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Home My WebLink About3031-zFO~M NO. 4 TOWN OF SOUT~HOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ....~./.~.......~..~..B....~,.O...~.~....(..~._~..~...~..). ............... Street Map No ..... ~ ............. Block No ........ ~ .........Lot No .......Z~. ....... ~t~.~..~..t~.~J~:~.O.~'.~ ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................... ,F~%...-.3.0 ............... , 19..66. pursuant to which Building Permit No...~..O.~..~.....~ dated ................................ Ma~.e......~O....., 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 ........ ....... Ctub..Hou~e...~.or...3:.~,.l~n~..End...O3,ub ..................................................................... ~ ........... The certificate is issued to ...... .z.s.~.a~d..l~ncl...a..:Lo~t..&..C, our~.t~.~..,a3~uh .............. ~.e~ ......... (owner, Jessee or tenant) of the aforesaid building. Building Inspector J TOWN OF SOUTHOLD i~UILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Yo BUiLDiNG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3031 z Date ..................... ~.I~ ......... 3~. ............ , 19...~...~.. Permission is hereby granted to: Eieht~.~...i~o~,.Z~.o.v. em~mt..Co.....~.~.C...~al~d ~;nd Golf Club ......... ~z~e~rt~e~ ................................................. to .hu&.ld...a~..~dd.i.~.o~..~m..an...~tat$~..~l~.b hl$Lld~.~ ............................................ at premises located at ....~/~.....~4~.~.~.J.~. ........................................................................................ .......................................... ~ ~:e ~.-.-}~e~:to~ · ~ - ~J~<ee~l~e~ %.~....~ ~ .~. ~.. - ..; ........................................... pursuant to application dated ....................... ;.,,.~,~ ....... ~ ......... 19..~., and approved by the Building Inspector Fee $.,.~.o. OC) ............ Building Inspector TOWN OF SOUTHOLD BUILDING DEPAI~TMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........................................ , 19 ........ Approved ........................................ , 19 ........ Permit No ............................. Disapproved a/c .............................................................................................. Application No ............................. (Building Inspector) APPLICATION FOR BUiLDiNG PERMIT Dat~ ............................. .~..~ ?...e.~..),.....~..O. ......... , 19.6.~.. ...... INSTRUCTIONS a. This opplicetion must be completely fi[Jed in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description .of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced' before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit tb the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose, whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS H.EREBY MADE to the Building Departr~ent for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. 1~$ ~ h.~.~.r... ~Iom ~...Imp. r .o.v.,~m~n.%...G o ................................ (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contragt~r. Name of owner of premises . . I.s..];..a..n.¢ End..~.o...],.~' ~¢ g.O.g~.~.r.M. C]J,!b If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Location of land on which proposed work will be done. Map No.: ....X~....~. .............................. Lot No.: ........................ Street and Number ..... N/.~.....M~it~...R4)ad......P,a~t..zMa.~.i4~D. ............. ' .................................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ~;..O...1.~::...¢..o..g,~.¢.fM~:...g.~l.g.b..]21¢[ ............................................ b. Intended use and occupancy .............. 88~fk..WJ,.C;h..a~..m.dCJ..t.zLozl ................................................................ 3. Nat~re of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .......................... ~ ............. 4. Esti~nated Cost ..................... ~. ..................................... Fee ............................................................................ ~ ............. (to be paid on filing this application) 5. If d elling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If g~roge, number of cars ................................................................................. 6. If b[usiness, commercial or mixed occupancy, specify nature and extent of each type of use .............. k ............. 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Hei~lht ........................ Number of Stories ................................................................................................................. DimensionsL of same structure with alterations or additions: Front .................................... Rear ............................ Dep~hq ................................ Height ............................ Number of Stories ................................ 8. Di~ensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................... : .............. 9. Size~of lot: Front ............................ Rear .................................... Depth ................................ 10. Dot~ of Purchase ........................................................ Name of Former Owner .......................................... ] .............. 11. Zon~e or use district in which premises are situated ..................................................................................................... / 12. Doe? proposed construction violate any zoning law, ordinance or regulation? ............................................................ 13. Na+e of Owner of premises ........................................ Address ............................................ Phone No ..................... Nar~e of Architect ...................................................... Address ............................................ Phone No .......; .............. Name of Contractor .................................................... Address ............................................ Phone No ....... .............. PLOT DIAGRAM L.ocot.~ 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 street names andl indicate whether in~'erior or corner lot. / STATE OFj NEW YORK, '~ c c COUNTY pF ................................ ................. j ............................................................................... being duly sworn, deposes ~nd says that he is the applicant .(Name of individual signing application) above named. He is the ......................................................................................................................................................... i (Contractor, agent, corporate officer, etc.) of said owlner or owners and is duly authorized to perform or have performed the said work and to make.and file this applicption; that all statements contained in this application are true to the best of his knowledge and b~lief; and that the wd~rk will be performed in the manner set forth in the application filed therewith. Sworn to b~fore me this .................~, ....... day of .............. ~ ........................... , ]9 .........