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Home My WebLink About3332-zFORM NO. ,4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BERTIFICATE OF E]P.[3UPANCY No. Z- 2~ 'Z- Date " THIS CERTIFIES that the building located at ~/S ~ G~ ~, Street Map No. ~ Block No. ~ Lot No. - ~ ~thold ~ ~,Y, ........ conforms substantially to the Application for Budding Permit heretofore filed in this office dated ~OV · ~0 , 19 ~ Dursuant to which Building Permit No. ~. dated ~e ~ , 19 ~, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ~l~te ~ f~ly 'd~e~ .......................... The certificate is issued to ~o~ S~i~__~--~ner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval FOl~! ~TO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 3332 Z Permission is hereby granted to: ~.~.~tmal.t~l..~ttl~tr~..~..C~t~u~.t~mm Corp A/C .'ohn S:lmiou! ......... S~u:t.ho3,d .................................................... to ....~.]....d.....~..e..~....,o. ,~e.....ff....a~...~..~.~'.., .d.~,~ ~..~, ;~3,~ ................................................................................ et premises located at ..... .~./,~........~.O.~....~.~.~..~.~'~V.I .................................................................. ............................. ~outhaldt.....~.~¥.. ............................................................................................... pursuan¢ to application dated ........................... ~.~IT~..."IO ................ , 19.~6.., and approved by the Building Inspector, Fee $..~.O..:...O~... .......... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exammed ~ ~ ~ 19~ /~ Approved ........................................ , 19 ........ Permit ~o ............................... Application No...~....~....~....~... ....... APPLICATION FOR BUILDING PERMIT Date ................. ~...~./~......./..l~.. ..................... , 19,.~...~.. ..... INSTRUCTIONS a Th,s application must be completely filled m by typewriter or ~n ink and submitted in duplicate to the Building Inspector. b Plot plan showing location of lot and of buddmgs on premises, relahonship to adjommg premises or public streets o, areas, and g~wng a detaded description of layout of propertymust be drawn on the d~agram 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 to the applicant. Such permit shall be kept on the premises available for mspection throughout the progress of the work. e. No bulldmg 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 HEREBY MADE lo the Bu,ldmg Department for the issuance of a Building Permit pursuant to thc Budding Zone Ordmance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o, Regulations, 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, ordmances, building code and regulations. ,.,, .... .......... (Signature of opphcont, or name, if a corporation) _ ............................ (Address of opplicdnt) State whether opphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ............................................................................................................................................................ Name of owner of premises ...... ~...~...'~... ........ ~ ..'~.'..~le.,~.: ............................................................................................. If applicant rs a corporate, signature of duly authorized officer ........... ................... J (Name and title of corporate officer) 1. Location of land on which proposed work will be done Map No .............................................Lot No: ................... Street and Number .... ...~...~....~.....~.. ..... :~.~.~.~..~..~.........~.~....~..~..-'~.....~ ................................................... /Vfumopality 2. 'State ex,stag use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................................................................................................. b. Intended use and occupancy ....... I~.~.-~../.~./,.~....~...~Z...-~.. .................................................................................... v 3. Nature of work (check which applicable): New Building ..... Ft ......... Addition .................. Alteration ...: ............ Repair .................... Removal .................... Demolmon .................... Other Work (Describe) .................................... 4. Est,mated Cost ............. /~.~,,~.,¢¢~2.....~... .................. Fee .... /~.,....~/~ ........................................................................ (to be pa~d on flhng th~s application) 5 If dwelhng, number of dwelling umts ............ ./.. ............. Number of dwelling umts on each floor ...... /.. ................. If garage, number of cars .... .~....¢f'/g~ ....... ~..Z'/-Agf.~ ......................................................................................... 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................... 7. Dm~ens~ons of existing structures, ~f any: Front .......................... Rear .......................... Depth ........................... Height ............................ Number of Stones .............................................................................................................. D~mens~ons of same structure w,th alterations or aod't OhS Front ................................ Rear ............................... Depth .............................. He,ght .............................. Number of Stories ........................................ 8 Dimensions of ent,re new construct,on: Front ....... ~..-~. ............. Rear ...... ~...~..: ............ Depth ..~..~ ................ Height ......... ..~..¢..: ........... Number of Stones ............ ./. .............. 9. Size of lot. Front ...... /...~.. ................ Rear ......... Z'.~ .......... Depth ......./..~..:....~. ......... 10 Date of Purchase ........................................................ Name of Farmer Owner .Z~/7~.,~.,...~...~..,~.~.~...-. ........ 11. Zone or use district in which premises are s~tuated ..... .~'~..¢~r/..~.~-rzv. Z-J~.'.¢. ........................................................ 12 Does proposed construction wolate any zomng law, ordinance or regulation? ../~..0 ............................................. 13 Name of Owner of prem~ses,,.Z~4:t~. ..... -~'/.~-~..~'~..'...Address ...... ,.~Zz~/,~ .................. Phone No .................... Name of Architect ...................................................... Address ....................................... : .... Phone No .................... Name of Contractor i~.~X-~/~...~.C~...~.C°.~'/'/~./....Address ..~'~'z--~.~.....~.Z~.~..~.'. ....... Phone No. J..q...-~...~.~Z,.~. PLOT DIAGRAM Locate clearly and d~stinctly all buildings, whether existing or proposed, and ~ndicate all set-back dimensions fron property lines. Give street and block numbers or description according to deed, and show street names ond indicat: whether interior or corner lot. e- c- STATE OF NEW YORK, ~ S.S COUNTY OF ................................ (Name of individual s~gnmg application) above named. He is the .~W~ ..... ~/~.~.~ ................................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and ~s duly authorized to perform or have performed the sa~d work and to make and th~s application; that all statements contained ~n this applicahon are true to the best of his knowledge and belief and that the work w,II be performed in the manner set forth in the apphcation filed therewith. Sworn to before me tbs ~o 523~3'~¢J 3~,~1 C untv. ferB Expres March 30, zg~ ~