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Home My WebLink About3184-zFOI~[ NO. 4 TOWN OF SOUTHOLD BUILDING DF. PAI~TMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..~.a.~.~...P...[..a..c...e. ......................................... Street Map No ..........~ ..... Block No....~ ......... Lot No. ~.~ ...................... f~.~..e..~.p~..~..~.~.....~.,....Y.: conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................................... ..~.t~l~.,.~....~....., 19.~.~.... pursuant to which Building Permit No...~.~..~..~.....~.. dated ............................. ~tlgtlB~,...[~,....., 19....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 ........ ............. i ................ a.dd.t,t ~,c~n...to....one...£a~,J,y...~e~l,~.~,~g. ........................................................ The certificate is issued to ....... ~.~ ~.~,1~.~, ...~.~., ............................. (owner, lessee or tenant) oF the aforesaid building. FOI~M NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFiC[ SOUTHOLD, N. Y. 3184 Permission is hereby granted to: BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON ,-[HE PREMts~S UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Z D~te ....'..!.:,,;...._.:; .......... .&~. ~L~,, 19..66... Knapp Place at premises located at ............... L. ...................................... ~ .................................................................... pursuant to application dated ....................... A~§.~.-.~.~.....~k~. .............. lC~6..., and approved by the Building Inspector .00 Fee ~ ...................... Building Inspector FOI~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ............. ~ 19....~.. Permit No. 3 14~'~'/- ~ Approved ........................................ , ............................ Disapproved a/c ..................................................... '3' ........................... (Building Inspector) Applica'tion No.....~....~.~....7 ........ APPLICATION FOR BUILDING PERMIT Dote .................................. , 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 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 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 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 Southo[d, Suffolk County, New York, end 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 lows, ordinances, building code and regulations. .... ...... ............................ ~ (~ ~,k ~ (Signature of applicant, or name, if a corporation) ........................... i~J~;ess of ~'1~'1~i1'~''''T .......... State whether applicant is owner, lessee, agent, architect, engi'neer, general contractor, electrician, plumber or builder. Name of owner of premises ..... ~.....'. .............................. ' ................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Location of land on which proposed work will be done. Map No.: ........................................Lot No.: ........................ Street and Number ....... ~ ...... ..~...~.~¢-'¢;~--... .................... ~ ......................... ~ ~ Municipality 2. State existing use end occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........... .~...~~ ...................................................................................... b. Intended use and occupancy ..............~.~ ...................................................................................... 3. Notj~re of work (check which applicable): New Building .................. Addition .... .......... Alteration Repair ........... Removal .................. Demolition .................. Other Work (Describe) (to be paid on filing this application) J 5. If d~elling, number of dwelling units ........... /. .............. Number of dwelling units on each floor If g?rage, number of cars 6. If I~usmess, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dnqens,ons of existing structures, if any: Front ........~.....~.. ........... Rear ....L~/....~.. .................... Depth ..~! ............... Hei~lht ..... ~ .............Number of Stories ./ ................................................. Din]ensionsj of same structure with alterations or additions: Front .... ..~..~.. ....................... Rear .~..~. .... ~ ....................... Height De~th ~f .... ..~.., .................. Number of Stories .......... 8. DiMensions'l of entire new construction: Front ........ ]...~. ....................... Rear ..../..~' ................... Depth ...~... Height .....~. ............. Number of Stories I 9. Size~of lot: Front ............................ Rear .................................... Depth ................................ 10. Dat~ of Purchase ........................................................ Name of Former ~er ..'~.~....~....~ ..... 1 1. Zor~e or use district in which premises are situated ...... ~ ................. 12. Do~s proposed construction violate any zoning law, ordinance or regulation? ........ ~ ......... Na~e of Contractor C,rtf~'r:~,~....~~ ................................................. PLOT DIAGRAM Loca!~ clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions fr property I~nes. Give street and block number or description according to deed, end show street names and i whether inLterior or corner lot. -- ..... 17' - p~4,~--- ~ STATE OFF NEW YORK, ~ ~ c ........ '~' ................... ~ ................. ~ ~ .................. being duly sworn, deposes and says that he is the applic (Name of individual signing application) _... above nalned. He is the ......................... ~..~ ......... (Contractor, agent, corporate officer, etc.) of said o~mer or owners, and is duly authorized to perform or have performed the said work and to make and this appli :orion; that oil statements contained in this application are true to the best of his knowledge and belief; that the ¥ ark will be performed in the manner set forth in the application filed therewith. Sworn to I~efore me this Notary PL~blic, . ......... ~ ..................... County M]g[A55 ][Ag't~i~nature of applicant) tSCAt-.E: V*> ~ " ') .I