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Home My WebLink About4306-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCOPANCY No..Z~,~9.~.1 ............... Date ........................ &U~.tll~4; ....... .~. ....... , 19-70. THIS CERTIFIES that the building located at "~JS..'~r.~JC~..--W/~../,,~J)..~.~l~,eO~& Street Map No....}~efl.~. ..... Block No .......~:~ ........... Lot No...~ ....... J~.t,~;J,~,~k ....... ~e~e ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................. Hr~ ....... 2'2 .............. , 19...6~ pursuant to which Building Permit No..)d'.~O~*-.. dated ....................... J.~'~r .......... 2~ ........... , 19..~1., 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 ........ ........ .gr. tva.~e..o~e...~m~y..~e~.~:in~ ........................................................................................ The certificote is issued to "~e~.er..S.,-.C~ra~' ............ Owner .......................................................... towner, essee or tena,nt) of the aforesaid building. ~ouse #388~ C.~.~t Bui ding Inspector]' FORM 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) N? 4306 Z Permission is hereby granted to: ]~et~eZ' Se G['a~/' ........... 2~.....gJ. ngshur~...Ikt ............................. ................ ..e.~.r..~.e..~...:.c.~,~y......~.,.×.,.....J..15..~. ..... to ~ULI~ ...................... an a~4it~Lon ~ an ~:~tln~ ~1.3...~..~ pursuan¢ to application dated ........................... ~ .............. ~,~;....., 19..~.., and approved by the Building Inspector. Fee $..~.?.?_0.. ............ ' ' ' Building InSpector' / . . . ~ ~., ~_~- ~.~ ~'~.~,- TOwN OF ~D ~/~' BUILDIHG DEP~T~T ~H~, H. Y. D~ a/c ....... ~ .............. · (Bulldl~ I~) APPLICATION FOR BUILDING PE~ ~ ..................................... .~/~.~ ........ , ~..~.~. .... 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 adjoinin~l premises or public st.reets or ~/~ areas, and giving a detailed description of layout of property must be drawn on the diagram which iS port of this apphcation.~ c. The work covered by this application may not be commenced before issuonoe 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 prem ses ava able for nspection 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 Occupanc¥~ 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 .o.f Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulati..ons, for the construction of buddings, 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. ......... (Signature of appllcant,~-~name, if a corporation),~J ~ .... (/ (AcCess of applicant) //,,s-Se ,/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of , , ~,~.,,~ ,,~,,,e owner of prem.ses .....~..'. ................. .~ ......................................................................................................... If applicant is o corporate, signature of duly authorized officer. ; 1. Locotion of Iond on which proposed work will be done. ,M~p No.: ............. ;......... ......... ~ ........ lot No.: ....... ; ................ Street~an~d~N~-uumber ,~,,,~,, 6~,~'~,,,,,,~,,,,T,,,e~:,,~/,'~! /~)//~ ,~,,,~,,,~~,,~ ~,,,,~,,,~ .............. ..................... ...... ..... ......... 2.State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. ~x~sting .. and occ~ .i .~...~~.~ ............................................................................ b. Intended use and occupancy .~.~ ........... ; ......................................................................................... 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 ............................ , ....... Rear ............................ Depth ........................ Height .................... Number of Stories ...: ................................................................................................................ / 9. S ze of lot: Front ..........~..o. .............. Rear ....... ~...O. ....................... Depth ...... ./...~..?..:..~...o. ...... 10. Date of Purchase ......... .~..~.. ...................................... Name of Former Owner ..... ~.~ ................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate anyzo~ law, ordinance or regu at on> ~...e.: ........ 13. Name of Owner of premises ....... Address .... ................. ; .............. Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .~..~ ................................................... Address ............................................ 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 corner lot. STATE OF NEW YO~K, COUNTY 9F ............... 1~.~.' "~-'~'~.~.7.~..'~' ~ ....... ~; ........ ; ................. being' duly sworn, d~oses and says t~t he s the app cant t~ame of inaividual signing a~licati~) above named. He is the ..... ~.~.~.~ .................... (Contractor, agent, co,rate officer, etc.) of said ~ner or owne~, and is duly aut~rized to ~rform or have performed the ~id work a~ to ~ke ~d file this application; that all ~atements contained in this application are tree to the best of his knowl~ge and ~lief; a~ ~at the ~ will ~rformed in the manner ~t fo~h in the ppplicati~ fil~ the~ith. m to ~rore me~ ...... .......... ~,,, ~..,/ ~ ~,, /,' .......... ~..~...~...~.~ .... N~a~ Public, ~~~c~w~o~~A~. ~BLIC, S (~ig"a~;~-~'nt)'~ "' ' .................. ,. N0. 30.6532485 ........ GI~_AY