The URL can be used to link to this page

Home My WebLink About3192-zFOI~M NO. 4 TOWN OF Sou'rHOLD BUiLDII~4G DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No..~.....~..2...2..2. ............. Date .............. 2~ug~t;..2.7.~ ................. , lc)~8... THIS CERTIFIES that the building located at ~,l:l..]~Ql~.~ ................................................ Street Mop Ne ....................... Block No ....................... Lot No...~I. ILt. CJ~O~IQ.,...Ig~...Y~I~ ...................... conforms substantially to the Application for Building I~ermit heretofore filed in this office doted .............................. ~l~g.~Jil.~..;I,~ ............ , 19.~.~.. pursuant to which Building Permit No.~.~.~..~...~... dated ................... ~,~1~.~1~.~;..,~,~i~ ........... , l C~...., was issued, and conforms to eli of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ~..~..~.U~.~,~ ................................................................................................................................ The certificate is issued to ..~.JllT~lll~..~,...g~O~J~ ................................................................................ (owner, lessee or tenant) of the aforesaid building. FO1~1~ NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. BUILDING pERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: · .......... ~ott~lto._ ~1...-.. ................. : ......................... ..... ~ ....................... ~ ........ ,--.:.' ............. .:?.~.. to ...j/j~J~l~....JBuf~.~cl...a" .~ce~p o~'a.~-~-z,!~e.. ~.a ~,e ~e.....7 ( A.p~z~vec~.. ~,y..-~d-A~p e~ 1 s ) et premises located at ..~./~..~OZ~I;;}~I...]~,O,~-~.O~..~.~.-.]~.~,O-~ ...................................... ~ ................. ....................................... ~r~.h~:~ d..F ·. · ..N.;;y-~ ................... ~ ........ : .......................................................... pursuant to application dated ........................... ~;l~;~t. ...... .~.~. ............ 19.~,.., and approved by the Building Inspector Fee $.~.~1~ ............. Approved ........................................ , 19 ........ Permit No .......................... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No. Disapproved a/c ~ ..... APPLICATION FOR BUILDING PERMIT Date ...... .~.~......~.~ ..................... ,19.~.~ .... 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 pa:rt 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 alteration~s or for removal or demol~on, as herein described, The applicant agrees t° c°mply with all applicable laws' °rdinan~'~uil. di~g c°de'and r~,~ns'~ ~Signature of applicant, or name, if o corporation) ...... ........................ - va ~ 0 ~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, en,oi'neer, 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) 7~~~,1'0 or ,llbedone Ma No q? Lot o ~..~.... 1. Location of land on which pro~?ose, d w k, w' · p .: .................. ^....~ ............... N .: ....................... Street and Number ~..~..~...? .......... · .~...~...~: ........... ..~.....~......~.....~.~ ........................................... Municipality 2. State existing use and occupancy of premises an~ntended use a~a~ncy of proposed construction: a Existing use and occupancy ~ .~...~.,~ .~ ~P.P.~ ~ ......... ..... .......... ; .................. ........................................................... 3. Nature of work (check which applicable): New Building ....,~. ......... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ................ t ......................................... Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars .................................................................................................................. ~-- ~~ ....... '~. .............. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of ~..~/~,~ .... 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ....... .~..~...I. ..................... Rear ...... ..~...6..~. .............. Depth ...... ...;~......(. ........ Height f2-1'~t Number of Stories ~ 9. Size of lot: Front ............ ,.....~ ........ Rear .................................... Depth ................................ 10. Date of Purchase ...... .?Z./.?Z.~...~.. ................................. Nome of Fpr, mer Owner ...~.~....~-- "'~ .......................... 11. Zone or use district in which premises are situated ...... ..~,~ ...................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... .~ ............................................... 13. Name of Owner of premisest~ee+~...~......Address ............................................ Phone No Name of Architect ...................................................... L./ Address ............................................ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-b~ck dim*ensions from property lines. Give street and block number or description occarding to deed, and show street names and indicate whether interior or corner lot. STATE OF N~._P~,, //' I ¢ ¢ COUNTY OF ~...~...,,..J~'~' /~.. . ....................... ~~ .......... ~ .......... being duly sworn, deposes ond says that he is the applicant (Na~o~individual signing opp~,~io.n). ~_ above nomed~e is the ......................... ~.~.~ .......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke and file this application; that all statements contained in this application are tr~o the best of his knowledg~nd belief; and that the Work will be performed in the manner set fodh in the applicatio~ filed therewith. Sworn to bef~ me this ~ I / ................... ........ ....................., ........ / ~ MARION A. REGENT ~,~' I - NOT~ PUBLIC StaLo c: ~:~w York Ter~ ~pires ~arc~ 30, ~9~