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Home My WebLink About3197-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ....... [~1;[.~..~,~...~.;[.~.~.. ~.~.~ ............ Street Map No ........ ~ ..... Block No..~ ........... Lot No ..... ~ ................... .~.q.~..t~.~..~.,.._.~....."~'i,. conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................ · '.~Bg.~l~.~..~,~ ............ , 19.~.6.... pursuant to which Building Permit No......3..~...9.?....~ dated ...................... ~.~.~.~..t,.....2..2. ............ , 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 ........ · . ~..~.V.a..~.e..d.e..~.C.~.e..~ .g.a..~.a.qe...,....~U...~..~e..e..~..~.u....:Ed..~..n.~ , garage £uel o:tl t:ruok O'ohn The certificate is issued to .............. ....................................................................................................... (owner, lessee or ten~,nt) of the aforesaid building. Building Inspe~:~/or 4 ,c FORM NO. 2 TOWN OF SOUTHOLD BIJILD[NG DEPARTMENT SOUTHOLD, N. Y. BUILDING PE~.MIT (THIS PERMIT MU£T BE KEP'I' ON THE PP~EMISE$ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~N? 3197 Permission is hereby granted to: ~'.o~..~o~ ......... ....................................... ....... ~O~th~t~ ..................................................... to l~,:l,d..~ae~..pzi.va~e .. ~ara g~ ................................................. . ................ at premises located at :/.~ ~a~ ¥~e~,~ Read. ...................................................... .................................................. 8c~tt~o~d ~ t~ ~-F~ .......................................... pursuant to application dated ............................... At~.~ ....... ~ .... 19..~., and approved by the Building Inspector Fee $..~.~.,O.p ............ ......... ~: ......... - ....................... :~ ................... Building Inspector ~ FO~M NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ........................................ , ]9 ........ Permit No ................................. Application No. 3 / ~' 7 Disapproved a/c ...................................................................................... ............................ ............................... (Building Inspector) APPLICATION FOR BUILDING PER.MIT Date ............................... ~U~.~ s.~ ....... 22,.., 19.~.6 ...... 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 propertymust 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. ) '~ ............ ~ ................ ~.o.h.h ...~.r.J.~o n J.~. ................................................. (Signature of applicant, or name, if a corporation) c, .......... ....................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....J. ohn..~'.::bt]~.n.~.s ................................................................................................................. 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: .Z~: .............. Street and Number ..~/.~....i~aJ.r~..]~8,7:....V.i~.w../&oAc% ......... ~o%1%h=1c~ .......... ....................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ~D.~'~.iiLr~6 ........................................................................................................ b. intended use and occupancy ...... s~m~..~i.~..~..~a.:eag, e..-(. ............................................................................... 3. Nat!ure of work (check which applicable): New Building ....... ..~....~..... Addition .................. Alteration .............. Repj=ir .................... Removal .................... Demolition .................... Other Work (Describe) .................................. 4. Esti~nated Cost .....~OQ..~,~ ........................................ Fee ..~ .................................................................................. / (to be paid on filing this application) 5. If d~welling, number of dwelling units ............................ Number of dwelling units on each floor ........................ If arage, number of cars ....................................................................................................................................... 6. If ~usiness, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dirt ensions of existing structures, if any: Front .......................... Rear .......................... Depth ........................ Hei ht ............................ Number of Stories ........................................................................................................... Din msions of same structure with alterations or additions: Front ................................ Rear ............................ Del: th .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ...... P..br .................. Rear ........ ~br ................ Depth ....... .~ ............ Heibht ............................ Number of Stories 9. Siz~ of lot: Front ............................ Rear ............................ Depth ................................ 10. Dat~e of Purchase ........................................................ Name of Former Owner .................................................... 11. Zor~e or use district in which premises are situated ........ 12. Do~s proposed construction violate any zoning law, ordinance or regulation? ...,~P. ......................................... 13. Na~e of Owner of premises .....9.~D...q~.~,~Q~ ....... Address ...... ~q.c~lzt,~].cl. .................. Phone No ................ Na~e of Architect ...................................................... Address ............................................ Phone No ................ No, ne of Contractor ...... ~.~ .................................... Address ............................................ I~hone No ................ PLOT DIAGRAM Locat ~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions f~ property li~es. Give street and block numbers or description according to deed, and show street names and indk whether i~ terior or corner lot. STATE 01: NEW.YORK, COUNTY OF ..~ ............ ~ S.S. .. ~ .... ,.T~.~..P~.'Ig~i~.i.B .......................................... being duly sworn, deposes and says that he is the applk Name of individua s gn ng app cat on) (Contractor, agent, corporate officer, etc.) of said o~,ner 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 be and that 'he work will be performed in the manner set forth in the application filed therewith. Sworn to efore me this m