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Home My WebLink About3028-zFO1LM NO. 4 TOWN OF SOU'THOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SO.UTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z 2657 Date Ja~lua~¥ 3]. , 19..~..T.. THIS CERTIFIES that the building located at M~,D .................................................................. Street Mop No. ~ Block No. X~ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................................... ~...~.:~....~, .......... , 19...~..~.. pursuant to which Building Permit No....~.Q~.$....~ dated ................. ............ k~.a.~..~..h....~..~. ....... , 19....~, 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 ........ add:L~,on tO one £amily. d~el].~n.g. The certificate is issued to J~hn Tutl'~ill (owner, lessee or ten.a,nt) of the aforesaid building. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3028 z Permission is hereby granted to: ~r7 amt...~abor..... A/¢.. J, ha...~u~h.i..tt ................. .............. ~:)r.~,ent~,...~,~, ..................................... to..B~A.I~.. ~r~..a~d ',.t ~n'-'o~"an" exi'~ ting" 'd~e ~['!:[rig ................... ..................................... at premises located at ....~/..[q.....~i~l..ROP,~ ........................................................................................ ........................................ ~ient~.....JLZ. .......................................................................................... pursuant to application doted ....................... J~'~t~l ......... .~ .............. 19.~3~., and approved by the Building Inspector Fee $ ..~[.~'.~. ............ Building Inspector FOI~M iNO. I ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT ×omin d ..... ...... , Approved ........................................ , 19..~ .... Permit Mo ............................. Disapproved a/c ~~~~ ............... ................................. Application No. '~ O %~r~ APPLICATION FOR BUILDING PERMIT 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in 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 a detailed description of layout of property must b~ drawn on the diagram wh ch is part of this appl cation. 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 a 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 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 1he Building Zone Ordinance of the Town of Southold, 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. (Signot~ of applicant, or name, if a corporation) ....... ......... ........................................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or ~buiider. 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' ~ /~ Lot No.: ...~.....~. ........... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing b. Intended use and occupancy ~ ~ ~ ~Z A ~ [ ~f ~ 3. NatUre of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repc)ir .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estir~ated Cost .........~,, ....................................................................................................................................... j (to be paid on filing this application) 5. If d~,elling, number of dwelling units ............................ Number al: dwelling units on each floor ...............' ............. if g(~rage, number of cars ............................................................................................................................... ~. ............ 6. If ~us ness, commerc a or m xed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .......... i ......... Height ........................ Number of Stories .................................................................................................... ............ Dimjensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimlensions of entire new construction: Front ........... ../....~. ................. Rear ......... ~.]1'~. ............ Depth ...."~...-~.. ............. 9. Size of lot: Front ............................ Rear .................................... Depth ................................ ]0. Dar, of Purchase ........................................................ Name of Former Owner .......................................... ; ............. 11. Zen or use district in which premises are situated ..................................................................................................... 12. Doe~. proposed construction violate any zoning law, ordinance or regulation? ............................................................ 13, Nar~e of Owner of premises .~.~......~.~..!..~..L~..~......Address ............................................ Phone No .......i .............. Nar ~e of Architect ...................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locat~p clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show ~treet names andi indicate whether in erior or corner at. STA'['E OF NEV~YORK~, , ~ S ~ COUNTY, )F ...~.)...~...~./..~..c!..c../..~.......,f .~. : ................. !....~..../~.~..~.~..'Z.......'-~../'~..~.~..C.~r.. ........................ being duly sworn, deposes and says that he is the ~pplicant (Name of individual signing application) i abow~ nan~ed. He is the .......... .?....°....A~....~...~..~.C....~..~.~.¢.~ ...................................................................................... t .............. (Contractor, agent, corporate officer, etc.)j of said owner or owners, and is duly authorized to perform or have performed the said work and to make! and file this appli(~ation; that all statements contained in this application are true to the best of his knowledge and b~lief; and that the w~rk will be performed in the manner set forth in the application filed therewith. Sworn to I:(efore me this ............... of ............ ........ , otary .......... ............................ ~J _. MARIO[I A( REG[[]T ,Term Expke$ NLarcl~ 30, 19..,~'"~