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Home My WebLink About3272-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 .~a3~.d~.~...~.....~..~.~....~.Q~ .................. Street Map No ~ Block No ~ Lot No ~ ....... ~99.~[~.. conforms substantially to the Application for Budding Permit heretofore filed m this office dated .................. ~~...~. ............. , 19.~.~.. pursuant to which Budd,ng Permit No 3~2 .~.. dated ........... ~.9~...~ .............. , 19 ....~was ,ssued, and conforms to all of the requirements of the apphcable prows,ons of the law The occupancy for which th~s cerhficate ,s ~ssued zs ........ .......... ...................................................................................................... The certificate is ,ssued to ......... ~..~.~e~ ............................................................................ (owner, lessee or te~nt) of the aforesaid budding Budding Inspe(~or ~ ......... FOP,~I[ NO. 11 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 3272 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) October Z D~e ~ 1 (~ ..... Permission is hereby granted to: 8outhold new accessory (PVT Garage) building at premises located at ....?..a...~..a..~.~.s..~.....~..o....:~....t-....~...o..~.d.......(.?..¥.~ .......................................................... ~outhold t E.Y. pursuan.t to application dated .......................... .0..~...~. ......... ..]...~. ............. , lC~...~....., and approved by the Building Inspector. Fee $~.00 FOEI~ NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No....~....~....?...~ ....... Approved ........................................ , 19 ........ Permit No. ~ D~sapproved a/c ...................................................... APPLICATION FOR BUILDING PERMIT Date ..................... ~.....(....~.. .......... ,19..('....~. .... INSTRUCTIONS a. Th~s oppficahon must be completety filled in by typewnter or ~n ink and submitted in duplicate to the Bufldint Inspector. b Plot plan showing location of lot and of buildings on premises, relahonsh~p to adjoining premises or public streets o, areas, and giving a detailed description of layout of propertymust be drawn on the d~agram which is part of this application c The work covered by this apphcat~on may not be commenced before ,ssuance of Building Permit. d Upon approval of th~s application, the Building Inspector wmll issue a Building Permit to the applicant. Sucl permit shall be kept on the premises available for mnspection throughout the progress of the work. e No building shall be occupied or used in whole or m part For any purpose whatever until a Certificate of Occupancy, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the ~ssuance of a Building Permit pursuant to th, Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described The apphcant agrees to comply with all apphcable laws, ordinances, building code and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engmneer, general contractor, electrician, plumber or builder ......... ~..~,,a.z~.m~z:-c',?--- ...................................................................................................................................................... Name of owne,' of premises ...... ....... .............................................................................................. If applicant is a corporate, signature of duly authorized officer ........... ........... ..... ~ (Name and t~tle of corporate officer) 1. Location of land on which proposed work will be done. Mop No ............................................ Lot No: ................... Street and Number ....~..,~...'~.....~..'i..~...~. ......... ~f.~/g?f~q....z.....~..~..~...4..~./.~-T. ..... ..~...~.:.......Z'..~Z ................................... Mumc~pality 2. State ex~stmg use and occupancy of premises and ~ntended use and occupancy of proposed construction: a. Existing use and occupancy .... ~...~.~t.(~--2~.C~..~. ........................................................................................... b Intended use and occupanc ....................................................................................................... 3 Nature of work (check which applicable). New Building ..~. .............. Addition .................. Alteration ................. Repair .................... Removal .................... Demohtian .................... Other Work (Describe) ................................... 4. Estimated Cost .............. ~..;~....cttf~.,....'~.. .................... Fee .../..~..:...~.. .......................................................................... (to be paid on fihng this application) 5 if dwelhng, number of dwelhng un,ts ............................ Number of dwelling units on each floor .......................... If garage, number of cars ...~.~Z~;.~..~.~: ......... ~..~.~..,~....-T.. ........................................................................................ 6. If business, commercial or mixed occupancy, speofy nature and extent of each type of use .............................. 7 D~mens~ons of ex~sting structures, ~f any' Front .......................... Rear .......................... Depth .......................... Hmght ............................ Number of Stones ............................................................................................................. D~menslons of same structure with alterahons or aad't OhS: Front ................................ Rear .............................. Depth .............................. Hmght .............................. Number of Stories ........................................ 8 D~mensions of entire new construct,on' Front ..... :.~..~..C: .......... Rear ....... .~..~...~.,.~.; ......... Depth ......~..~...~ ............. Hmght ......./..~.. ............... Number of Stones ...... ../. .................. 9. Size of lot: Front ..../.,...~J~...?T ............ Rear ........ ./~..~..:...'C. ....... Depth ....~....~?..%.../C...~.. ........... 10. Date of Purchase ....................................................... Name of Former Owner ...................................................... 11 Zone or use d,strict ,n which premises are s~tuated ......... ..~...C~..~...~.-~...~¢..~.'.~ ........................................................ 12 Does proposed construction violate any zoning law, ordinance or regulation? .~..o....~. ......................................... 13. Name of Owner of premises ..~'...:...~.~.,~..~..~Z...'~?.. ................ Address ..:?'~'~'z~'~/.¢'.~.~. ....................... Phone No .... ...~..f.~./. .... Name of Architect ...................................................... Address ............................................ Phone No ................... Name of Contractor ~.~'~..~.~. ........ ..,Z~......~..~.~.'...:~.l..Z..Address '-~'u...z~..4?. ~'~ Phone No. ~'.~-~ PLOT DIAGRAM Locate clearly and d~stinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro~ property hnes. Give street and block numbers or description according to deed, and show street names and indicaJ whether inter,or or corner lot. ~ --~¢~-v,~ ~//' STATE OF NEW YORK, } S.S. COUNTY OF .............................. ....... ~..z..~..,~--.~ ........ ~..~..~-~.~.~.*..~.Z'~. ................................... being duly sworn, deposes and says that he ~s the applio (Name of indwidual signing apphcation) above named. He ~s the .... .~ ...... .~.~ ............................................................................................................. (Contractor, agent, comorate officer, etc.) of sa~d owner or owners, and is duly authorized to perform or have performed the said work and to make and this apphcat~on; that all statements contained in this applicahon are true to the best of his knowledge and bel and that the work w~ll be performed in the manner set forth in the application filed therewith. Sw~r~ ~before me th~s/. _ _ ~-. - ~ /~ x ...... ~.~~ ...... ~.~.~.~ ......................... Notary Public,t.~.~.~..~:~.~.Z~ ....... County ~ (S,gnoture of applicant) ..... t~ 52 ~2~20 S~[fcii~ County Term Expires Ms,ch 30,