The URL can be used to link to this page

Home My WebLink About3103-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTNOLD, N, Y. CERTIFICATe OF OCCUPANCY No. Z....2~.2 .......... Date ............................. ~Tl,t],y.....~,~ ........ , 19..6.~.. THIS CERTIFIES that the building located at "~'~'"}[O~'"N~J]J"'"~E~$' ................... Street M F~,shers lsland~Est~tes ap ,'~o ....................... ~iocK ~o ....................... Lot No. 2'~L't ....... conforms substontiolly to the Applicotion for Building Permit heretofore filed in this office dated ............................. ~l..y ........ ~9 ................. , 19~(~... pursuont to which Building Permit No. doted ................... ~ ....... ~ ................. , ] 9.~(~.., was [ssued~ and conforms to oil o~ the requirements of the applicable provisions o~ the Iow. The occupancy ~or which this certificate is issued is ........ ............... P.~.ve .~ .. en~..ge, ra.i.~..~ ..d~e ~..~,~g. ................................................................................. The certificate is issued to '"'])~t~;"~"'~T~',~ ........ ~ ........ (~t~*l~' ...... : ....... '.'~ .............................. Lowner, lessee or tena.nr) of the aforesaid building. muilding Inspector FOP~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF'THE WORK AUTHORIZED) Permission is hereby granted to~ .... i ........................... P~.~.,.R.o~d.....O/8...~ddle...F..a~m$.~. ............................................................... . ~.~ab~..,ta:~,.~,~.. ]~ ................... pursuant fo application dated ........................... ~. ...... 4~.~. .............. 19~...., and approved by the Building Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. Exam,ned ..... Approved L t 19 ........ Permit No. Disapproved a/c ........... ~~ ................................. 3/03 Application No ............................. APPLICATION FOR BUILDING PERMIT 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 port 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 Buitding 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 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 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. (Signature of applicant, or name, Jfa corporation) . Fishe~-s Island, New .Yot-k . . . (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Genet'al ConCractor' Name of owner of premises ..... I~ [.d..~.,...l:[enke. J ............................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) / 1. Location of land on which proposed work will be done. Map No: .......... ............................. Lot No: .~...~ Street and Number ......F..J..s...h..e...r,.~....l..$..].~..n..d. ................................................................................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........... 0:e'.ft.J.J..J~t9 .................................................... ~.. .............................................. b. Intended use and occupancy ......... Du.e.[.I,$~9 ..................................................................................................... 3. Nature of work (check which applicable): New Building .................. Addition ..... ~ ........... Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) 4. Esti~nated Cost ......$.6~.0.0.0.~ ..................................... Fee .......... ~..L0.,~ ~ (to be paid on filing this application) / ,5. If d~velling, number of dwelling units ..... I ...................... Number of dwelling units on each floor If g~rage number of cars 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 ....... 2~)..~, ............ Depth ....2~. Height ....... .~ ........ Number of Stories I Di~sions o~ s~e str~ct~r~ with ~lt~r~tions or ~ddffio~s: ~ront .......................... R~r ..... ............. Depth ......... ~Z.~ .............. Height ......... [.~.~ ............... Number of Stories ...... construction: Front ............................ Rear ............................ Depth 8. Dimensions of entire new - Add Room 17~' x 12' Height ......... ~4.1 ............. Number of 5tor~es ..... J ...................... 9. Size, of lot: Front ...... .~.50 ............ Rear ...~.59. ............... Depth ...~.~5~. ................... 10. Dat~ of Purchase ........................................................ Nam~ of Former ~ner 11. Zon~ or use district in which premises are sffuated ....... 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? ........ Name of Architect ...................................................... Address ............................................ Phone No. PLOT DIAG~M Locat clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr property Ii ~es. Give street and block numbers or description according to deed and show street names and, whether in ,rior or corner lot. .......... ;[~, ........... 7' '"~:'?;'"'['"X"": ........................................ boino duly sworn, deposos *nd ~oy* that ho i~ tho opplk ~momo or mow~ouo s ~n~n~ opp cotion) above na~ed. He is tho ....................................... ! (Contractor, o~ont, corpor~to officor~ of s~id o~or or owners, and i~ duly outhorizod to porform or h~ve por{ormod tho ~*id work ~nd to moko ond th s appliqation; that ami statements contained in this application are true to the best of his knowledge and bom and that the work will be performed in the manner set forth in the application filed therewith. Sworn to ~fore me this ) ~ Qualified In SuffoI~ Coun~ [[ , Term e~ires March 30, 19 ~ ~ '