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Home My WebLink About4434-zFO~ ~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy THIS CERTIFIES that the building located at .... I~.~....~ .~....R~..5. ....... Street Map No..~x ......... Block No. <]~ ....... Lot No.. l~ ..... I,a~tt'~].... l{,~, ......... conforms substantially to the Application for Building Permit heretofore filed in ~his office dated ........&l~ .....3~T..., 19 .'~. pursuant to which Building Permit No.. dated .........A.~ ..... 2~..., lf~:., 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... P~LVate .aeNss~. - ~.ld~ .................................... The certificate is issued to ...O.e.d..~'...~...0~. ...... .....Q~f~e.. ¥ ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .........][.,~t, ...................... .... ....... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. EUILDING PERMIT (THIS PERMIT MUST BE KEPT ON TIlE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: Ceeil T. ~oun~ ................... ~..J~,~l ....................................... .......................... ,lA.'Ar~tl. ...... ~X~ ...................... to ........................ ~3.~,..m~t..aO,~ti.tl~a..~n..e~ta.~..ax:CaBaa~...~aLl~LL~l ........... at premises located at ......................... ]l~.....]~.,L~-.~/~ ................................................................ ................................................................ l~ml ...... ~l~Z. ................................................................. pursuo:n~ to opplicotion c~tecl ......................... ~jU4tr ......... 2.~....., 19..6~, ond approved by the Building Inspector. Budd,ng Inspector iFORM ,NO, I TOWN OF SOUTHOLD ~,~ BUILDING DEPAR~ (~ TOW]~' ,C~-~-~K'S OFFICE SOu'r~LD, N.Y. ~/~ ~ ~ Examined ................... , 19 .... ,.~/__~ Approved ~ '~.,19 't Permit .o.~'~ ('-/ ~ Application No ........ ; ........ APPLICATION FOR BUILDING P~BMIT 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 ~f buildings o n premises, relationship to ad~ining premises or public streets or area~, and giving a detailed description of lay out of property must be drawn on the dia,,ram 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 a Building Permit to the applicant. Such permit shall be kept ~<m the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole o~ in pe~t for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspecior. APPLICATION IS HE~Y MADE to the Building Department for the issuance of a Building Permit pursuan .C-'N to the Building Zone Ordinance of the Town of S~athold, Suffolk County, New York, a~d other applicable. Laws, Ordinances or Regulations, for the construction, of build ings, additions or alterations, or for removal or demo- liti0n, as herein described. The applicant agree~ to corn ply with all applicable laws, ordinances, building code, housing code, and regulations. //~ ~/] ~-'~/~ / ............... "'iS~g~i~:~ ~'~ii'c'a'~'o'r'~e~'~ corporation) (Address or ~'ant) State whether applicant is owner, lessee, agent, architect, engineer, ~eneral contractor, electrician, plumber or 0~ner builder ................................................................................................... Name of ~wner of premis~ ....... .~.~C J~].. ~,. ~O~m.g .................................................... If applicant is a ~rporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will b e done. Map No ................. Lot No..~ ........... Street and Number..R.O.~. ~.e...~.~....~..:~. ~q~..~..'~. · · · ................ :.. ~ .~~.~. · ff / '~ ~-0_~ Municipality 2. State existing use and occupancy of premises and in~ended use and occupancy of proposed construction. a. Existing use and occupancy .. ~. ~P~. g~]~,~ ............................... ; .................. b. Intended use and occupancy ~00:~ ~lhe~ 3. Nature of work (check which applicable): New Building ........ Addition . .X .... Alteration ........ Repair ......... Rem°~v~l^0-~:~w ~ .....Demolition ........ Other Work (Describe) ...................... 4. Estimated Oast ................................ 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, commel'cial or mixed occupancy, spec fly nature ~md extent of each type of use .............. 7. Dimensions ~f~ ~xisting structures, if any: Front ....~.2..I. ...... Rear ...]-.2.I. ....... Depth . .20.' ........ Height ................ ~'~ Number of Stories ... ~. ..................... ~ ...... ~..~ .................. .. · Dimensions of same structure with alterations or .additions: Front .... 1~. Rear . f~... Depth . ~i~...~/~f... Height ..7.'..$.q.~.':... Number of Stm~Ids ...~L ................ -- h 8. Dimensions~of eh. tire new construction: Front .... ~. ........... Rear ...... ~ ....... Dept - · Height ~.. %. ~. .... Number of Stories ........ , ................................ 9. Size of lot: Front ................ Rear ............... Depth ............... 10. Date of Purchase ............................... Name of Former Owner ............................. 11. Zone ar use district in which premises are situated .... ~ ................................ 12. Does proposed constructi~)n Igola~;e any zoning law, olx[inan~e~' or regulation!? .... ~ ...... ':"i '~'~ 1'2 13. NameofOwnerofpremises(.~...~--...-.~/~...A, ddress~A~A~..j....~../..<./'--~ Phone No~..~.:.~.-'fl.b.~. Name of Architect .......... _.._. ~) .......//.~ ..... Address ...................... Phone No ............ Name of Contractor ...... ~ ............ Address ~ ..................... Pkone No ............ I 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. .. Notary Public, . ................... County~ COUNTY 0]~ (Name of individual signing cant ebove named. He is the ................... (Ckmtractor, agent, c,~,porate officer, etc.) of said owner or owners, and is duly authorized to periorm or have performed the said work and to make and file this application; that all statements oontained in this application are true to the best ~f his knowledge and belief; and that the vaork will be p~ed in the mann er set fortll in the application filed therewith. Sworn to before me this ......... ~ day of .... ~ ...... ~ 19'~'/ ............ ~I~ ...............