The URL can be used to link to this page

Home My WebLink About3118-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. OERTIFIOATE DF OCCUPANOY No. ~.. 29.7.0 ..... Date ............ December...28.., 19.67. THIS CERTIFIES that the building located at ~/~.. :enr~tnzula. i~oa~t ..... Street Map No.. xx ...... Block No. ~cx ......... Lot Noxxxx .... Fishers..Is~a~d~.. conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ ,iul~e. · .7 ..... , 19~.. pursuant to which Building Permit No.. dated .......... Ju~e.. · -9 · ..., 196~.., 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~rl~;a.te, one. family'. ~.wel~.,%~ ..................................... The certificate is issued to .. l{tchard..&. Pa~;]:ic-~ a ./:alc~l~ ........ fl%me~'~ ......... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ../~.e..n.cl.i.~g ........................ FOP~M NO. 2 TOWN OF SOUTHOLD ~UILDING DEPARTMENT TOWN CLER~('$ OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FuLL COMPLETION OF THE WORK AUTHORIZED N? 3118 Z Permission is hereby granted to: ~t.e.~.~..¢l..~...~ i~ ~lr.~ ......... ..:.: ............. pursuant to application dated ............................ ¢T?~J-~ ....... ~. .............. lC~(~...., and approved by the Building Inspector Fee ~.~_.~;;;~ .... Building Inspector ~ FORM NO. 1 TO~h'N OF SOUTHOLD BIJiLDIN~ DEP.4RTJ~EiqT TOWN CLERK'S OFFICE E×om,ned ................... .7. .......... , ~c~roved c/c ........................................................................... ........ .......... .......................... , (Buildinfl Inspector) Application No. ~ I I ~ APPLICATION FOR BUILDING PEP, M~T INSTRUCTIONS o. 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 o detailed description of layout of property must be drown on the diagram which is port of this applica- tion. 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 opplica,nt. 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 pa rt for any purpose whatever until o Certificate 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 Coqnty, New York, and other applicable Laws, Ordinances or Regulations for the construction oF buildings, additions, alterations, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable lows,ordinances/~, ~~'°n¢~ regulations. '~Y'~ ~'~ ~n~ ~,{Sig~ ature of applicant, or name, if a corporation) (Address of applicant) Stace whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. if applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) F, T, Estates 1. Location of land on which proposed work will be done. Map No.: ....~BI~C~./~4~ .................... Lot No.: 1~ . Street and Number e, _R~. ad,' Fi~her.~ Islan~ '~New York Municipality 2. State existing use end occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy ~acant b. Intended use and occupancy Residential NatUre of work (check which applicable): New Building .I( ................. Addition .................. Alteration 3. RepAir ....: ............. Removal .................. Demolition .................. Other Work (Describe) .................. 4. Esti~nated Cost ~'.0.0.0... '. ........................... Fee $ (to be paid on filing this application) 5. If d veiling, number of dwelling units ....1. ........................... Number of dwelling units on each floor - If g~rage, number of cars ............................................ 6. If b 4siness, commercial or mixed occupa,ncy, specify nature .and extent of each type of use 7. Dim msions of existing structures, if any: Front ....; ....................... Rear ............................ Depth Hek, ht ...... ...................... Number of Stories ~ . ..................................................... , Dimgnsions of same structure with alterations or additions: Front ................................ Rear Depth ............. ; .................. Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ..... 'J12.!.' .................. Rear ..~.[. .................... Depth Height ...... ],~.~. .................. Number of Stories ..]....g..v..e.?..~..J......t~..~®mel~ , 9. Size!of lot: Front .......... ;~f)f).t.[.~...ff... Rear ..... ,~i.~)~..~.~ ................ Depth ...~.~9'!..:.+..'. .............. 10. DateI of Purchase "l~.~.~.~6b, Na,m~ of Former Owner ~../l',,,l~t,~e~ 1 1. Ton, or use district in which premises are situated..?~1~,.81~.e~ ............ 12. Doe: proposed construction ~Jolate a~y~zo~ina law ord nonce or renu at on~ r ~ iJ 1r ' ~ ............................................... ~ ........ 13. Nan of Owner of premises~.~..??.~.~.~..4.~.,....~..~.~.~..... Address ..~.~.~..h..e~...Z.~?.~:.~:. ......... Phone No. Nan of Architect ...... (~J¢*II~.~:: .................................. Address ................................................ Phone No ............. Nan of Contractor O~ner . .................................................. Address ................................................ Phone No ............. PLOT DIAGRAM Loca'e clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions f property nes. Give street and block numbers or description according to deed, and show street names and indi, whether irjterior or corner lot. STATE O~= ) COUNTY ) S.S. ..... ~.'..4 ..~-....~.~ £ ..~.. ............................ ~.'.!..(~.~. .......... being duly sworn, deposes and soys that he is the applic¢ (b~ame of individual signing application) above nam~d. He is the ..(,~.-P ..... ..... i (Contractor, agent corporate officer, etc.) of said owner or owners, end is duly authorized to perform or have performed the said work and to make and f e th application;jthat all statements contained in this application are true to the best of his knowledge and belief; ar that the walk will be performed in the manner set forth in the application filed therewith. Sworn to b~fore me this ~ / ~/' ,,~ Notary Pub ic ~.%,.~.~..~.~.~....q-).~.~¢~.A0. pAs..~Aq ......... County ~ / (Sianoture of aDo ca'hr) ..................... ,t \1' ' IQualified ~n Suffolk Count" - .... j ' '~ '~erm ox~ire~ March 30, 19 ~ ~