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Home My WebLink About3937-zNO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ..... ~..314~% ......... Date .................... .tull. ......... 9e ............ , 19.6ILL.. THIS CERTIFIES that the building located at ...Sa3,t,..A;I~...W,a¥. ..................................... Street Map No ....................... Block No ....................... Lot No. 3~....~l~tt/tu~.,...~tel~...~/~r~. .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .................. ~TI&i~ ....... 1~ .......................... , 19..68. pursuant to which Building Permit No...~J.9.~.~....2] dated . ....... Ju,l.y ....... ,1..r ........................ , 19...68, 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 ........ ........... p~ ~.~,,~e.. ~m~e imo~¥., bu4Ll~g... (s.tozage ....e~-¢..). ................................................ The certificate is issued to ..... /~L~ha~&J..~.,...G:Z~l.f~:L]~h ................................................................. (owner, lessee or tenant) of the aforesaid building. %u~dir~ln~pector · FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT ~ (THIS PERMIT MUST BE KEPT ON THE PREMISE~, UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3937 Z Permission is hereby granted to: at premises located at ............... ][~t~.~ ...... ~-,~.~J ~l~J~ .............................................. pursuan¢ to application dated ................................ ~ ....... ~.-.?..., Building Inspector. Fee $ · .~[.~ ............ and approved by the ' ~ Buildi~g!~spect°r I ' FOF~M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ....................................... 19 ........ Permit No ........................... D~sapproved o/c .................. ~:, ........ T ...... T~ ........ ............................... ......... ............. ..................... (Building Inspector) APPLICATION FOR BUILDING P~RMIT .............................. , INSTRUCTIONS : o. This application must be completely filled in by typewriter or in i~k 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 o 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 befor~ issuance of Building Permit. d. Upon approval of this opplicotlon, 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 port for any pu!pose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building OeporCment for the i~suance of o Building Permit pumuont to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or fbr removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances building code, housing code, and regulations. ' '"' . ~;i. · ~;~'~;'i'gRi ......... ....................... ....... iX~i~;~'~;~ op~ii'~>;;i ................. State wh~ther applicant is owner, lessee, ~ent, architect, enaineer, ~n~rol' contractor, electrician, plumber or builder, ......................... 8:~.~:.:::~.: .................................................................... : ......................................................................... Name of owner of premises ....~_~..~'C¢~......~..:...~c<L~..~.~..~'. ........................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work will be done. Map No.: ..... ~ .................................. Lot No.: ........................ Street and Number ....................................................................... ! ............... ~ .................... /. ........................... ~ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ..~..,~'~//~)~J(~'~ , .......... b. Intended use and occupancy ....................... ~ .................... :.. ....................................... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. P~moval ~:~ ............... Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .......~.,~....1~.. ......................................... 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 use ............................ 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~,~f lentire new construction: Front .................................... Rear ............................ Depth .....~... ............... Height ..... 'w'. ............. Number of Stories ...................................................................................................................... 9. Size of lot: Front .....~.~ ............... Rear ....... .~.~ .................... Depth ..... ...,~....~....O. .............. 10. Date of Purchase ...... ./....~...~...~....../..~'...~....~... ............... Name of Former Owner ....~....~..~.~.../...~.~.7~.~.?.. ................ ! 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violi:te any zoning Iow, ordinance or regulationP ................................... 13. Name of Owner of premises ....~...L...~....'~..~..~.-~.../....~........^ddress ......~..~..7..d../...~........~...d..~... Phone'~ei~.'.~.~.~.'~ Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM l_ocate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-bqck dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................................ .................................................... '. ........... '.i ............................... being duly sworn, deposes and soys that ho is the applicant (Name of individual signing application) abow; named. He is the .................................................... i .................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this opplication; that all statements contained in this app!ication are true to the best of his know[edge and belief; and that the work will be performed in the manner set forth in ith~ application filed therewith.,// Sworn to before me this ,q / ,,~ , ~ //, ............ ~./~....... day of ..... .~.~, ........................... , 19~.~... Notary ................ ..................... ~ ~ARI ....... NOTARY PUBLIC, State ol N~ York ~o. 52-3233120 Suffolk C'~dnty.