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Home My WebLink About4882-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. J~l~ .............. Date ......................... ~J~t.....~,,~. ........... , 10...~l~J THIS CERTIFIES that the building located at 'G.l~J,"JJJ,~J,.]~..~llJl~J..&-.~l~J?..~lb... Street Map No. '"~DI~ ............. Block No. "~lJ ............... Lot No...,Jill ......... Je~Jt, Jl4JJ~J, ...... ~J~e. .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................... ~J~ ....... ~..~ ........ , 19..~1~. pursuant to which Building Permit No.J~zSJ~ ..... dated ....................... A~i~ ............ ~r .......... , 19..J~FO, 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 ........ The certificate is issued to ......~J.t,e.'V~ll..~[O~.QB~r~ ............ (~l~g~.. ....................................................... (owner, lessee or ter~,t) of the aforesaid building. 39fro FORM NO, 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, hi. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK, AUTHORIZED) N9 1882 Z Permission is hereby granted to: .............. ~tewr'~'-~)oz,~ ........................... ................. ~1~1 ........................... ~ ................ at premises located at ........... t~'~..t~...~[~}.i~l~..~..&..~l/~.~l~l~.;]~ll~ ................................. ......................................................... ~OU~;B¢~I~ ...... ~,,;Z~, ................................................................... ~ 19...~, approved by pursuan¢ to application dated ................................ ~'~ ..., and the Building Inspector. Fee $"'~t/0~ ........... Building Inspector · 'tOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. A roved ........... t-- . ..~ ..................... PP ............................ , 19 ........ Permit No. Disapproved a/c ..................................................... or) Application No......~.....~,-~. .......... APPLICATION FOR BUILDING PERMrT ............................ ....... ........... Date INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Build~ r~ Inspector. b. Plot plan showing location of lot and of buildings on premises, r~lationship to adjolnina premises or public streets~r areas, and giving a detailed description of layout of property must be drawn an the diagram wt~ch is part of thle appllcatioh. c. The work covered by this application may not be commenced before issuance of Building Permit. "ti 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 i~pection 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 Occupar~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pureuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lov~, Ordinances or Regulations, for the construction of buildings, additions or al.teratJons, or for removal or demolition, as herein descr bed The applicant agrees to comply with all applicable laws, ordmanl~, building code, housing code, and regulations. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....~.t~g~..~.p~g~l~;~ ................................................................................................................ 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 . .~.~. .................................................................... , .~ 7s'$O ~-~ Municipality 2. State existing use and occupancy of Premises and intended use and occupancy of proposed construction: f, sn & aekin ) a. Existing use and occupancy ........ ~ · l) . . ~....'~ .......]~ ........ ~ ................ b. Intended use and occupancy' ...... i~,l~..~.~.t,~..~,g.C, eA~g~r...li.l~g~'.~Kg.. ~).g~.~,.6....~..~ ................................ 3. Nature of work (check which applicable): New Building ~ .......... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ............. .~. ............................................ Fee ..... ~;t.Q.~. ........................................................................... (to be paid on fi~ing this application) 5. If dwelling, number of dwelling units ..l~z~e ................. 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 R~l~:Ll~eS~l~ ....... 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 ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........... ~.O .................... Rear ............ ~O ........... Depth ...~.~. ................. Height .................... Number of Stories .............. ~zze ............................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ............................. :.. 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ It # ] 1. Zone or use district In which premises are situated ............ ~,...~u,~t, ................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulatlonP .................. ~,e ..................................... .......... .9......9.~'.9.~.~ ........ Addre~ ....... ~l~,t~Q~ ................. Phone No ..................... 13. Name of Owner of premises J~telr D Name af Architect ...................................................... Addre~ ............................................ Phone No ..................... Nome af Contractor ........ Jt~Ike. .................................. Acldre~ ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all bul d ngs, whether ex sting ar propa#d, and Indicate all ~et-b~k d rnen~lons from p.ral~..rty Ilne.~. Give ¢tr~.t and block num6er or description according to deed, and ~hmw ¢treet nam# and indicate wnemer nter or or comer lot. l~J ~.....~_~_~ _ STATE OF NEW YORK, ! · · COUNTY oF ,,~.lJ~ ............ $~, above named. He II the ....................... ~i~®~ .................................................... ; ..... '~; ....................................................... (C~ntractor, agent, comorate officer, etc.) of said owner or owners, and Is duly author zed to perfmrm or have perfmrmed the ~ald work and to make and file this application; that all statements contained In this appllcotlmn am tree to' the b#t of hie knowledge and belief; and thor the ,work will ~.p. erformed in the manner set forth In the appllcqtlon flied therewith, ~wom To.~.Dlrarl mi ~'t~ll = ~ ...... ........ cloy ............... :.., . /),,. No.o, ..b,,c. .......... Count , .................