The URL can be used to link to this page

Home My WebLink About3520-zF~I~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the budding located at ..... ['f~;i,10,..i~..~.,~i~ ........................................... Street Map No ...................... Black No ..................... Lot No..xvis.[~.~lr,~.,...~..e~......~...~.~...]f.. ...................... conforms substantially to the Applicahon for Building Permit heretofore filed in this office dated ............................ .~...~...~..e.......]....~.~ .................. 19..6..7... pursuant to which Building Permit No .~J,~.~.0...~. dated ............. ..~.~.~..?......2..~..~. ............... , 19..6.?.., was msued, and conforms to all of the requirements of the applicable provisions of the law The occupancy for which this cerbficate is issued ~s ........ ..... ~.~.v...a..t...e....~.o.e...~m~3,~...~e~,3.~g. ........................................................................................ The certificate is issued to .........~.~.~l)~...~..e...~.~.~.~.l~, ...... (.I;:~.~.) .................................................. (owner, lessee or tenant) of the aforesaid building. TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...~....~.]....]:.0.. ............ Date ...................... ~.une ....... .1,]., .......... , 19.68._ THIS CERTIFIES that the braiding located at ~;[I.~'ll..~l~fJ ................................................ Street Map No ...................... Block No ....................... Lot No.....J~....~..~..~.~..~...C~...~.....~...e~......~...O..~.~ ...................... conform~S substanhally to the Appl~cahon for Buildzng Permit heretofore filed in this office dated ............... ...l~....~..c..h.. ....... ~.7.~. ........................ , 19..~..~.. pursuant to which Building Permit No..3.4:L?...Z. dated .......,'~...~C..h. ....... .~..~ ...................... , 19..~..7.., was ~ssued, and conforms to all of the requirements of the apphcable prows~ons of the law The occupancy for which this certificate is issued is ........ .......... ~. ~ .t. ~ .a. ~ e. . ~ . .a. . .~. .e. .e. . ~ ~ .~. .z. .y~ ~ .b. . .~. . ~ ~. ~ ~ ~g. ~ ~ ~( .~. ~.~. ~ .a. g~ .e. ~ . ~a. ~.e. ~ .~.. .) .................................................... The certificate is issued to ....~..~...a...~......~........C...a..~...[..~..~. ........ (...o'ff....~..e.~). ...................................................... (owner, lessee or tenant) of the aforesmd building. FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT ,(THIS PERMIT MUST BE KEPT ON THE PRF-.J~ISES UNTIL FULL COMPLETION OF: THE WORK ^UTHORIZED) 3520 Z Permission is hereby granted to: .................. .~.~...9.~..~.~ .......................... ~ ..... to Budding inspector. .............................. ;-v.',_'-~= ......... ~Z~....~i,~, ............ : ............... :,.....,: ......................................... pUrsu~a4~? to application, dated : ~ ~...~.~ ~.., 19..~:., anti. approved by the TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Approved t 9 ....... Permit No ........................... Disapproved o/c ...~ ..... Application No. ~ '~'~ APPLICATION FOR BUILDING PERMIT Date .......... i ..... · .~.~....../....d...~.. ..................... , 19...~....~.. INSTRUCTIONS a. Th~s applicatzon must be completely filled m by typewriter or ~n ink and submitted in duplicate to the Buildin Inspector. b Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giwng a detailed description of layout of propertymust be drawn on the d~agram which is part of this applicatior 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 wdl issue a Building Permit to the applicant Suc permit shall be kept on the premises available for inspection throughout the progress of the work. e. No budding shall be occupied or used in whole or in pa rt for any purpose whatever until a Certificate of Occupam shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Budding Permit pursuant to t~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buddings, addit,ons or alterations, or for removal or demolition, as herren describe, The apphcant agrees to comply with all applicable laws, ordinances, budding code and regulations. ........ ..................................... nature of applicant, or name, if a corporation) ,... . .. ...................... (/~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engine, er, general contractor, electrician, plumber or bu~ldc ...................... ................................................................................................................................................ Name of owner of premises .... ..~..,~..~.....~..../..~....f~.~..~..~.././..~. ......................................................................................... If applicant ~s a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done, Map No ............................................ Lot No: ................. Street and Number ~...~./..~....~...~..~....~......~...~..~..?.~...?....'~.. ..... ~..~./~....././..~...~:.~. .................................... Municipahty 2. State ex~sting use and occupancy of prem*ses and intended use and occupancy of proposed construction: a Existing use and occupancy ~...~.~.~..`~..~.~...?....~.~..~.~L..~//~...~.~..~.~.~..~.~..~.~...~.....i~....~.. ................ ~ .............. b ' nt e nd ed u se a nd occupa n c y . · ,//-/....~'....'..~.......~.-......c~...z..~......,..~......~..-...,..~......~',~'.../'(/..,:..~....~:.....~_~.. r-~.. ~7..¢.~....7~...~:~..~..~~ 3. Nature of work (check which applicable): New Building ........ ..~........(~Addition~ ................. Alteration ................. Repair .................... Removal .................... Demohtion .................... Other Work (Describe) .... /~./2./~...~..f..K~..A1'...: ...... 4. Est,mated Cost ......... ~...~..~.~ .............................. Fee ............ i;~;'~;'l~a,d on fihng th,s application) 5 If dwelhng, number of dwelling units ..... ./~'...~..r'~..~?. ........ Number of dwelhng units on each floor ....x~...~....~.f~. ........ 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use ....... Z/~.?...~....~.~ .......... Dimensions of same structure w,th alterat,ons or additions. Front ....... ~.~...~....~.. ......... Rear ..... ,~.~..Z.....~.....7~... ...... 10. 11 Zone or use district ~n which premises are situated ............................................................................................... 12 Does proposed construction wolote any zoning law, ordinance or regulation? ..... .z~...~.. ........................................ PLOT DIAGRAM Locate clearly and d~stinctly all buddings, whether ex~sting or proposed, and indicate all set-back dimensions fro~ property lines. G~ve street and block numbers or description according to deed, and show street names and ind~cat whether ~ntenor or corner lot. k STATE OF NEW YORK, } COUNTY OF ................................ f SS. ............................... : ................ being duly sworn, deposes and says that he is the applic~_ · ~ (Name of ind~vidua sigmng app cat,on} above named. He is the .......................... i .................... .,~....,~.~Z...4. k'....'~.. ........ ..c~..~f~.,~....../~..~..K!...~..'. ............................................. (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 f th,s apphcation; that all statements contained in th~s application are true to the best of his knowledge and beh and that the work wdl be performed in the manner set forth in the apphcation filed therewith. Sworn to before me th~s .......................... day of ........................................... ,19 ........ . ..~....~ ~~ Notary Public, . ........................................................... County (Signature of applicant)