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Home My WebLink About4163-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No....~.....3...4~.~.. ........... Date ............. ~ .............J~, .................. , 196.9.... THIS CERTIFIES that the building located at ¢.G~'~IO~..O.~..~II~I~y..~.ILJ~II~..&.. . Street Cheil. nut,~t,z'eet ......... Map No ....................... Block No ....................... Lot No....~c~tr~cJr..Jl~l~..y~ ....................... conform~s substantially to the Application for Building Permit heretofore filed in this office dated ................. .~'..~rji.g,~'.~' ............ .~., ................ , 19.~.~.... pursuant to which Building Permit No. dated ...... ~.~.~!~3~.~'. ........... .~..~ .............. , 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 ........ ...... ,~;t,Y~t,e...one...£a~.t¥...cl~elling ............................ The certificate is issued to ...... ~.~]~,...~.Oat,~3& ................................................................................ (owner, lessee or tenant) of the aforesoid building. House # 55 ChertS. nut: Road Building InspeCtOr FOlt~l NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT N? ~163 Z Permission is hereby granted to: ............ .~.:~::...~..E.~.,?.~.,.....z...a..,.......~......;., s. ~mt~z~ 8outho~ ot ~rem~ses ~oted ot ...... .~:.7....~..~...C..h..e.,~,~..~.t........~...~ ...................................................... ~m:tthold NoY. e .pursuan¢ to application doted San 6 19.~ and approved by the Building Inspector. ............. .u,, SOUTHOLD, N. Y. Disapproved o/c ........ ~ ............................. APPLICATION FOR BUILDINg. ~ Dat~_~]...:. _...:...,:, .......................... : ........ 19...~....~... INSTRUCTIONS a. This application must be completely filled in by typewriter or ~n ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings On premises, relationship to ad oining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram 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 on the premises available for inspection 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 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 York, and other applicable Law~, Ordirmnces or Regulations, for the construction of buildings, additions or alterations, or for removal or cJ~molition,' as t~erein described. The applicant agrees to comply with all applicable laws, ordinances, building co~;, hou)~g c~ode,~d regulafions.~... - ~e, it O co?oration) (Address of opplicant~t' State whether applicant is owner, ressee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .....~..'....~........~..~ ............. ........................................................................... , of du o tha''zedD/. 1. Location of !and on whlch,,~ ~ ~?_ ~ ~ ~ ~ ..z.-- ~v ~.-~- J~ --' ~* Z_~,~,~prOpOsed work will be done· Map No.: ...... ~'..~....~..~..~..~. ....... Lot ~_j ,_...~.....~ ....... Street and Number ~;~.~,.i.;~..~..~.~..~~'~....~ ..... ------ "" '"'~--~-{.:~ .: .- ,~ MUn,cipal,ty 2. State existing use and occupancy/~) . ' ~'°f premises and intended use and Occupancy of proposed construction: a. Existing use and .occupancy ..~ ........... ; .................. ,.... ................... ........................... i .......... b. Intended use and occupancy ....~-~Y-~ ......................... : ................................. ~ ................................... . 3. Nature of work (check which applicable): New B&ilding .................. Addition .~...... ........ Alteration Repair .................. Lt . .~- -Rem°vol ........... ~ ...... Demolition ........ :'"~'"c~erc _ 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 e,~.e.n? O~.e.a..c.I~ ;type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ,.,.~ ............................ Depth .................... Height ........................ Number of Stories .................::.: .................. ,s...~...~ ........ ~.~ .................................................... Dimensions of same structure with alterations or additions: Front ................... ,.,,, .......... Rear ............................ Depth ................................ Height ............................ Number of Stories 8. Dimensions of entire new construction: Front ........ ................... ............... Dept--'~..~.......i ............. Height; .................. Number of Stories 9'~ Si-ze6f Io~: Frodf ..~.~..:....,...~ ............. Rear .............. ;;.;.~.:.!~....~ ....... Dept~'~.... ......... i".~ ............ 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 ...................................................... Addres's ............................................ Phone No ..................... Name of Contractor .................................................... Address ........................ : ................... Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly oil 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. ST~TE~ ~ YORK, [ c ~ COUNTY OF ................................ ~/ ............... ~.~ ........... being duly sworn, d~oses and soys t~t he is the applicant ~e~f individual sFgning applicaTion)~_~ ~ ~ ,-r above named. He is the ................................... ~ ................................................................................ (Contractor, agar, co~orate officer, etc.) of said Owner or owners, and is duly authorized to perform or have performed the said work and to ~ke ~d file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set fodh in the application filed therewith. Swam to before me this ~ _ ................... ....... .............. ' t .... i ...... ............................. ~o ~ u ic, .~~.. _ ....... ~County ~ ~A~ PUBLIC, State of New Yolk // ~ 52-0618100 Suffolk Cou~t~ CommissJofi ~p~res March 30, 19 ~_~