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Home My WebLink About4327-zFOI~ NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF occUpANCY THIS CERTIFIES that the building located at ~(~1~1~..~'~/~ ................................................. Street Map No. P.:8.~....~...~.~... Block No ....................... Lot No...~..'~..~..~...~...?..~....~.~. ......... ..~..e..e...o..~..~.~......1~..?~' conforms substantially to the Application for Building Permit heretofore filed in this office dated .............................. ~T1,1,1Q~.....6 ................... , 10...6.~. pursuant to which Building Permit No.i+~2~;r~ ...... dated ........................... ~.1.~ .......... 6 ....... , 19.~¢~.., 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 ........ ........ ~r ~..wt~ce.. ~n~...~ar~.t~y.. d~e.,t:.'t .~n~;. ............................ ~ ........................................................... The certificate is issued to ..~¢~.~',,~L.,~,..,~[~IZ ............. Ol~le~ ........................................................... (owner, lessee or tenant) of the aforesaid building. ~tou~e # ~+t+0 ........... ......................... Building InspectOr FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT fi.HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 4327 Z Dote ............................................. ,' ....~... Permission is hereby granted to: ................ ..~/.~... ......... Z//.~...,;......~ ............. to at premises located at ................... .ff....~.....~.. ............ .?..q.,,~..~.:....~.. ....... ..~.....~...-~,. ................................... ............................................................................ ~..~.~.:.~...:..~ ................ .~ ./.;,,!~. ........................ ~t' / ~.L~...,~ 19..(...~, and approved by the pursuan~ to application dated .................................. i~ ........ ; ....... , Building Inspector. .....~....,.e:. ........ ~...~ ........... Building I n~pec'tor Application No..~.i~.-~.~.. ............ APPLICATION FOR BUILDING ~ERMI't' INSTRUCTIONS a. This application must be completely filled in by typewriter or in ipk and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relahonsh~p to ad ommg premises or pubhc streets or areas, and giving a detailed description of layout of property must be drawn 6n the diagram which is part of this application. c. The work covered by this application may not be commenced befor~ issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issueia Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the profess of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Ce~ificate 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 ~ork, and other applicable Laws, Ordinances or RegulatJons, for the construction of buildings, additions or alterations, or ~or removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances building code, h~usina code, and regu at OhS (Signature of applicant, or name, if a corporation) ......... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi.n~r, general, contractor, electrician, plumber or builder. Name of owner of premises... ,~.. ~.. ~X~.~ ....... .~...~.~ ............]...] ....................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~-~//~ 1. Location of land on whlch, proposed work will be done. Map No.: ....Z.~.~j ....................... Lot No.~.,~::.~..~ Stree~ and Num r ......................................................................... } ............................ ~ ......................................... ~1- ~ ~/ D : Munici~lity 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and ~cupancy ../.z 4,.,:~ ,..~:;~:~.4. ' f<; .................... : ................. ........................................................ b. Intended use and occupancy .~ ff./~.'.?. ~.~?.~.::...'...~ .............. ...................................................................... 3. Nature of work (check which applicable): New Building .. ................ Addition .................. Alteration .................. Repair .................. Rem~,.al .................. Demolition .................. Other Work (Describe) ........................................ 4. Est,mated Cost ............ ................... fee ................................................................... (to be paid on fiHng this application) · 5. If dwelling, number of dwelling units .....~..i ................... Number oF dwelHng units on each floor ...~. ..................... If garage, number of cars ........... ~c ..................................................................................................................... :. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7, Dimensions of existing structures, if any' Front ..... Z~..~. Rear .. ~ Denth Height .....~] ........ Number of Stories ....... .~. ................................................... ~2 ................................ y....g ..... Dimensions of same structure with alterations or addiHons: ~ront ........ ~.~.~.,~ ........... Rear ...~,.~...~ , ~ · Depth ........ ~ .............. He,ght ........ Z.: .............. Number of Stones ........ ~: .................. 8. Dimensbns of entire new construction:' Front ....~..~...f ............... Rear .....~..~.~'...~ ...... Depth ....Z~.f .......... Height ...... ~ ..... Number of Stories ..... Z ...................... ' ....................................................................................... s z. of ....... ............. ....... .......... ' ......... ........ 10. Date of Purchase ...... ~....~..Z~ ......... Name of Former Owner .~..~..~.~/~.~ ............ 11. Zone or use district in which premises are situated ..~.f.~..~& ................................................................ 12. Does proposed construction violate any zoninfl law, ordinance or reqplation? ...~ ............................................. 13. Name of Owner of premises ~/~..~..~4~.Address ~Z~..~,~.~,,~. Phone Name of Architect ..................................................... Address ............................................ Phone No'~ ................ Name of Co.t~octo~~..d.~_~Z~Z..~....Add~Z~..~.. Phew. PLOT DIAGRAM Locate clearly and distinctly ali 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 w~hether interior or corner lot. 3'OdA/~0 ~Y~ /y' STATE OF NEW YORK, ] ¢ ¢ COUNTY OF ................................ .... ...~.....~.....Z~.....~..~.~.. ...... ..~..~.~....bZ..Z'..../~...~..~ .............................. being duly sworn, deposes and says that he is the applicant (Name of individual signing application) abow: named. 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 oppUcotian; that all statements combined in this application ore true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the applicdtion filed therewith. Sworn to be,~,pre me this /]_ AG ,,~ ~, / /~ /~ .~ / ................ · ~..... day of ...... ......................... ,,L',~ ,//~Z ,~, . ........... ~.- ,-. ~.~.:r.~......~ .~rr...~=...-.~:.T_.r..:=r.~ ........ i ........ I/ .['¥/},, I ~ ( I ~ ~'~ ~LIZAB~TH ANN N~VILLE ~ ~/i~.,M~'~2 ~ ¢ ~..~,,¢~ NOTARY PUBLIC, State of New York ~ Term Expires March 30, 19