The URL can be used to link to this page

Home My WebLink About3844-zFOI~,M NO. 4 TOWN OF $OUTHOLD BUILDING I~EP,~RTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No....~.,...3. ~r.~l~ ............ Dete .................... .~l,,h~. ....... ~,1,.~. ............ , THIS CERTIFIES that the building located at ../~.~.~:JJ~.~,.l~.~...~..~.e .................................... Street Mop No...~..~.~....i~'...~.~.~... Black No ....................... Lot No. ~LS...,.8~U~O,~_.]~?~,.,~'O~J¢. ................ conform~ substantially to the Application for Building Permit heretofore filed in this office dated .......................... /'~'.;J,~......,~,, ................ , 19..~. pursuant to which Building Permit No...~..~.~..~ dated ............... ~.~.,!.,1~.....~,~..~ ............... , t 9....~.~., was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ ............. ................................................................................. The certificate is issued ¢o ........... .~.....a~...e...B....~...l:.~.~,,~..o.~..d.......(..o~.,..~..e..,~.). ................................................... (owner, lessee or tenant) of the aforesaid building. / Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUSTBE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE:WORK AUTHORIZED) ,- Ne 384 Z Permission is hereby granted to: to ............ ~,~S~J~g .................................... ................. : ........... . .tlle~'~.~. i~.. .......... ~.~.....r ......................... .................................. pu~$uanr~ to Opplicot on datecl,..~ ......................... ~,~.~.:.....1~...., 19....~ and approved by the , Bdilding InsPector~ ' · Building Inspector FORM[ NO, ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Approved ~ ~' ........................................ , 19 ........ Permit No ...... D~sapproved a~ ............................. ... ....... ^Pp,lC^,lO. FoR BUILD'UG PE.M * Date ...~.~...../..,/.: ......................... INSTRUCTIONS a. This application must be c~mpletely filled in by typewriter or 'in ink and sulJmitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premi.ses or public streets or areas, and giving a detailed description of layout of property must 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 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 o Certificate of Occupancy shah 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 Ordinonce of the Town of Southold, Suffolk County, New Yeti% 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, J;rpusing code, and regulations. -- ............. (Si~(6ature of applicant, or name, if a corporation) ............. ........................... · ~*,~ ~, , (~ /,~ ~ (Address of app cant~) [ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a coj'J~orate, signatur~ of duly ajuthorized officer. (Name and title of corporate officer)' 1. Location of land on which proposed work will be done. Map N~.....~...~."'-~ ~ ~ Lot No.: ../....'~... ............... Street and Number ~~..?~.........~.~'~'' ........... ~' ,~.,z~~.~.. .............................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....//..,~. .......................................................................................................... b. I ntended use and occupancy ... ~.~...~.......~.....~..~ .......................................................................... 3. Nature of work (check which applicable): New Building .................. Addition ..~ ....... Altero,tion .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ...../~g?.~..: ...................................... 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, ilc any: Front ....... ~,.~... ............ Rear ..:.~...~ ................... Depth .~'....~. .............. Height ........................ Number of Stories ........ ~ ......................................................................................... Dimensions of same structure with olteratigns or additions: Front ......~...~.. ......................Rear .,.'~....~.. .................. Depth .....-~..~. ................. Height ........ .~.. ............... Number of Stories ...~ .............. 8. Dimensions of entire new construction: Front ....... ~...~. ..................... Rear ,..~..,.~. ................... Depth ,,2,.,~'.. ................ Height ......)..~.. ......... Number of Stories ...~ .................................................................................................... 9. Size of lot: Front .....Z .~../. ............. Rear ..../..~,.../. ...................... Depth .~.,,~. ................... 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ T L Zone or use district in which premises are situated ....... ~..~...5 ................................................................................... 12. Does proposed construction violate an~,,~.~Z- I_;w, ordinance or re/gu~.~....~.. 13. Name of Owner of premis,9~l¢~....~ ........ Address ,~.,¢~k~,~r~..~"'/~' ................... Phone N .~...4~.~.....~..~'../.~... NameName olaf Contractor~.~.~.~~~..~-:C.....~AddressArchitect ............... ~ .......... ~...,~ ................ Address ~iiiiiiiiiiiii PhonePh°ne Ne.N° ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, 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. //O/ ' STATE OF NEW YORK, COUNTY OF ................................ ................................ of in'~ividual si~hin§ application) i.'.. being(Novone duly sworn, deposes and says th*t he is the *pplic~nt above nome& He is the ......................................................................................................................................................... (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 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 forth in the application filed therewith. Sworn to before me this ""7'"'"~~~;)~' nt .................. Notary Public,/.~.~,~.~¢~unty ~.c_~.k,/ (Sig ature o~applicant)