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Home My WebLink About3176-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z 2652 Date ......... ~.~..~.U.~.~. 31 19...67.. THIS CERTIFIES that the building located at ~/,rl 19,O~ad ...................................................................... Street Map No.....~/J~J~... ........... Block No...~/~ ............ Lot No. ~ ~..~.~l.t.h.O..~..d. ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................... .~'..~1,~,~...~.~. ........................... , 19./~.~.... pursuant to which Building Permit No..3...~.~...~.. dated ............ .3'...~..~.~...,~..~ ........................... , 19.....6_6., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ~r :Lvat:e .g.a=acJe The certificate is issued to Ronald ~¢. & Mt.g. non T. Ryan (owner, lessee or tenia,nt) of the aforesaid building. Building Inspec of~f FORI~ NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3176 Z Permission is hereby granted to: ~ou~ old to Built] an a~;di~ion on an aeee~so!~~. b~ii~in~ pursuant to application dated ........................ .J..'.~..]:?,.........,~...~. ............. 19.~..~..., and approved by the Building Inspector 5.00 Fee $ ........................ / FO~M NO, 1 TOWN OF$OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. ........................................ , 19 ........ Permit No ........................... Application No...-.~.....~...Z..~... ........ Disapproved a/c ........... i~z;~-~=-~ ................................... -- ....................... ......... ................ (Building Inspectorl ( APPLICATION FOR BUILDING PERMIT Dote ..~..~...~....?....,~. ................. ~ .............. , 19 J 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 Iocgtion 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 drown on the diagram which is part of this application. c. The work covered by this app]ication 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 oil applicable laws, ordinances, building code and regulations. .......... ........ ...... ............... (Signature of applicant, or name, ii~'a corporation) ........ (Address of applicant) v State whether applicant is owner, lessee, agent, arch tect, engineer, general 'contractor, electrician, plumber or builder. Nome of owner of premises ..... ..~....~...?.../?.. ................. : ........................................ 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 .~x?~r~..'..~ .......... ~...~..~...¢f:~....~ ..................................................... / Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a, Existing use and occupancy ....'..~..~.~..6...~....~..) ...... ~ (..~.. .............................................................................................. . b. Intended use and occupancy p~....(~...~..~....'~....~....~..~......' ........................................................................................ 6. 7. Din' Hei Dim Dap 8. Din' Hei! 9. Size 10. Dot, 11. Zon 12. Doe: 13. Nar Nar Nan L.ocat~ property Ii whether in1 / NatUre of work (check which applicable): New Building .................. Addition .................. Alteration Repc}ir ............. .~¢. Removal .................. Demolition ............ ...... Other Work (Describe) ..................................... Esti~ated Cost .~....../~..~.~..:...~...d. ................................... Fee ...................................................................................... (to be paid on filing this application) If d ~elling, number of dwelling units ............................ Number of dwelling units on each floor ........................ If g, irage, number of cars ...... ~ ......................................................................................................................... usiness, commercial ar mixed occupancy, specify nature and extent of each type of use ........................ ~nsions of existing structures, if any: Front .......... ~.~.:. .......... Rear ........ (.~..~ ............... Depth ....Z ............. ,hr ........ .~ ............ Number of Stories ............./ .............................................................................................. msions of same structure with alterations or additions: Front .............. L..~...~ ........... Rear / ~ ' ~ f ' Number 'h ................................ Height ~ of Stories / ' ensions of entire new construction: Front ............... ~ ................. Rear Depth ................... iht ....~ .......... Number of Stories ...... ( ......................................................................................................... o¢ bt: ~,o,~ ....... ~¢~ ..... ~ ......... ¢¢.¢.,.~ ........... D,~t~ ..... ~.~.¢..:..~. ....... o¢ ,,,~h~,, ..... ~=...~,......¢~.~.%. ....... N~ o¢ Fo~ 0~,~ ....... %.~..~r~ ........................ or use district in which premises ~re sffuoted ................................................................................................. proposed construction v~lete ony zoning I~w, ordinance or regulationS. .......... ~_..; ................................ ~e of Architect ...................................................... Address ............................................ Phone No ................. ~ of Contractor .................................................... Address ............................................ Phone No ................. PLOT DIAGRAM clearly ond distinctly ~11 buildings, whether existing or proposed, ~nd indfc~te ~ll set-~cR dimensions fr ~es. Give street ond blo6k number or descri~tio~ according to deed, ond show street homes ond indic, erior or comer lot. ~*~/~* STATE OF[ NEW YORK, '~ ¢ c COUNTY ID F,.~x ............................. .f'~'°' r,~ j(Nome of individual signing application) above na~ed. He is the ..................................................................................................................................................... j (Contractor, agent, corporate officer, etc.) of said oW.'ner. . or owners, and is duly authorized to perform or have performed the sam work and to makebelief;andtJili' this appl c,m~on; that all stotements contained in this application are true to the best of his knowledge and that the w~rk will be performed in the manner set forth in the application filed therewith. Sworn to b..e_fore me this K' / . ,~ / / Nota,'y Pu~h~LT~-~/~~~.....q~. County (Signature of a, pjClicant) Notar~ Pubhc In t l~ ~f~to of New York