.c..~.e..~.$.m;~... ~ .~.~,~.~..n..~ } ...................................................................... The certificate is issued to ..... .~.~..~.~i~t...~.e....~.O~.~.~...{.~ll.~/.~] ............................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector ~ro ~.~ ~o. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, H. Y. BUILDING PERMIT ,fi'HiS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL .COMPLETION OF THE WORK AUTHORIZED) crt premises located at ..~4~J....;J~J.,.~j~..]jJa[~. ............................................. ; .............................. ................ :; ............ , ................. 4th~t~t4~..-~..~ .......................... : .................................................... pursuar~t to application dated .............................. -l~jJ-....~ ............ , 19~..., and approved by the Building Inspector. Buildi.ng Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLO, N. Y. Examined Approved ........................................ , 19 ........ Permit No ................................. Application No...,,~...~..~,...~., APPLICATION FOR BUILDING PERMIT ............................... , INSTRUCTIONS a This applicahon must be completely filled in by typewriter or in ink and submitted in duphcate to the Buddi Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoimng premises or public streets areas, and giwng a detailed description of layout of propertymust be drawn on the dmgram which is part of th~s applicati. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Budding Inspector will issue a Building Permit to the applicant. St_ permit shall be kept on the premrses avodable 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 a Certificate of Occupa, shall have been granted by the Budding Inspector APPLICATION IS HEREBY MADE to the Budding Department for the issuance of o Budding Permit pursuant to Braiding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construchon of buildings, additions or alterahons, or for removal or demolition, os herein descnb The apphcant agrees to comply with all apphcable laws, ordinances, budding code and regulations. -T% ......... ............. ~, (S'gnature of apphcar~ or name, ~f a corpor'~on) .... o, ow,,r o, ................................................................ If apphcont ~s a corporate, signature of duly authorized officer. (Nome and title of corporate officer) Locot on of land on wJ'tich proposed work wi be done ~Map Nc~ ................................. Lot No' Street and Number..~..~~..~..~... ~.,~......~.~..~....~.~~.-,.~...; ................ ',.iiiiiiiiiiiiii Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: o Existing use and occupancy .,~.(~..~. ,~:~...~.. ................................................................................................ b. Intended use and occuponcy......~...~.~;;~ ........ ...,.~:~....,.,~..~..~ ~ 3. Nature of work (check which applicable): New Building .................. Ad&tiaa ................. Alteration ................ Repair .................... I~,emoval .................... Demolition .................... Other Work (Describe) .................................... 4. Estimated Cost ........... .~..~....~.., .................................... Fee ........................................................................................ (to be pa~d on fihng thru applicahon) .5. If dwelhng, number of dwelling units ...~.......~. ............... Number of dwelhng un~ts on each floor .........-'--'. ............... ~f garage, number of cars ....~ .................................................................................................................................. 6. If bus~ness, commercial or mixed occupancy, specify nature and extent of each type of use ~o~.%~.. ...~...~...¢. ............. Rear ...,~.l. ............. Depth ..~..~.i ................ 7. D~mens~ons of ex~sting structures, ~f any: Front Height .......................... Number of Stories .... .~ ......................................... -~zz~; ...................................................... D~mens~ons of same structure with alterations or addmons: Front ........... ..'~.....2~ ............................. Depth .............................. Height ............................. Number of Stories ........................................ / 8. Dimensions of entire new construction: Front ..~...~.. ................... Rear .....,~...~z....../. ......... Depth ...~?.~..../. ......... Height ..../..~....x. .............. Number of Storms .....~ ...................... 9. Size of Jot. Front .... .~.~.~...~...~ ....... Rear ...~..~.?...:.~....'~.. ..... Depth ..~m...\.(~...~...:.k...~.. ........ 10 Date of Purchase ...........~ ....... .~..~....~....! .......... Name of Former Owner .'~.~X~..~....~...'~.~..~.~...~..~....~...%~... .... 11. Zone or use d~stnct m which premises are s~tuated ............................................................................................. 12 Does proposed constructiomwolate any zoning law, ordinance or regulat~on~ ~ c~ 13 Name of Owner of prem,se~X'~.:..~...~....~.~x~..~.~X.....~.. ........ Address~B..~.~.%.~..~.~..~..~.~...~x~.~..~..~..phone Nome of Architect .............................. ..~...'~..~_ ............ Address ............................................ Phone No .................. Name of Contractor ..%q-.?.x~.~ ....................... Address ............................................ Phone No .................. PLOT DIAGRAM Locate clearly and d~stinctly all buddings, whether ex~sting or proposed, and indicate all set-back dimensions ftc property hnes. Gwe street and block numbers or description according to deed, and show street names and md~ce whether interior or corner lot. STATE OF NEWx~ORJ~-z,_~ COUNTY OF "~"-'-'!'( '~ ~"~'fx/'~.., ~~c.,....---,:~...~ ...... ,. I~;;~'~L ~'~ ..... ~ema deposes and says that ~e is t pi ....................... ~ ............... ~ ................................................ _ duly sworn, (Name of ind,vidua, sign,n~~ above named. He ~s the ................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make an~ th,s apphcation, that all statements contained and that the work will be performed in the manner set forth in the apphcation filed therewith. Sworn to before me th~s ..................... .... : ......... ..... ....... Z/ ..... .......... Term Exp)res M~rch 30,