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Home My WebLink About3188-zTOWN OF SOUTHOLD RUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y. CE:RTIFICATE: OF OCCUPANCY No. Z. ~'.~ ..... Date ............ .~l~nbe:E:.....~ .... 19 TI-II~ C~-~IBIgS that the building located at .~.~...~ .~)~ ............ ~treet Map No.. ~0~ .... Block No .... ~ ...... Lot I~o. ~=~ .... ~;~. ~,~ ........ conforms substantially to the Applicati.on for Building Permit heretofore filed in this office dated ............. gkllgllt~L..~tD19.66, pursuant to which Building Permit No..~8~[ dated ........ ~.~gl~.l~.~...~,4~ ..... 19(~.~.., was issued, and conforms to all of the require- mants .of the .applicable provisions of the law. The .occupancy for which this certificate is issued is . ~.lp~r$~O. Cfi0. I~alll~y. (tl~,~].~ltla~g .......................................... The certificate is issued to .. F.~.,al~.{. P{~.~k~' ........ 0',ql~9.~ ........................... (owner, lessee or tenant) of the afore.said building. .Suffolk County Department of Health Approval ............. .~[~...]~.~ ................... Building Inspector FOP~i~[ NO~ 2 TOWH OF $OUTHOLD BUILD[HG DEPARTMENT TGWH CLERK'S OFFICE SOUTHOLD, ~. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ONTHE PREMISES UNT LFULL COMPLETION OF THE WORK AUTHOR!ZED) Ne 3188 z Permission is hereby granted to: ct premises located at ..JDa~..;D]?.;~.~e...(.b~, ~,¢,p,~}, ................................... ~ ............................................ .................................. C:tr~h~D~e .....~.,.~Z., ..................................................................................... ~ ...... pursuant to application doted ...................... ..A:~g ......... -];(~ ................. 1~/,~..,.., and approved by'the Building Inspector Fee $.2.,.Q.0. ............. Building Inspector FOF~M NO. 1 'I~OWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ............................ (Building Inspector) Application No. ~ / ~'~'- 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 whote or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS H.EREBY 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, ordi~:um;~sT~Jilding~ode a/~ubtions. (Si~ure of applicant, or name, if a corporation) (Address of applicant) Name of owner of premises .~.2........~..~........~...~ .................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on wh~ch~roposed work w_ill be done. Map No ..........................................Lot No.: ........................ Street and Number .................................... ~/. ......... .~.,.~ ................... MuY/icipo l ity 2. State existing use and occupancy of premises and in~nded u,,se and occupancy of proposed construction: a, Existing use and occupancy .....~..~, ........................................................................ b. Intended use and occupancy ...... ~~.....~T.. ................................................... 10. 11, 12. 13. Nature of work (check which applicable): New Building .................. Addition ............. Alteration Rep[air .................. Removal .................. Demolition .................. Other Work (Describe) Esti~ated Cost .............. I~1.~ ............................ Fee ........... .~...r...~... ! (to be paid on filing this application) If lwelJing, number of dwelling units ........... ~ ............... Number of dwelling units on each floor ..... If glarage, number of cars If Business, commercial or mixed occupancy, specify nature and extent of each,rtype of use Dir~ensions of existing structures, if any: Front .....~...~.~..'.."'~'.. ......... Rear ......~...?...!...~ ........... Depth ....::~.....~...../.... Hei~lht~ ...... , .~....~ ......... t Number of Stories .................................................. ( .f.?z,_, Dir6ensions of same structure with a.lterations or additions: Front ....... ..~...~.z....2-~.. ........... Rear ,...~(._~..,...~..Z~.... De~th ........ :~....(. ............... Height ......~ ................. Number of Stories ........ ~...../.~.'~ff.,~ .......... Dimensions of entire new construction: Front .............................. , ..... Rear ............................ Depth Hei!ght .................... Number of Stories Siz~ of lot: Front ....~...~.;..t(....~_ ...... Rear ...... .~...~..,...'.~.....k.~, ........ Depth .I..~..L .~..~.....~..../ S 2,0 Da~e of Purchase ..........J....~......~....G~.. ......................... Name of Former Owner .~....~ ..... Zo~e or use district in which premises are situated ....J~. ,.,J~t..._.:.~.~ ......... Do~Js proposed construction violate any Tar)lng law, ordinance or regulation? ...... ~ ....... ~7~hone No. Narco( Owner of premises ~.~.../.~..~..Address No,ne of Architect ............................. .~..~~......Address~ ................ i'"'Address ....................................... ~Z,~.....~._~,~. ~ ~c~,; Phone No. Nalne of Contractor ...~-:m~.....::....'-m~....:.~r:,;.~.'".~n~nne No. PLOT DIAGRAM ~ clearly and distinctly alt buildings, whether existing or proposed, and indicate all set-back dimensions fr nes. Give street and block number or description according to deed, and show street names and indic ~erior or corner lot. 7 ,3y Locat property whether STATE O1: NEW YORK, tS S CO).~TX OF ~ ......... ..~../::) ......... ~ ' ' f ........ ~....~...~..,/~ .~ ................................... being (Name of~l~r~J~vidual signing application) above nat'~ed. He is the of said m this appli that the ~ Sworn to Notary PL duly sworn, deposes and soys that he is the applic (Contractor, agent, corporate officer, etc.) ~ner or owners, and is duly authorized to perform or have performed the said work and to make and :ation; that all statements contained in this application are true to the best of his knowledge and belief; ark will be performed in the manner set forth in the application filed therewith. .efore me this ........ day of ............................................ , 19 ........ r blic, . ........................................................... County (Signature of applicant)