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Home My WebLink About3954-zTOWN OF $OUTNOLD: BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF ocCUPANCY No. Z..a2~J. ............. Date ............ ....Sm~Z..~., ........... , 19..~.~J. THIS CERTIFIES that the building located at ..J3~,~..,~V.~,~; ............................................... Street Map No ....................... Black No ....................... Lot No....I~II~t~.~,u~P~,...~T~...Zq~P~ .................... conform~ substantially to the Application for Building Permit I~eretofore filed in this office dated .................... ~1'1.~...1.~, ........................... , 19.~Jt.. pursuant to ~vhich Building Permit No..~..~.,5..~....~.. da¢ed ......... .~..~.~.....1.~.., .......................... , 19..§.8..., was issued, a~d conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ The certificate is issued to ............ Cla~'~...T.~]~.~ ................. ~ ................................................. (owner, lessee or tenant) of the aforesa'id building. FORM NO. ~ TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~ SOUTHOI..D, N. ¥. BUILDING PERMIT (THIS PEP, MiT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK ^UTHORIZED) N? 395 Z Permission is hereby granted to: i ........... ~i~ ..~a~££e~..i,~....~'l~a i~ei, t~e~ . . ~i;~,~. ............................ i~ ................ at premises located at ......... t~l~..~*e .................................................................................................. .............................................................. Y, at.~k ......... li~,,~.~ ......................................................... ' ,~ ~ 19,.~, approv~ by pUrsuan~ to application d~ed ............................... ~ ....... ~.~.,-., and the Building Inspector. Building InSpector TOWN OF SOUTHOLD BUILDING DEPAI~TMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ............................. Application No ................ Disapproved a/c ................ ~ APPLICATION FOR BUILDING PERMIT Rte ...... 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 ocation 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 port of th s appI cat on. 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, housing code, and regulations. T Francis McCaffery (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor Name of owner of premises ......q~...B..~...a.....l~..~.l~..~.~.~' ................................................................................................................... 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.: ........................ Street and Number ........... ..~..a.~....A..9'.e. ............ ..~...~.~c.~....~...~... ........................................................................ Municipality 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 occupancy ................ sa~e...w&t,~..a,t,~;&ol;ted....o&T...p~.t, ................................................ 3. Nature of work (check which applicable): New Building .................. Addition ~ Alteration z:[ Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .....~[0~..~'~. ...................................... Fee ..... ~..AQ.~. ........................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... .0~ ............ 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 a.lterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ......... .1.,~. ...................... Rear .......... ~.3 .............. Depth ...... 2.6 ............. Height Number of Stories one 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ........ ~,.....~,~,~ ..................................................... 12; Does proposed Construction Violate any zoning Jaw, ordinance or regulation.;> nO ...................................... 13. Name of Owner of premises ...Clarz..~/ehbe,~ ........ Address ....... ~.'C.'C~C'~1,C~ ............... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ....~........~...c..C..~.~.~.e.z,..~. .................... Address ....... .C..g.~..c.~Qg.~,~. ............... Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildihgs, whether existing or proposed, and indicate all set-back 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 Y~RK t-- COUNTY OF ....... ~'.~.O....]~... ........ $5.5. ........................................ ~s3,~,~.~.....~g.~.~,~..:~. ............. being duly sworn, deposes and says that he is the applicant (Name of individual signing ~pplication) above named. He is the .................................. C~e.~ .............................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and i~ duly authorized to perform or have performed the said work and to ~Ee and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set foHh in the application' filed therewith. Sworn to before me this .................... ~.~day~f ................... ~..~ ........... , 19.. 6~ ~ ~ ~ ~_ ~ /~. .o. ' ~mmiSs~0n ~plres ~ ..... ~ ~