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Home My WebLink About3304-zNO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .......... HO..~..~..O..~.....~..~...~..tl.~. ........................... Street Map No ..~ ......... Block No ...~ ........ Lot No. ~ .................... ..J~....t..~.:lt..t...~..~..~...~.....~......~..... conforms substanhally to the Apphcahon for Budding Permit heretofore filed ~n thru office dated .................... ..~..O..V.~.~....?. ............ , 19.6...~. pursuant to wh,ch Build,ng Perm,t No 3..~...0..~.....~.. dated .................... .~....0~..~'..'/ ............ , 19...6..~..., was issued, and conforms to all of the requirements of the applicable prows~ons of the law The occupancy for which th,s certificate ~s issued ~s ....... ............... ~..v..a.~e......c~...~.a.~.e..~..~.a, ~g..e.~...s:,o. c~ ........................................................... The certificate is issued to ...... .~.~....&......*~...~.~.~.~.....~..~.t,~.~. ................................................. (owner, lessee or tenant) of the aforesaid budding Building Inspector FORM 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 PULL COMPLETION OF THE WORK AUTHORIZED) N? 3304 Z Permission is hereby granted to: at premises located at ...il~/6....~l~13~r,~...&~ .................................................................................... ..................................... ~,t..t.~ ................................................................................... pursuan,t to application dated ......................... II~.~ ......... ~ ............... , 19~..., and approved by the Building Inspector. F~ NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam,ned .......... }~.7 ............. 19..~......~. .Approved ........................................ , t9 ........ Permit No ..O.. ...... D,sapproved a~..~... (Budding Inspector) Application No....?...?....~...~. ........... APPLICATION FOR BUILDING PERMIT ....... ..... ........................... INSTRUCTIONS o This application must be completely filled m by typewriter or in ink and submitted in duplicate to the Buildin, Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o areas, and gw~ng a detailed description of layout of propertymust be drawn on the d~agrom which is part of this application c. The work covered by this opphcation may not be commenced before ~ssuonce of Building Permit. d. Upon approval of th~s application, the Budding Inspector will issue a Budding Permit to the applicant. Sucl permit shall be kept on the premises available for inspection throughout the progress of the work. e. No budding shall be occupied or used in whole or m pa rt For any purpose whatever until o Certificate of Occupanc: shall have been granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Budding 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 applicable Laws, Ordinances o Regulahons, for the construction of buddings, additions or alterations, or for removal or demolition, as herein described The apphcant agrees to comply with all applicable laws, ordinances, building code and regulations. To -.. ....... ....................... /1~ V ~ ~W~ ~ .6 r~ ~ (Signature of applicant, or name, ,f a corporation)' .... ,/)? 7 (Address of applicant) State whether applicant i~lessee, agent, architect, engineer, general contractor, electrician, plumber or builde, Name of owner of premises ................ ~ ......................................................................................................................... If applicant ,s a corporate, signature of duly authorized officer (Name and t~tle of corporate officer) 1. location of land on which propgsed work will be done. Mop No ................................. Lot No: ..... Street and Number ............................................ i~ ........................... 2. State ex~sting use and occupancy of premises and ~ntended use and o~.upancy of proposed construction: a Ex~sting use and occupancy .................. ~ ............................................ ~ ....... .*. .......................................... b. Intended use and occupancy ................................................... ~ ................. ~ ................................................... property lines. Give street and block numbers or description according to deed, and show street nar whether interior or corner lot. _%* 3. Nature of work (check which applicable}: New Budding"~1, ,.t~,~ Addihon Alteration Repmr .................... Removal .................... Demohtion .................... Other Work (Describe) ..................................... 4 Est mated Cost ...................... .4...~....'f. ............................. Fee ..................... .'.--2.. ................................................................ (to be paid on filing this application} 5 If dwelhng, number of dwelling umts ............................ Number of dwelling umts on each floor ........................... tf garage, number of cars ~'~ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. D~mens~ons of ex~sting structures, if any: Front .......................... Rear .......................... Depth ........................... Height ........................... Number of Stones .............................................................................................................. D~mens~ons of same structure w~th alterations or additions. Front ................................ Rear ............................... Depth ............................. Height ............................. Number of Stories ........................................ 8 Dimens,ons of ent,re new construction: Front ........... ~:2.~ ........ Rear ........... "'--!'~<'"~:"~' ...... Depth ....~"r.~ .............. Hmght ............................ Nur~ber of Stones ........ 9. S~ze of tot Front ......../..?...?. ............ Rear ............................ ~'~th ................................ 10 Date of Purchase ....................................................... Name of Former Owner ....................................................... I 1. Zone or use dtstnct ~n which premises are s~tuated ................................................................................................ 12. Does proposed construction wolate any zoning law, ordinance or regulation? ............................................... 13 Name of Owner of prem,ses ,~1.~ .~....~~..~q ..... Address ./...~..~..(~...~g~. .................. Phone No~.~..Z....~...~.~. Name of Architect ...................................................... Address ............................................ Phone No .................... Name of Contractor ...................... 7..~; ........................ Address ............................................ Phone No .................... PLOT DIAGRAM Locate clearly and distinctly all bu~ildmgs, whether ex~sting or proposed, and indicate oil set-back fror and ind~cat STATE OF NE~Z/C,,.~,,,....~.~.¥.,,,. · c°uNT .............. s.s ,, .................................................. , ............................................. being duly sworn, deposes and says that he is the applico (Name of individual s,gn,n~n~ above named. He ~s the ..................................................................................................................................................... (Contractor, agent, corporate officer, otc of sa~d owner or owners, a~d is duly authorized to perform or have performed the said work and to make and f th~s apphcohon, that all statements contained in this application are true to the best of his knowledge and bell, and that the work wdl be performed in the manner set forth ~n the apphcotion filed therewith. Sworn to before me this / ...................... /~-¢.':~'r'~ ..... ~:~k~,'c~'~ ~. , , ~, L ~ -- ,bhc, .: ....... .............................. .............. ..................