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Home My WebLink About3346-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at . ~elltl~l, la .~B:IVd ....................... Street Map INO ...................... BlOCk No ................. Lot conforms substantially to the Apphcat~on for Building Permit heretofore filed in th~s office dated ....... ~e~.~l:~lbe~..,2,~, ..................... 19 66- pursuant to which Building Permit No 3~[4~0~... dated .. ]~l~.¢~j~ll~..~J ........................ 19 ~6., was issued, and conforms to all of the requirements of the apphcable provisions of the law. The occupancy for which th~s certificate is issued ~s ....... (owner, lessee or tenant) of the aforesaid building ~'0~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. N.o BUILDING PERJV~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPEETION OF THE WORK AUTHORIZED) 33z]6 Z D. te ............... ,~e~ ....... ,~ ......... , ~....~...~ Permission is hereby granted to: ...~,~....~.,~.~..~.....~...~..,.0.......~ela.~ ............... ~.~.°...Z.~.L...~.:~.'. ............................. at premises located at ..~.~..~t..~~..~Zll~ ................................................ ,_pursucm¢ to application doted ................... ~JltJJ~ ....... ~JJ[ .................. , 19.1l~.., and approved by the Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. om,ned ........... Approved ........................................ , 19 ........ Permit No.'~..~....~....~. .................. Disapproved a/c .................. ............................... ............................ APPLICATION FOR BUILDING PERMIT Date ..................... .D...e.g.~..~...'g..e. ?.. ......... ..~.~....., 19..0...6. ...... 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 propertymust 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 o Building Permit to the applicant. Such perm t sba be kept on the premises available for inspection throughout the progress of the work. e. No bud ng shall be occupmd or used m whole or n part ~or any purpose whatever unt I a Cert f cate of Occupancy 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 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. Robert Hyatt (Signature of applicant, or name, if a corporation) Southold (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~g.'-~{~.~.~....(~.~...$.¢,~'1~..c1,~,~. .................................................................................................... If applicant is a corporate, signatuKe of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which pr~osed work will be done. Map No: ...... ~.~..~.~.~.... L~ No: ...~ .......... E~S East branch Mi~ehaha Blvd Sp.~.~ol~"' ~.~.t Street end Number ~ ,~ ....... ~unicipeli~ 2.Stete existing u~ ~nd ~cupency of premises end intended use end ~cupency of pr~osed const~ction: e. Existing use end ~cupency ......... ~.~.~.~E ...................................................................................................... u,e occupancy ............ ................................................. 3. Nature of work (check which applicable): New Building .................. Addition ........ ~ ..... Alteration ..... ~ ...... Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost ..... ..'~....~...~.. ................................... Fee .~.,0.Q ............................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... 4)z~e ............... Number of dwelling units on each floor ............................ If garage, number of cars ................o~e .................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front ..........................Rear .......................... Depth ............................ Height ............................ Number of Stories ............................................................................................................... Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ..... ~,0C~ ............... Rear ....~.~.0 ................. Depth ......'12.~[/...~3,c,i ...... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ........ .~.~..A..t!....~...J...s...1;. ..................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ......... ]3.~ ........................................ ]3. Name of Owner of premises .~..:..0..:..S..q,..~3.~.~f~.~.~ ......... Address ..~.~.~,~]4RCLT..{~ ....................... Phone No ..................... Name of Architect ...................................................... Address ............................ ................ Phone No ..................... Name of Contractor ..~o...~[.~re,.l~¢ ............................... Address ......... .S...o.~.1;;.~.o.,],.cl, ................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. ~ . / /o¢' "2' / STATE OF N% Yg~RK. ~ COUNTY OF :....~.~,~ ............. / S.S. · Rob..e. rt .~.~.{~.~ be n duly deposes and says that he is the applicant ................................................................. g sworn, (Name of individual signing application) above named. He is the .................... .~.O~.~C.~,oz'. ............................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and t~ make and file this application; that all statements contained in this application are true to the best of ~lis Is{m~Ddg® and belief; and that the work will be performed in the manner set forth in the appliccj~on filed thRre~..,'~~ ~ ' Sworn to before me this ~ ~}(:.%. .................... ~2,. day of ............ Dacemb~ ............ , 19.(;~6.. ~'~ Notary Public,. ........................................................... Count}: ........................ ' T '(-S'i~'~; ~'~'~;' ' ~1~ ~ i [~'c~i ............................