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Home My WebLink About3668-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...~...3.0.7.6 ........... Date ................. ~. .......... ~.,].., ................ , 19...~.~. THIS CERTIFIES that the building located at .~LoQ~.~&~O~T~ ..................................... Street Map No. ~p.~.~.o.~.~..g. oBIock No ....................... Lot No..~..7. ....... .8.Qp.~.9..],..ct.,....~..e..~.....¥..o..r..k.. ............. Map 585 conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................ ~.~g.~ ....... ~$., ........... , 19.62._ pursuant to which Building Permit No. ~G~..~,. dated ..................... .~...e.~?..~.t......2..5.~. ......... , 19..G.2.., 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 ........ .... P. ,~ i. ~ a_t., ,e, ,. ?l ,a..r..a. g,.e, ,-, ....(,a.q q .e. ~.~.Qr.Y.., ,]~ 1,~ ~ng.) .................................................. The certificate is issued to ...H..e..~m.~.~...~,....~t. Elgh,k.~.,....ow~er ..................................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector I~OR~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT ~HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL , . ,COMPLETION 'OF THE WORK AUTHORIZED) N? .3668 Z Permission is hereby granted to: ............... :~x..:L~:,~... ............................................. .................... ~mml~ ........................................ to ~B~t4,~,a...aeV, · ~t ~t~aehe~ · · 9.1~.ve~t,e~ · .g~e~e · ·: ............................................... ~..~ ...................... - at premises Io~:ated at ]~/~..~:~4,~,.~....~l~.~...:~,.....~O.~..~,..(~s~l~ ................ ~ ............. ............................................. ~ea~..~[~,......, ........................................................................ pursua:~' to application 'dated ................... ~.~....~[ ..................... , 19,~..., and approved i~y ~the 'BUriiding Inspector! ~{)~lJ 4~P~IF~ ~ ~ O~ ~.D~O~,~ ',~ FORM 1~0. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......~.....~......~. ......., 19..~.~.. ^~:oved ........ ~....../...5...... ,9.~.~..Perm,t No..~.~..~...f....~ ..... Disapp ~'oved o/c.. ~ ...~-..;......~.....~.........c~..~.....-~.....,~..,~,~ ........ .......... .............. APPLICATION FOR BUILDING PERMIT Date ................... ,19 ............ 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 of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of propertymust 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 Laws, Ordinances or 7)~.~-- ~ . ~ ........................ iXg~';;;;";¢";'~'~'i~q;i~""'F ..................... S,o,. whet,.r ~i.nt i~o.~:~ I.s.., .,eh,, .rc~i~.c,. en,ineer, ,ener. I con,r, ctor. el.,,ici.., plumb., or builder. ~pplic~nt is ~ corporate, si~n~ur~ o~ dulv ~u~orized officer. 1 Locatonof and on which r osedworkw be done Ma No · p~ . p :~....~. ....... ~..~?..o..;~ .......... Street and Number ~/~ ~..~..:. ~ ~~' Munici~ali~ ........................................................ 2. State existing use and occupancy of premises,and intend~use and ~cupa~osed construction: u.a d cu onc ......... ....................................... ...... ...., ........ b. Intended use and occupancy ............... ~,....~'.~......~'~ 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................... R,e, moval .............. ___. ..... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost ~...6....~..~..: ................................ 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 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 .............................. N~urgber of Stories ...... .~d;~¥ ........................... __ · 8. Dimensions of entire new construction: Front ....~ ......................Rear ....: ....................... Depth ............................ Height .................... ~.,~lumber of Stor'~es ....... J 9. S~ze of lot: Front ~ ....................... .,.. Dear ................... Dep ........................ ~..... 10. Date of Purchase/4/./?.~....~....~..~...C...~..."''' ~'~--''~ .......................... Name of Former Owner ..~..-~..;.~..?.';......'~'' .................................. ] 1. Zone or use district in which premises are situated ................................................ ~...;~,~./ .................................... 12. Does proposed construction,~violate any 79ning ~9~4~ordinery~,,,~l~ legj~a~c~:../~..;~.~/.] ..................................... 13. ~Name aT ~ner at premises ........................................ ~aaress ............................................ Phone ~o>...~.....~..z.~ PLOT DIAG~M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, 1 S.S. COUNTY OF ................................ ...................................................................... being duly sworn, deposes and says that he is the applicant ............... '~t~1'~'~'~ o~' individual signing application) above 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 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 forth in the/~pplication filed therewith. Sworn to bef, gre me this f? // ~ ................ . % . Notary Public .~.~~ .,~.:../~~Count} ' ~Signature of applicant) No. 52-3233[20 Suiiol~ C(;u ~erm Expires ~arch 30, 19~