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Home My WebLink About3811-zFOI~M NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TO~VVN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...~.[~..~.cj.e.....~..~.,q.e.. ......................................... Street .. NaSsau Pt°n, ~,, Map ~xio ....................... O,OCK ,~o ....................... Lot No..~..~..2.......~..~.s..~..a..~...~...q~p...~..~....C..u.?..~h.o..c~.g~., N.Y. Club Prop. conforms substantially to the Application for Building l%rmit heretofore filed in this office dated ................. .~...~..~..,~.~.....~..~ ......................... , 19..~..8.... pursuant to which Building Permit No....~..8...~..~....~ dated ...... .M..~...~..~.~.....~.f ......................... 19...~..8,.., 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 ........ ............ ~.e...e..e...~.~.o...z. ~..,~ ~..z.~.~....(~.~ .e.,~.~... k°. ~..e..). ........................................................................ The certificate is issued to ........... ..~.~..e..~..~..9..~.....~...O.~..? ............................................................................. (owner, lessee or tenant) of the aforesaid building. FOR~ NO. ~ 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) 3811 Z Permission is hereby granted to: ........ ........... ~{a~,~ ~A, ua~ ............................................... to I~e.v.e.. ~.~ ..ax1 s.t, tug..d.w~Z:LJ.z~...to..z~r..l~m&t ~_ ~ ...................................................... at premises located at ......~.~...1..1L~.....~.JJ.~.~i~J,..~.Q;J,D,t~...I~.~..~.~'.(:I~). ........................................... .................................. ~ldg~a..i._~e~..... ~a~s c~ ..~. ~ ~a~t ~...C~t~l~te .................................... pursuo.n,t to opplicotion doted ........................... J~i~.~. ......... ~ ...... , 19.~., ond opproved by the Building inspector. Fee $...~.Cl. ~O .......... Buddmg Inspector FORUM[ NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam,ned Approved 3 ........................................ , 19....~[. Permit No ......................... Disapproved a .......................................................................... ............. ......................... ................................ 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 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 o 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 Sou,hold, 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 reguiations~ (Signature of applicant, or name, if a corporation) .... ~C&t.ti.t~ck ~... I~, Y,, ........................................................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, enpineer, general contractor, electrician, plumber or builder. Con~z~aetoz, Name of owner of premises ..E.~_..e..a.,~Q..z'...~.Q.h..e.. ...................................................................................................................... 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.: ...~..~..s..~.~..~...?...°..~...~.~....C]...~..~-.~_o~ ....... .J.J.~ .......... Street and Number ...]~:~J,d~a..~a~.a .......... ]~s.~.~,..~.~.i~e...Q~g~.~ ...................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ....... .~.Q..~O.~.a.,,~]fJ, c~.~J.~,~;,,.Ct,W.~,]~],:~,,P.~,,,~,,,~P,~ .................................. b. Intended use and occupancy ................................................................................................................................. 4. 5. 6. Nature of work (check which ~pplicoble): New Building .................. Addition .................. Alteration .................. Repair .................. Removal ................. Demolition .................. Other Work (Describe) . .~.p.~.~...~l~,~3,~t,J,~g ....... Estimated Cost .... .1. ~. ~.O.C)...'J:... ~ .................................... Fee ..... .1.C),.Qf) ......................................................................... (to be paid on filing this application) If dwelling, number of dwelHn units ....... ~10,~. .............. Number of dwelling units on each floor ............................ If garage, number of cars .................................................................................................................................. If business, commercial or flixed, occupancy, specify nature and extent of each type of use ............................ Dimensions of existing structures, if any: Front ..........~.0 .............. Rear ......... .~0. .................. Depth ..20 ............. Height ........................ Number of Sro, ties ....Q~.6..: .......................... .......................................................................... Dimensions of same structure With alterations or additions: Front ....................................Rear ............................ Depth ................................ H~ight ............................ Number of Stories ................................ Dimensions of entire new construction: Front~ .................................... Rear ............................ Depth ........................ Height .................... Number bf Stories ...................................................................................................................... Size of lot: Front ........... .1...0..0.....~. ..... Rear .................................... Depth ..~.~ ........................ Date of Purchase ................... ~ .................................... Nome of Farmer Owner ........................................................ Zone or use district in which p)'emises are situated ...... .t!~!!...~.j..~.~. ............................................................................ Does proposed construction vioiate any zoning law, ordinance or regulation? ................ ~Q ....................................... Name of Owner of premises ~.~..e...~..zl...q.z'.....~..O.]2..~ ........... Address ....... .g.l~'b.C~l. Qg.'O. fl ............... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... ~a...e.s!~ .................... Address ....... ~.~,t .$~;~.¢~ ............... Phone No ..................... Name of Contractor ~.~A_t~..:' ' 10. 11. 12. 13. I.ocate clearly and distinctly all property lines. Give street and bloc whether interior or corner Jot. STATE OF NEW YORK, COUNTY OF .... ~o~ ........... PLOT DIAGRAM ~uildings, whether existing or proposed, and indicate oil set-back dimensions from number or description according to deed, and show street names and indicate ...................................... ~..~..~.~...~...~.~.e...s..~...i. ............................ being duly sworn, deposes and says that he is the applicant (Nome of individual signin~ application) above named. He is the ................. ..~ ...... .O..gJ~.~.~..~..q~.O.~ ........................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and s duly authorized to perform or hove performed the said work and to make and file this application; that all stotementsjcontained in this application are true to the best of his knowledge and belief; and that the work will be performed in th~ manner set forth in the application filed there,,~J~ Sworn to before me this 1 y ~lic, 4LI'.J. ' ............. ~.¥,4¢~rj,~_.~... y g rg4'e otJappHconT) NOTARY PUBLI0, State of New York Jqo. 52-3233120 Suffolk C~unty ,Term Expires M. arch 30,