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Home My WebLink About3402-zFO~! NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at . JJ~ JJlt,~lll..~:~l ........................... Street Map No ...... ~ ...... Block No .............. ~_~ot No ..... ~ ..... :...:..~lZt,.C~lg't~.,...jj..,,."~,, .... conforms substanhally to the Apphcahon for Building Permit heretofore filed in thru office dated ...... Jll~.~JX..~J~ ........................ , 19~ pursuant to wh,ch Bu,lding Perm,t No ..~..~...0..~.....~.. dated .... ~J~.~.~1j .~ ........................... , 19 ...~.'~, was ~ssued, and conforms to all of the requirements of the apphcable prows~ons of the law The occupancy for which th~s certificate ~s ~ssued ~s ....... ............. o~m..~u~t:Ly., d~e111~g .wt~. ~c~,t~ox~ .............................................................. The certificate is msued to ............. ~TO~:LI~.,14~I,//~I, ............................................................... (owner, lessee or tenont) of the aforesaid building Building In, Sector FOR~ NO. ~ TOWN OF SOUTHOLD 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) 3402 Z Permission is hereby granted to: ............ ~ Fe-...#~tnl..-~l.~e~..aeaa .............. ....... · ~t~m..$~z,~eh~ll~...l~.,,X~, ...................... ~o JBu.t3,4 ..nn .. a~dd~l,t,tOZ~ ..~.. --~.. ~t.n~,n{ · d~m.l.l.~n[, ...................................................... at premises located et .~..~t,~]l';~;l~h~..,X~tl~ ................................................................................. ........................................ ~h~.tehn ~m~...l[ .¥... ................................................................................... pursuar,,t to application dated ............................ ...~J~JJlJ, ...... 3.J~ ....... , 19~..., and approved by the Building Inspector. Fee $... ~.e. O0, ........... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×am ned .... .............. Approved ........................................ , 19...~...Permit No...~.....~....0..~..~. D~sapproved a/c .... ~_~ ......................... .............................. i'l~'~'ii~J i'~ ............................... Application No...?...?....~..,.~,.. ......... APPLICATION FOR BUILDING PERMIT ............ ..... INSTRUCTIONS o Thts application must be completely filled in by typewriter or in mk and submitted in duplicate to the Bu~ldin, Inspector. b. Plot plan showing location of lot and of buildings on premises, relahonship to adjoining premises or public streets o areas, and g~wng o detailed description of layout of propertymust be drawn on the diagram which is port of this application c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of th~s application, the Budding Inspector w~ll issue a Budding Permit to the apphcant. Sud permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used Jn whole or m pa rt For any purpose whatever until o Certificate of Occupanc' shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building D~portment for the ~ssuonce of o Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described The opphcant agrees to comply with oil apphcable laws, ord~nan~c~s, building code and regulations. ,~,~c~" ~5~''~''~ ~ -- YZ~ (Signature of apphcont, or name, if a corporation) ' /., ,. ..... State whether opphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ................:~....~....'~....~/. ..... ~..'~.4 .¢~...~....~....~..~...~.~. ................................................................ If applicant ~s a corporate, signature of duly authorized officer. (Nome and title of corporate officer) Location of land on which pro~,ased work will be don~ Map No' . .......... ~ ............................... Lot No: ................... Street and Number ....... .~..~.J. .................................. ~ ................ '.fff....~.~.. ~..~.. ~'~ ..................................................... Mumc~pality State ex~st~ng use and occupancy of premises and intended use and occupancy of proposed construction: a. 'Existing [~s~,_and oc~uponcf ,[ ....... '~.',..J~,.~,..,,~,,,~,.'4~,,.~,,/,....~,, ...................... ~. ....................... : ...................................... b. Intended use and occupancy · ~...~"~'>~-- (~<-J~' ~"? c"~C'cFc~ ~ ~' -~ ~ 3. Nature of work (check which applicable). New Building Addmon I x Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................................... (to be paid on fihng this application) 5 If dwelling, number of dwelling units ..... ~ ................... mumber of dwelhng units on each floor .......................... If garage, number of cars .......................... '~..~..~..4 .~..~./. ................................................................................... 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use .............................. Height ........................... Number of Stories .......... :~.~.,f~..~ .................................................................................... D~mens~ons of same structure w~th alterations or addmons' Front ................................ Rear .............................. Depth .............................. Height .............................. Number of Stories ........................................ 8. D~mensions of entire new construction' Front ............................ Rear ............................Depth .......................... Height ........................... Number of Stones ............................ 9 Size of lot: Front ............................ Rear ............................Depth ................................ 11 Zone or use district in whmh premises are s~tuoted .............................................................................................. 12 Does proposed construction wolate any zoning law, ordinance or regulation?,. .................................................. 13. Name of Owner of prem,ses F:.q~.~,~.~'~Address ...... I~hone No .................. Name of Archaect ...................................................... Address ............................................ Phone No .................. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex~sting or proposed, and indicate all set-bock dimensions fro property hnes. Give street and block numbers or description according to deed, and show street names and mdma whether interior or corner lot. STATE OF NEW~)~.ORK, .~t 1 S S cou NTY OF f ' , /, t ................................................ ~:~.~...~=.~ .................... e g duly sworn, deposes and says that he is the applic (Name of indwidual signing apphcation) ~bove named. He is t~e ....................... ~;. ..... ............................................................................................................ (Contractor, agent, corporate officer, etc.) of smd owner or owners, and ~s duly authorized to perform or ~ave performed t~e said work and to make and this application, that all statements contained in this apphcat,on ~re true to the best of His knowledge and bel and that the work w~ll be performed in the manner set forth in the app--.filed therewith./~ /. Sworn to before me this , ~/ /- / ) / N~t*~ Pub~l.}..~.~.~.¢.~./.....~.q.:..~.~..g-~...~¢..~ ..... County '~t{~ (St~noture of opplic~nt) , / ~Org~Y ko~; ..... Term ~plres ~atcn ou, &o~