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Home My WebLink About3196-zFOR~ NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...Z...2~',~]L ........... Date ......................... eT..l~l~e.....[~. ........... , 19..6.~... THIS CERTIFIES that the building located at .....~./~..~.....~...O...~..~...~.....~..~...e..~.....~..~...~.i.; .................... Street Map No..3CIO~ ........... Block No...:~OC~ ............ Lot No...~;3~ ..........SO.l~hO[l~9...~.e.~'.e ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................................ A~i~.~.....[~., 19..~.6.. pursuant to which Building Permit No ..... ,~.~.~).6...~; dated ............................ ~ ....... ~,.~. ........ , 19...6~., was issued, and conforms to all of the requirements of the applicable provisions of the taw. The occupancy for which this certificate is issued is ........ ...... ~%.o r~ge....b.~L~ct~,g,..~'.o.~...$~...~ m~ ..................... .......... The certificate .is issued to .~..~...e.....C..~..e.~.~..~.e..~....~...~..~.... ~.e.?.. ................................. (owner, lessee or tenant) of the aforesaid building. '"Building Inspector ...................... FORM NO. 2 TOWhi OF $OUTHOLD BUILDIhiG DEPARTMENT TOWhi CLERK'S OFFICE SOUTHOLD, hi. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ~DN THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N?. 31'96' Z D~te ..... :...~..'~...~...~.'~. ~0) , l~. .... Permission is hereby granted to: ..~...~.:~,.~,..~ .............. ~ ........ '... ..... ~m~..~%~e ......... [ ........................ ,~ .... to ~J~.d new a~ceeso~y buildinE (S¢orafe) at premises located at ~.V..~ 1%.0~'~, ..a££ ~.t~ S,mmd...'~ta~,z. AV.e ...... ..................... , ......... ~amp .. ~ue~ ~......8mu~hold,~...N.,,Y.,, ................. pursuant to application dated ........................... .~..~.~¢n&...CL~.......~l,.O.. .......... 19.,~..~,..., and approved by the Building Inspector TOWN OF SOUTHOLD ~UILDING DEPARTMENT 'f'OWN CLERK'S OFFICE SOUTHOLD, N. Y. rI.I:'RTIF'II~ATE rlF' rlnl~UPANi2Y No. Iii. 21{6~® Date ................... ~.1I~7.. ~ .... , 196.6. CO e THIS CERTIFIES that the building located at Map No. F~.t~ighg ~ Ho..T336 ...... Lot No. ~... Fishe~. l ~hn~,. }t.,.T, .... conforms substantially ~o ~~~' dated ........ ~ ............. 19 .... pursuant to which Building Permit No. dated ......... ~X~ .... 19 ..... w~, a~~~i~the require- me.nts .of the .applicable provisions of the la~v. The .occupancy ~or which this certificate issued is ....... ~i~ag0 · ~,. $1ly..~W,l. Li~g ..................................... The certificate is issued t~o . .~oh~ .~iok0i~ ........ ~0~ ........................... (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Appzoval ..... ~$~ .............................. FO~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, ........................................ , 19 ........ Permit No ............................. Disapproved a/c .............................................................................................. ..................i Application No 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. (Signature of applicant, or name, if o corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general con. tractor, electrician, plumber or builder. ......... .................................................................................................. : ......................................................... Name of owner of premises .~..~./.~..~..~J.:..~.~... ~/~...~.~2..~..~./....~...~..., .......... ' .............................................................. If applicant~ ~/~,/~is a corporpte, signatur~ 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.: ........................ .......... ....... ................................ Munici~lity 2. State existing use and occupancy o~ premises and intended use and occupancy o~ proposed construction: a. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy .................................... ~ ................................................................................. 10. 11. 13. kocQl property I whether ir NatL~re of work (check which applicable): New Building .................. Addition .................. Alteration .............. Repdir- ................. .,,Removal .................. Demolition ...... ~ ...... Other Work (Describe) ..................................... Estinhated/ Cost ....~/...~.,~...~..~.?.x..~.~.'~/ .......................... Fee ...~ ........................................................................... J (to be paid on fil'ing this application) If d' elling, number of dwelling units ............................ Number of dwelling units on each floor ........................ If g~roge, number of cars ......................................................................................................................................... If ~usiness, commercial or mixed occupancy, speci~z,noture and extent of each type of use ........................ Dimbnsions of existing structures, if any: Front ......... ~-- ................ Rear ....... Z .~..I ................. Depth ..~.~'..~...I ......... ....... /. .............. Number of Stories ...... ./. ............................................................................. Height g? } Dimensions of same structure with a,lterations or additions: Front .................................... Rear ........................ · Depth ............. Height ..... Number of Star es ............................ Pi~[~nsions of entire new construction: Front ........ ,~'..~... ..................... Rear ....... ~ .................. Depth ....~5...~...I. ........ Heiiht ....../,~..) ....... Number of Stories .................. ~. .............................................................................................. Sizd~ of lot: Front ............................ Rear .................................... Depth ................................ Dot, of Purchase ........................................................ Name of Former Owner .................................................... Zon or use district in which premises are situated ..... ./.'(...~.:~/.x~.~¢.'.?./..~..! .......... ~.. ...... /~.Z-f,...7.L.A../.~ .......................... Doe proposed construction violate any zoning law, Ordinance or regulation? .............. ..~...~. ................................... · ~'~?Z2'.~.~ -~ .~, f'~ ¢.. Address -~'.'~..Zl.?L~.?~..· J~/'~.~ Phone N~ Nor ~e of Owner of premises ............ ~....~.' .' .~..~..~..~. ................ ~ ................. Nar~e of Architect ...................................................... Address ............................................ Phone No. Nar ~e of Contractor .................................................... Address ............................................ Phone No. PLOT DIAGRAM ~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions nes. Give street and block number or description according to deed, and show street names and indic erior or corner lot. \' STATE O1~ NEW YORK, 1. ¢ c COUNTy,I OF ................................ I .............. ~-~.~.~..,.,....~'..~........~...(,~.~..~.....4~.... ................ being duly sworn, deposes and says that he is the appii¢ ;. (Name of individual signing application) / ~ above noeed. He is the ........................................... ...~r./~...~.,~.4~..~./.~..C ........ ~..~....~...¢..~=. ....................................... / (Contractor, agent, corporate officer, etc.) of said o' this appli that the ~ Sworn to · ,TOM WARD ,~<,~,~.i~ ~,~es Mai-ch 3~ 196~ vner or owners, and is duly authorized to perform or have performed the said work and to make and :arian; that ail statements contained Jn 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 L ~ ~ ..... day of 19 ........ gnature of applicant)