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Home My WebLink About4564-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...Z~...,~82.~ ........... Date ........................... ~T~l~e....~ ........... , 19....~0 THIS CERTIFIES that the building located at 'M:[~e[nJld3~"~].'vl~ ..................................... Street N~ap No. '"7,5[ ............. Block No ....... ~ ............ Lot No..x3r. ...... ~G1,1~;]3o3,~ ......... ~.~e ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................... ~OV. ......... ~ ........ , 19..69. pursuant to which Building Permit No..~,~.. dated ........................ ~. .........~ .......... , 19...6~), 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~.~a ~ee"en® ..~'em,~.~r ...d~e.l.~ia~, .................................................................................... The certificate is issued to ........~-e...Pa~...~.l.%e~ .............. ~/t'~e~ .................................................. (owner,-l&~see or tersest) of the aforesaid building. House ~ 1710 Bui ding Inspector/ FORM NO. 2 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) Date ...................... JJ,D~.JJlJJ~Z.... ~ ...., 19....~'9 Permission is hereby granted to: · . J,l, dlit~.t,t,.....,~tC,..~,.-t~ ~..&~.,mS ......... at premises located at ..;...~j....llfJ.~ll~.~j),~,j~ljl..jj~jl~..~j~j ..................... ~ .......... : ........... ............................................. ~..~e~s~-.~e~t~.e:J~l ....... ti~-3;~- ..................................... pur~s~an, to application dated .......................... J~V~ .......~ ............ , 19..4j~, and approved by the Building Inspector. IN)B~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFK:E SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ............................. Disapproved o/c .............................................................................................. APPLICATION FOR BUILDING PERMIT 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 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 port of this application. c. The work covered by this application may not be commenced before issu~ce 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 descr bed The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, f~ ........... ..................... ,. ........ (Signature of applicant, or name, it a corporotioni (Address of applicant) State whether applicant is owne~arc~gineer, general contractor, electrician, plumber or builder. Name of owner of premises .............................. ...~... ~ ..~...~ ~ .......................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Street and Number . . . ~i~ ~ ~~~iii~'~': ........................ ff l - / 7 / /~ Municipality ............................ ' ...... State existing use and occupancy of pr,~mises and intended use and occupancy of proposed construction: a. Existing use and occupantS/ ....... ~......~...~....~.~ .............................. 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition ................ ~her 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 ..... ............................. ear Depth..........,... ........... Height .................... Number of Stories 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Fg~ner O~ner ........................................................ 11. Zone or use district in which premises are situated ...... ~1, ........ ~ ................................................................. 12. Does proposed construction violate any zonin~L law, ordinance or regulation? ........... ~ ................................... 13. Name of Owner of premises ..~...:.~'~..~'.....Address ./..~.~..::.~:.::~.~.... ho~'-~ne No.~..'..~.i'~.~.J ....... Name of Architect ...................................................... Address Phone No ..................... Name of Contractor ...~..:..L..:....~~"~ 'z '~'' .......... Address ii~.~iiiiiiiii Phone No ..................... 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 corne.r lot. STATE OF NEW ~.~ lj~ I cOUNTY OF ..~~..$ i ' / .......................... ~..~'....~...~.~~..~ing ~ly sworn, d~oses an~ says t~t he is the applicant (Name o~ i~ividua, ,igni~~ above named He's · ~~ ........ n '"'~'"~ ...... ;"i'""~i;'"; ........................ ....................................................... o of said owner or ~ne~, and is duly authorized to perform or have performed the ~aid work and to ~ke and file this application; that all statements contained in this application are tree to the best of his knowle~e and belief; and that the work will be performed in the manner set fo~h in the application' fil~ therewith. Sworn to before me this .............. ,. o, ............ ........... ....... . ....... :. ......... ....................... Nota~ Public,~~~.. Coun~ (Signaler applicant) - HOTA~y PUBLIC, State o~ New York ~o. 52-8~25850, Suff01~ C0 Term [xpires March 30, V