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Home My WebLink About4356-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at .1~/$ ~M~a].Ow. L~ ......... Street Map No....~X. ........ Block No. ~ ....... Lot No....~.. .... . .M~.t..t.$~ .... N:.][.; .... conforms substantially to the Application for Building Pemit heretofore filed in this office dated .....J~l~.. ~ ....... , 19 .~.~[. pursuant to which Building Permit No...~.~..~...~ dated ..........,~lt~'...¶ .... , 19 .$9., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ..... 1~1,~;~. [~l~cell.l.e~)...IU. ~t4~l..~..~. ........................... The certificate is issued to . .C.l~ff.~l~l....l~13~..t.l'..t..J.F. .............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .ll,le ............................. .... '/'' '~''' [~' '~ding InspectOr' ........... FOKM NO. 2 TOWN OF SOUTSOLD 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? 4356 Z Permission is hereby granted to: A~ell~..~~.A/~..g~l~.~e~ ......... A~aeb~a~ ............ li,~, ........................... to ......... e~e~,..a~., em,,~a~a..e..pl~A~&~e-. (eeeesoe~)..~ ..Ime~ .............. at premises located at ....................... ]~il~.~,l~ ...................................................................... ..................................................................... II~t~.i~am~ ....... ~l~'~v ..................................................... pursua~¢ to application dated ................................... ~'~ll~.-...~....., 19..~1~., and opproved by the Building Inspector. Fee Sgsa~ ...... : ....... 'TOWN OF SOUTH.OLD BUILOING DEPARTMENT TOWN CLERK'S OFFICE Examined .................... , 19. ........................................ , 3~ ........ Permit No .... .... APPLICATION FOR BUILDING PEp, MIT INSTRUCTIONS ,,.', a. This.~application must be completely filled in by 13q~writer or in ink ahd submitted in duplicate to the Building Inspector. · .' b. ' Pl~..plan showin~ location of lot and of buildings ~l~premises; relationship to adjoining premises or public streets or areas, ondglving a detailed description of lay~~.must bed~wn o~the diagram which is part of this application. c. The work coverKI by this applicatio~_.'~..r~t..~J[e, commencec~efor~',ssu~ce of Building Permit. d. Upon approval of this application, eh~i~llding Inspector will issue'a Building Permit ~to the applicant. Such permit shall be kept on the premises avail.able for i~ion throughoUt~t~ · progress of the work. . " e. No building shall be occupied or used in. whble or in part for any purpose whatever until a Certificate of Occupancy ~.~1 ha~.~.n granted by the Building Inspector. . ' ~ · · APPLICATION IS HEREBY MADE to the Bult~rtment for the issuance of a Bulfd~.mg Permit Pursuant to the Building Zone Ordinance of the Town of Sout .~d;~Suffolk County, New ~York, and other apphcable Laws, Ordinances or Regulations, for the construction of buildings, ~dditions 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. (Sigr~ure ,o a~3plicant, or name,..,if c~orporation).~. State wJ~ether applicant is own, er, lessee, agent, architect, engi. neer, general contractor, electrician, Plumber or builder. Name of owner of premises ........ :'""; ............................. i ........................... If ~pplicant is a corporate, . signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. ~Aap No.: ........................................Lot No.;. ....................... Street and Number ..... ~....~..../.....~,~.~.~-e.~e~,,,...,/~......~.l. ................... /~/- ,/3~7.~'--" -- -- ----0 -- MunicipalJ-ty' ~_J 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing u~ ond occuponcht .......................... ........................................... i .................... b. Intended use andoccuponcy .............................................................. . .. .................................................... ~ ........... 3. Nature of work (check which applicable): New Building .................. Addition ..... .............. ,~ltera~ion .................. Repair ............. ~,.. Removal .................. Demolition ................ ~ at_her Work (Describe) . . 4. ,~timated ~est .~'.~.~.~ .................................... ~-ee ..,,.~ ................................................................................... (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. Size of lot: Front ..... .~'...~..~. .......... Rear ....... .~....~....~.. ................. Depth ........~....~..~..~. .......... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 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 ........................................ Address ............................................ Phone No ..................... 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 COUN~~~ ~OF .._~~ ~' ' ...~~~..~ ........................ being duly sworn, d~oses and says t~, he is the applicant '-- ~dividua' signing a~icatio? - above named. He is the ........................................... ~~~ ......................................... : ............................. - (~ontroctor, agent, co,orate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said wore and to ~Ee and file this application; that all statements contained in this application are true to the best of his Enowledge and belief; and that the work, will ~ performed~e manner set fo~h in t~e application' filed therewith. Sworn to ~fore me this ........... .......... ~ot