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Home My WebLink About4469-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ~t~"~l~),l~'"~J~lltl~"(O~')'~ ............. ~. Street Map No....~ .............. Block No ....... ~ ........... Lot No. ~ ....... ~11~1111~....~1¥~¥ ......................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .................... ~ .......... ~O ..................... , 19.~1~1~.. pursuant to which Building Permit No. ~1~... dated ........................... ~er~....~.~ ........ ~, 19..~1d1~., 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 ........ The certificate is issued to ............ ~r~..~lt~ll ............ t)1~1~ ...................................................... (owner, Tessee or tenant) of the aforesaid building. / ~' Building I~'s~or / FOF, M NO. ~ TOWN OF $OUTHOLD 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? 469 Z Septeaber 221o 69 Permission is hereby granted to: ........... ~..e.~.~....~.a.~.~ .......................................... ........... ~Q ~.,~ b...?~.~ ~,.....(.C~b~ ?.). ......................... ........... ~eeet~.e. ......... Ig.¥.. ................................ to ........... ~l~Xd...ue,,'..~c,c e,~a ~ F...~ ~t ~ ,l~; ........................................................................... at premises located at .................... -~/~...}~L¢~.le..~.~,O~.d..LC~.~..~ ........................................... ? ....... ........................................................ · .eaonie ......... .~.3;. .................................................................... pursucm¢ to application dated ........................... ~F.~ .........~- ........ , 19....~.(~ and approved by the Building Inspector. Building Inspector 'r~v)4 of/4)UTHOLD ~ lUll,~l~ DifAILTMINT ~ a.iP, K'~ OFFICl SOUTHdX. D, N. Y. Approvad ................................... ....., 19 ........ Permit No ............................. Disapproved a/c ..~ ................................ (euildi~g Inspect&r) APPLICATION FOR IUILDIHG PERMrT I~'mucrlo~s a. This application must be completely filled in by tg~ewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of bu.ilding? on premises, relationship to adjoining promises or public streets or areas, and giving o detailed description of layout of proj~ must be ckawn on the diagram which is port of this appllcation. c. The work.covered by this application may not be. cammenced before issuance of Building Permit. d. Upon :ap~ 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 thmaghout the progress of the work. e. No building sh~ll 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 pureu.a...nt to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable I.a~..., Ordinances or Regulations, for the construction of. buildings, additions or alterations, or for removal or demolition, as Fmrein described. The applicant agrees to comply w~th all applicable laws, ordinances, building code, housing code, and regulations. ...... ........................ ..-[. ......... .......................................... (Signature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................... ..o..~..,y...~..~ ........ ~ ......... ~.0...!.£.~.~ ................................................................ :.. Name of owner of premises /~-Z ~ U T HA ~ ~ If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Locatian of land on which praposad work wtll be done. MapNo.: ........................................LOt No.: ,.., ................... Street and .............................................................................. ~ ......................................................................... ,: MunlcipQIIty 2. State existing use and occupancy of premises and Intended use ¢~d _,~;¢,~ancy of propased construction: · o. Gxistlng.useand Z)H/'ELL /~/~-- ' oc~:uponcy, ...., .........~.~.~..,..4; ..................................................................................................... b. ,.te.~.- and .~ap.~..:: ...~.... ......... .~/..E~ ........... 4.C..~.~.-~..S.~.~.~ ...... ~..~.~.~ ....... 3. Nature of work (check which applicable): New Building ~-L;~;.~..~;.' ...... Addition .................. Alteration .................. Repair .................. Removal .................. "Dernbli~i°~.~....~....~ ...... Other Work (Describe) ........................................ 4. Estimated Cost ..................... ./. ................... i.....~.. .......... Fee .:. '-~_...; ................................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling~units on each floo~ .............. , ............ 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 ............................ Pear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ D~pth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of.entire new construction: Front ............... ~.......L .......... Rear ............................ Depth ........................ Height .....~..../. ......... N,umber of Stories ........................ ._. ............ ~ ...................... ~.....~ .................................................. · /~ R r /. ~p Det' .~O 7'- 9. S,ze of lot'. Front ............................ ea ................................... p h · ............................... 10.~ate of Purchase ............... ../.~...~.~.. ........................... N~ of E?mer Ow.er ........... ..~..ZI:..~.~.. ........................... " 1 1. Zone or use district in which premi~ or~ situated ............... ~ ........... ..~'..~.....~.. ........................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ........................................................ ;... ] 3. Nome o~ Owner of premises .....~,., ............................... Address; ........................................... Phone No ..................... Nome of Architect ...................................................... AcJdress ............................................ Phon~ No ..................... .................................................... Acldress ............................................ Phone No ..................... Name of Contractor 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 ad-ording to deed, and show street names and indicate whether Interior or comer lat. ~. ~ 9L~. ~. STATE OF NEW YORK, ( cc ' : ' COUNTY OF ........................... ~....)'~"~',. /o~ 7' ................................................................................................. being duly sworn,cl~pases and says thc he is the applicant (Name of individual signing application) _.z ,. .. the . .... ............ obove n~med ............................................................... ~ ................................. ~ ....... (~tr~or, a~t, corparote o~icer, otc.} of said owrm~ or own~r~ ond is duly a~thorizod to porform or .h~e I~r~ormed the said work ~ to rrmi~ o~d file this appli¢ofion; that oil statements contoin~d in this application or~ tru~ to the b~st of his knowledge and belief; ond that the work will be performed in the m~n~r ~t forth in tl~ip, ll~ation flied tt~with. .............. o, ........ ............................... No~v ~ub~c, .,,,..., ............... .~ ....... ~.,, ......... :.........~n~ ~ ...... ~ ^~ ut~t~ure o* app~canO '