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Home My WebLink About3000-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE: OF OCCUPANCY THIS CERTIFIES that the building located at ....... ~/.I],....~1t4,~8...~t, ............................... Street Map No......~.. ............... Block No....~,.. ................ Lot No. ~ ....... .~...~.~.~...e..~...~....[...S..~..~II....~.~..~..*. ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............................. ~..~.~l~.l~j~'......~, ....... , 19...~..... pursuant to which Building Permit No..~....~.. dated .............................. ~.~.~ .......... ~....., 19..~;~.., was issued, and conforms to all of the requirements of the applicable provisions of the Jaw. The occupancy for which this certificate is issued is ........ ...... ............................................. i ............................................. The certificate is issued to ....J)Z'.....]~I~.~ll .............. .(~1]~'. ................................................... (owner, lessee or tena,nt) of the aforesaid building. FOI~FI NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT N? (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 3000 Z Date ...................... F~b~?8~.~' .... ~.6 .......... Permission is hereby granted to: A. ~.,e, ad~.....A/~...~.,..:~.a:~.ph...}~e~tt ................ .......... P~.s~e~.s...:[s.~.~ .................................... FORM NO. I TOWN OF SOUTHOLD ~ BUILDING D£PARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .................................~......, ........ Approved ........................................ , 19.:.......Permit .... D,sapproved a/c ........ ~.~ ........... ~~~ · ....................... .................................. r~(Building I specf~or) Application No ............................. - APPLICA!ION FOR BUILDING PER,MIT ............... ., INSTRUCTIONS o. This application must be completely filled in by typewriter or m ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving o detailed description of layout of propertymust be drown on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue o Building Permit to the applicant. Such 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 in part for any purpose whatever until a Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of SouthoJd, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. (Signature of applicant, or name, if a corporation) .......... ~i~eJ~j.. ~r ..~..¥~r~ ................................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor electrician, plumber or builder. ...................... C.~_ z~J, .C~*. ~, ~.~ ................................................................................... Name of owner of premises ................. ~.,..'~1~..~¢.~..~.~h ............................................................................................. If applicant is 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: .l{ll~Jg~..J~.t~ ................ Lot No: .................... Street and Number ....................................................................................................................................................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: 3. Na ReF 4. Esti 5. If If 6. If 7. Di~ Hei Din Dep 8. Din Hei 9. Siz~ 10. Dar 1 1.Zor 12. Do~ 13. "No~ Na~ Na~ J-oeo property I whether ir STATE 0 COUNTY Jre of work (check which applicable): New Building Addition X Alteration i 3¢ ~ir .................... Removal .................... Demolition .................... Other Work (Describe) ........................ .............. (to be paid on filing this appl,ication) ~elling, number of dwelling units ............................ Number of dwelling units on each floor ............................ ~rage~ number of cars ........................................................................................................................ , .................. usiness, commercial or mixed occupancy, specify nature and extent of each type of use ................................ msions of existing structures, if any: Front ....,~3.!.~{J.". ......... Rear ..~.~..?.{)!! ........... Depth ...~.~..~.?.~, ............. ht ..... ~4~.-..~I~ ......... Number of Stories ................ ~ ........................................................................................... ;nsions of same structure with alterations or additions: Front ....~1~..*~1~ ................ Rear JlJJ.~.~..¢l~.....: .............. th ...... ~...~13 ............ Height ....JJ~...,{) ............... Number of Stories ...........~....'.....' ................. ensions of entire new construction: Front .... ' Rear Depth ~ht ............................ Number of ,Stories ............................ of lot: Front ............................ Rear ............................ Depth ................................ of Purchase ...~L~...,~.~...~ ................. Name of Former Owner ...... ~...~...U~...~,~.~.l ............. or use district in which premises are situated ........... ..~.~/~.~.~.~'~. ............................................... i ............. proposed construc:tign viola]re any zoning law, ordinonce or regulation.;) .......... ~ ......................... i .............. ............................................ No. ~.~.,.! .............. ne of Architect ...................................................... Address Phone Contractor .~.......~.~.....~......,..~..,....~....J~..~.X'..:~,ddress .~...J..~.~.m....J..~..J.~..,.~..~,.~'.,~. Phone No.'~.~?...~..~.... PLOT DIAGRAM i clearly and distinctly all buildings, whether existing 6r proposed, and indicate all set-bo~k dimensi!ons from les. Give street and block numbers or description according to deed, and show street names and indicate ..... be ng duly sworn, deposes and says that he is the ~pplicant ' Name of individual signing application) above no* ~ed. He is the ........... ............................................................................................................................... , .............. (Contractor, agent, corporate officer, etc.) of said o~ner or owners, and is duly authorized to perform 'or hdve performed the said work and to make and file belief; this application; that all s{atements contained in this applicat on are true to the best of h s knowledge aqd and that ~he work will be performed in, the manner set forth in tfi~ application filed therewith, , Sworn to ~ef~re me this ~; _ ~ j ......... ....... F ...... .......... . ................................................................................. ¢ .............. [,ot~r~ ~, Jbli6 ~/~~~ ~ounty (S onature of opp cont) NEW YORK, }, S.S. terior or corner lot. i ! jg' ~" i