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Home My WebLink About4881-zFORmal NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ~*~,J[1,..~C~f~; ................................................ Street Map No. ~ .................Block No ....... ~ ........... Lot NoT~_~......g.~hO~lZ~ ....... J~.,.~Z., ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................................... · ~.l~k~. ....... 27 ....... , 19.~0.. pursuant to which Building Permit No. dated ......................... J~U'~ ....... ,~'1 .......... , 1 ¢)..~0., was issued, a~d conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........... P. :r.X.v~ te .. ~c c~ ~o~.y...(.~et...s.to~g~)...b~X.t~t~g .................................................... The certificate is issued to .....8..~.~.~k~ty...&..~.b.a~ra..J~kct~i~z .......... .O~z~r,s .......................... (owne~, lessee or tenant) of the aforesaid building. ouse # Building Inspector/ FORM NO. 2 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) ~ss~ ~ ~, ....... ~....i....~.:...~...a..l...,,,...zo Permission is hereby grant~t~ /~ q~ ~,~ # /j'~ ~ ~* pursu~n~t to opplicotion dolod .............................. ~ 19.. . ond ~pprov~ b~ tho TO~YN OF SOUTHOLD BUILDING DEP*RT~EN'T / TOWN CLERK'S OFFIC! 0 ~ C.' ~ ~ ~~ /.~ :.....,~.. !. BOtr13,10LD, N.y. .~.,.~/ 5 ........ ................... A~ed ........ ~... 19.2~ Pe~J, No .... ~ .... Di~pp~ o/c .......... ~ ................................................. (Buildi~ In--or) ~ APPLICATION FOR BUILDING PEP. Mrr INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building Inspector. ,: b. Plot plan showing location of lot and of buildings on prem~sl relationS, ip to adjoining premiere or public streets or areas, and giving a detailed description of layout of property must arawn on the diagram which is part of thio appllcat on. 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 impection t~nroughout 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 MA, DE to the Building Department for the issuance of a Build ng Perm t pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other app cab · Lawl, OrdJnancel or R~egulati.o. ns, for the construction of buildings, additions or alterations, or for removal or .demo t on, as herein de~rlbed. ~ ne applicant agrees to comply with all applicable laws, ordinonc~ building code, hous~mg code, and regulations. (Signature of applicant, or name, If a co, ration) ............................. ........... ............... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... C?.~.,C'£~. ..... . .................. Name of owner of premises ............ ~, .................................................... '~'" '"'"~" ' 7""; .................... ";~"~ ........... ~ .......... If applicant is 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 ...................... ..~ ~ .~' ~,~6~ Municipality ...... ~ 2. State exl~ing u~ a~d ~cu~n~ of promises and intended use and~ ~cu~ncy of pm~ c~tmctl~. ~ · a. ~istlng u~ a~ ~cupan~ . ~.~ ~.~..~.~ ~ ~.~: ....................................... cu an v' ..~ ..... ~ .~ .. b. ~tende ~se ond ~ p :, . ...... ~ .~ ,~.&..,~ ........................................................................... 3. Nature of work (check which applicable): New Building ~ ................. Addition .................. Alteration .................. Repair ................ 2 Removal~_) .................. Demolition ............. :.... Other Work (Describe) .'~...~..~....~......~..//..~....~.- .......... 4. Estimated Cost .~..~.:....-: ................................. Fee .....~....~.'.'..~ ........................ , .................. (to be paid on filing this application) §. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed accupancy/ sp~ify nature and extent of each type of use ............. ;. ............. 7. D.menslons .of e~xlstlng structures, If any: Front ......_~...~..~.¢.~..~..... Rear ..~.......~...~. ......... Depth%~...~. ............. Height ....~....~. .............. Number of Stories ......~...~ ............................. ,'",'v ........... ................................. ' ............... Dlmenslon~, of ~me structure with alterations or addltlarm: Front ......~.. ...................... , .... I~ar ...~....~.. .................. Depth ...~.~.~..: .................. Height .....~....~....~. ............. Number of St6rlel ~..?...~., ................ 8. D mens OhS of ant re new construct on: Front ...... ./. ............................ a,~r ../~' r~..,~ / Height ~.. ................ Number of Storle~ .....~...' .............................................................................................. 9. Size of lot: Front ..~...~.R.,~...?'...~ ....... Rear .....~.'....~...../. .................. Depth ./..~,-~....~ .................. Date of Purchase /./...../,~.~Z~., ~.~ ...................... Name of Former Owner ~.-~..~.~...~../'~/ 10. ! 1. Zone or use district in which premllee are iltuated ..................................................................................................... 12. Does ed construction vi ate an zen n law- ar m~ul"tl'-a ..... ~.~. prapos '1~ y. g .ord~.~ce. ,.. :. ..................................................... 13. Name of Owner of "rem les .~,,~.,A.~,,~/,c,,~. Nam. ^rchlte:t ..................... ....................... ............. ..................... ,.... No ....... ........ Name of Contraator ................... : ................................ Addreel ............ : ............................... I=l~ne Na ..................... PLOT DIAGRAM Locate clearly and dl~tlrmtly all bulldlngi, whether existing or p~aalad, and Indicate all sat-back dimension fram property Ilnel. Give street and blo~k number or deKrlptlen a~cardlng to deed, and ~haw ~tmet nam# and Indicate whether Interior ar corner lot. STATE OF ................................................ .,, lng duly lynn, dlpe~a and aaya that he la the applicant above named. He II the .........: ............................... ~ ........................................ '.~. ....................................................... ~ (~ntractor, agent, corporate officer, et~.) of said ,.mvn.e.r .o.r .owner?t and Is duly auth.orlzed to perferm or have perfen, ned the laid w~k and to make md file .t.hls .a}~puca?on,.,,t.hat all, itate.me, n.t.I contained I.~ .thll app!lcatlert am tn~,. to the be~t of hll knowledge and belief; and tnatrr~bejl~me work wl~el~ll~l rrarmea^ .In tn. manner let ?arth in the ap.l cation flied therewith, .................... ~:LIZRJ~ETH ANN NEVI . .term Expires March 30,