The URL can be used to link to this page

Home My WebLink About3820-zFOP~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TO~A'N CLERK'S OFFICE SOUTHOt. D, N. Y. CERTIFICATE OF OCCUPANCY No..~,...3.,!~..0. ............ Date .................... ~.~11~......,~.~., ............... , 19.~..J}... THIS CERTIFIES that the building located at ...~'.~l~l.t,~..~Q~.~ ...................................... Street Map No, ...... .?.~. ............ Block No ....................... Lot No....3..:~..[.......C.M.~...~..~..o..cj.g..e.~.....~..e.~...¥..o..~.~ .......... conform,s substantially to the Application for Building Permit heretofore filed in this office dated ....................... .~.~..~..$~......2.,f ...................... , 19...6..8... pursuant to which Building Permit No. 382.0..~.. da'ted ........... .~..~.~.~.~......~.f ...................... , 19..~.1~..., was issued, end conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ ........... .~.~ .v...a.~.e.....a..~ .q.e..~ ~..o.~...~ .~.$..~ ~g. ..................................................................................... The certificate is issued to .....~...~........~..,.....~...e..~..l~..e.~...(.i;T~..~,.~'.)' .............................................................. (owner, lessee or tenant) of the aforesaid building. Building Inspector / FORI~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N?- 3820 Z D~te .................. .i ........ ~,,.,.~. ....... i 19~.. Permission is hereby granted to: ~ Fee .............. pursuoz~t to opplic~tion d~ted ................. , ......... ~..,.;~..,:...,;....i 19..~., 'and appr°ved by the , Building inspector. , ·~::* · .: . :.:,-' ~ ,Ts NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No .............................. Application No...~.~.....~.....~....('.2.. ......... Disapproved a/c~ ...~ APPLICATION FOR BUILDING PERMIT Date .................. ~' ........................... ~ , 19..~....~.... 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 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 hove been granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of o Building Permit pursuant 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 for removal or demolition, os herein described. The applicant agrees to comply with oil applicable lows, ordinances, building code and regulations. State whether applicant is owner, lessee, agent, arch~~,, general contractor, electrician, plumber or builder. Nome of owner of premises ............ ..~,..~. ....... E ....... ~ ................................................................................................ If applicant is o corporate, signature of duly authorized officer. (Nome and title of corporote officer) 1. kaeation of land on which proposed work w~ I be done. ~op lq ....................... ~....~ ............. lot No ..................... Street and Number ................................................................................. ...*.;........~....j~. ..................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................................. n ................................................................................. b. Intended use and occupancy ................................................................................................................... Locate clearly and distinctly ali property lines. Give street and block numbers or whether interior or corner lot. 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost ........ /~.~..~.~.. ........................................ 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 of entire new construction: Front .......... ~,.~..i .......... Rear ....... ..~..'[ .............. Depth ..... ~f .................. Height ............ ./.~,, .......... Number of Stories .......... ./. ................ 9. Size of lot: Front ...... (..'~..~. .............. Rear ....... ./...~...~J ............ Depth ....... ~.~...?. .............. ........................................................ Nome of Former Owner ........................................... 10. Date of Purchase 11. Zone or use district in which premises are situated .................... ~ ......................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ........ ~ ........................................ 13. Name of Owner of premises ..~K.....~.~I~[.c.C ................. Address .~..l~£,,~q,.~..~......~..t..d..e.~..~.~Phone No.~?..(.:..a'.].?.~... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .....(~'..~ ...... ~.~/~.c~ ......................... Address.....~.~¢n~... ............ ~/ Ce...~.-~ P.e. .... ... Phone No....~...<T.(K...?..~..~'O PLOT DIAGRAM existing or proposed, and indicate all set-back dimensions from street names and indicate to STATE OF NEW YORK, / S S COUNTY OF ................................ I '.' ...... ~ ............. ,-~ /1 [1~ ...............................being duly sworn, deposes and says that he is the applicant .... (Name or'individual signing application) L. ) J,',4~/2~,./)//)1~/ above named He is the ................................................................ ~.-r~w~..~., ......................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, a~"i~"~l't~i~"~¥J~ri*:~ to perform or have performed the said work and to make and file this appJication; that all statements contained Jn this application (~re true fo the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. ........ ......................... No. 52'3233120 Suffolk C?~.~/.~,