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Home My WebLink About3305-z~OI~M I~O. 4 TOWN OF SOUT~-IOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, E:ERTIFIE:ATE OF OO{]UPAN[IY THIS CERTIFIES that the building located at . B.~$9~eaR .~.~.e, ............. Street Map No... ~ ..... Block No... ~ ...... Lot No ...... ~ ............. ~I~U~%O~... conforms substantially to the Applicati,on for Building Permit heretofore filed in this office dated ......... ~OV~I~eX .7 .... 19.66. pursuant to which Building Permit No.. dated ......... .~0.~.9..~...~. .7 .... 19..~.~., was issued, and conforms to all of the require- ments ,of the .applicable provisions of the law. The .occUpancy for which this certificate is ~O~t:~:~ ~OV~.~ issued is ................................................................. The certificate is issued t.o ..... ~..?O.r.g.~..A.* ..B.~..~.~.~.~..~..q.~; ............................ (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health App~oval . .XX~ ............................... FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3305 Z Dote ........................... ~OVel~i~e~....7.., 19.~6.. Permission is hereby granted to: ................... ~g.~,~..~a~'~&c..J.~ ...................... ................... ~s~a~t"Age ................................ ................. 8'6tl't'fii~:8 ............................................ to ....... ]~1.~ .id...ne~.. ~ g.],~ut.tu.~ .]....~.].~ ~g..-(.p~l.ty...h~use .) .................................... ct premises located ct ...~/.S.....]304-,~Se~,lT....A.~ ............................................................................... ............................................. S~u.~o.14.,...N.,¥... ................................................................................. pursuan¢ to opplication doted ............................ ]~.CI~ ....... .7. ............... , 19..~., ond opproved by the Building Inspector. Fee $...~,~.QO ............ FO~M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ............................. Approved ......................................... 19 ........ Permit No. O Disapproved a/c...~ . APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. 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 drown 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. ............................ (Signc~6re of applicant,Jr nar~, if a corporation) ....... ........ ............................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................. .......................................................................................................................................................... Name of owner of premises ................. ~ .... ; ......................................................................... If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Mop No: ............................................ Lot No: Street and Number .....~..~(......~..~./.:~..~:..~..8~/... ........ ~./Z..~.,.....~ ............. ~44~.~.~../.('~.~....../~'.tZ; ................................. MuniciJ)ality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............................................................................................... .. ................................... b. Intended use and occuponcy ..... ~, ........ ~ .............................................................................. 3. Nat!ure of work (check which applicable): New Building ...... Addition .................. Alteration Repbir .................... Rer0~val .................... Demolition .................... Other Work (Describe) I (to be paid on filing this application) 5. If ((welling, number of dwelling units ............................ Number of dwelling units on each floor If g?age, number of cars 6. If I~usiness, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dim,'ensions of existing structures, if any: Front ...... .~'.L. .............. Rear ..... Z~.. .............. Depth ....~...~ Height ............................ Number of Stories Dimensions of same structure with alterations or additions: Front ................................ Rear De~th .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ........ ~.~.~ ..........Rear ........ ~.~ ............ Depth ......~. .............. Heibht ........ ~.~ ............. Number of Stories ....~..~ ............. 10. Dat:e of Purchase ...... ~df.~ ...................... Name of Former ~ner ]I. Zode or use district in which premises are situated ........ ~ ..... 12. Do~s proposed construction violate any zoning law, ordinance or regulation? .......... Na~e of Architect ...................................................... Address ............................................ Phone Na~e of Contractor .................................................... Address ............................................ Phone No. PLOT DIAGRAM Locale dearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr property lines. Give street and block numbers or description according to deed, and show street names and indic whether i~terior, or corner lot. STATEO~NEW~ORK .~ ~ ~ '~(~ame of individual signing apphcat~on) above na~ed.~ He is the ........... ~.~ ........ (Contractor, agent, corporate officer, etc.) of said o~ner or owners, and is duly authorized to per~orm or have performed the said work and to make and this applJ~at on; that a 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 ~fore me this -- ~ -- Notory