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Home My WebLink About3153-zFOl~l~ NO. 4; TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at 1~ SO~C~ Road Street Map No. ~ Block No.~ ~ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office ,dated ........................................ .~...~..~.~....¥..3. ......... , 19.....~.~.~ pursuant to which Building Permit No. 3153~ dated Ji/l~ 13 , 19 66was iss ' n ' · ............................................................... , uea, a a contorms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ................ .~..~.¢.$..o.,.....¢~..~.~. ~.~...9..~.~.~ ...~.~.t...z.~,...~.~.~.~ ................................................... The certificate is issued to JO~e~..h.. (owner, lessee or tenant) of the aforesaid building. FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLi~RK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT N9 Permission is hereby granted to: ..... ........... .G:~.~...~ ...... ~ ........ : ......................... 3153 Z (THIS PERMIT MuST BE KEPT ON THE PRE/~ISE5 UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) at premises located at ..~.~.....J~.q~...~.e,~ ..................................................................... J .................. .................................... ~e~a~;~..~,~,, ......................................................................................... pursuant to application dated ................................ ~t~,~.~* ........ -~-~ ..... 19.~..., and approved by the Building Inspector Building Inspector T~WN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ............................. Disapproved a/c ~~/ - n 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 property must 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 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 a 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. -~-~ ---~ Mra J~s~ph..Bma~di ........................................................... (Signature of applicant, or name, if a corporation) ......... .................................................... (Address of applicont) State whether applicant is owner, lessee, agent, architect, engi,neer, general contractor, electrician, plumber or builder. ............................................... ...................................................................................................................................... Name of owner of premises ...J'o. se.~..~z'~i .................................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done..Map No.: ..... ~ ......................... Lot No.: ....~ ............... Street and Number &%.....~O~d...Ho.ad.~ ........ G.~e~n~.or.t ................................................................................... Municipality 2. State existing use and occupancy of premises and intended use a~J occupancy of proposed construction: a. [xisting use and occupancy ....~...~.lY...~fl~].~g ................................................................................. b. Intended use and occupancy .......... same...with...a~..&dd&¢io~ .................................................................... 4. 5. 6. 10. 11. 12. kocat . property whether in Nat~re of work (check which applicable): New Building .................. Addition ...-~.~ ......... Alteration .... Repcjir .................. Removal .................. Demolition .................. Other Work (Describe) Estiraoted1 Cost ........ ,], ~ .0.0O...12~ .............................. Fee .......... j (to be paid on filing this application) If d~velling, number of dwelling units ...... ~tn.e ............... Number of dwelling units on each floor If gqrage, number of cars If b'usineSS,r commercial or mixed occupancy, specify nature and extent of each type of use Dimbnsions of existing structures, if any: Front ............................ Rear ................................ Depth Height ........................ Numbe. r of Stories Dimensions of same structure with alterations or additions: Front ....................................Rear Dep{h ................................ Height ............................ Number of Stories ................................ Dimensions of entire new construction: Front ...... '1~ ......................... Rear ............ ~.~. ........... Depth ....~1,~ Hei ht .................... Number of Stories ..... O~ ..... Size of lot: Front ............................ Rear .................................... Depth ................................ Dot~ of Purchase ........................................................ Nome of Former Owner Zon. or use district in which premises ore situated .............. Doe' proposed construction violate any zoning Iow, ordinance or regulation? ..................... Na~e of Owner of premises ...,,T~8~0~..]]k~.;~,cl, rI......Address ............... Q~.ee~l,O~.~ ....... Phone No. Nome of Architect ...................................................... Address ............................................ Phone No. Nar ~e of Contractor .................... ~l.e ...................... Address ............................................ Phone No. PLOT DIAGRAM ,' clearly and distinctly oll buildings, whether existing or proposed, and indicate oil set-back dimensions fr nes. Give street and block number or description according to deed, and show street names and indi erior or corner lot. L STATE OF! NEW Y_OR[< ~ c c ................. i..~[z',~....]'.o~.e.~...]~.~.ft~ ................................... being duly csworn, deposes and says that he is the ](Name of individual signing application) (Contractor, agent, corporate officer, etc.) of said o~,ner or owners, and is duly authorized to perform or have performed the said work and to make and this opplicbtion; that all statements contained in this application are true to the best of his knowledge and belief; that the w~)rk will be performed in the manner set forth in the application filed therewith. Sworn to b~fore me this Notary Public, . ........................................................... County ~/' ~gnature of applicant)