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Home My WebLink About4888-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...J.~ ............... Date ........................ ~.ll~......~J.0 ............... , 19..~.~. THIS CERTIFIES that the building located at ...~ ..~.......~. ~,~....~J~ .................................... Street Map No ...... ~ ............ Block No ....... ~ ........... Lot No ..... Jl~ ....... ~.~..~J~,J4JJ.....J[e,~* ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................... ~.lJ~ ........... ~1 ....... , 19...~J pursuant to which Building Permit No...~.~lt~... dated ............................. Ajj~ ......... .~ ...... , 19..~{~., was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ ........ lJ~.~.ta., a~Jeas~i~...{ at~p )...ll~t3~ ~1 ..................................................................... The certificate is issued to ...... ..~....~...?~....,~..~....~.. ............ ~. .................................................... (owner, lessee or tenant) of the aforesaid building. FO~V~ 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) N? 1888 Z Permission is hereby granted to: at premises located at .......... ]l~..,....~l]~*.~lll~ ................................................................................ ....................................................... ~,..*~1~ ....... ~.~.'" ......................................................... pursuo:n¢ to application doted .......................... ~ ....... ~ ........... ]...., 19....~ and approved by the Building Inspector. .Fee $..~.~ ............ ~ " BuiMing I~gpector [ Approved ........................................ , 19 ........ Permit No ...... BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. APPLICATION FOR BUILDING PERMIT % Date ....................................... INSTRUCTIONS a, This applicotion must be completely filled in by typewriter or in ink und submiltod in a~pli¢ote to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to odjolnlng pmmim or public streets or ar~s, ~d givl~ ~ d~afl~ de~ri~l~ of I~out o~ p~ must ~ ~mw~ on t~ dl~mm ~l~h I~ ~ o~ ~i~ ~pll~ti~.l~ ~, ~J wo~ ~er~ by this appli~ati~ m~ ~ot be ~ommen~od before i~u~e oJ BulMI~ d. Up~ ~r~al of thi~ ap~li~oti~, the Building I~tor will I~ue a BuiMI~ Pe~lt to the ~ll~t. shall be k~t ~ th~ premiss avail~le Jot in~ction th~aghout the p~ of the wo~. e. No ~ullding ~11 ~ ~upied or used i~ whole or in part ~or any pum~e whote~r u~til a Ce~ifl~ o~ shall h~ been g~ by the Building APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, al heraln described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Signature cf applicant, or name, If a corporation) lO (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nomeo ow era p ' s ................................................................................................................................. If applicant is a corporate, signature of duly authorized officer. .................. ................... 1. Location of land. on which prqpos, e.c~w~rklo~ wdl be done. Map No.: ........................................ Lot No.: ...~.~.. ................. Street and Number .~.~1.1.~..~ ....~...~..~.,/~.~. ........ ,~~.1~.(.~...~... .................................................. Municipality 2. State existing u~ and ~cu~ncy of promises and intended use and occupan~ of pmpm~ a. Existing use and occupancy ................................................................................................................................... b. Intended use and occupon:-, ..~..~.~-$. ~ ............................................................................. 3. Nature of walk (check which applicable): New Building ~ ................ Addition ................. Alteration ............. Repair .................. Remora! .................Demolition .................. Other Work (Describe) .................................... 4. Estimated Cost ............................................................ Fee ....................................................................................... (to be paid on filing this application) 5. If dwelling, number o~ 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 exist!ng 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 .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size at: lot: Front ............................ [<ear ................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ....................................................... 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construct;on violate any zoning law, ordinance or regulation.;) ............................................................ 13. Name of Owner of premises ........................................ Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No .................... Name of Contractor .................................................... Address ............................................ Phone No .................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicat'e whether interior or corner lot. STATE Of NEW ~OR~_ ,~J t S.$ COUNTY ~ ...~e2,4,4V~l~4~&~ .......... $ ' ................ ,~,~r/~.'.....~~ ........................... being duly sworn, deposes and says that he is the applicant (Name of individua)~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 tl-.o{ the work wi[l be performed in the manner set forth in the application filed therewith. Swam to before me this ,.~ ....... of .......... I~0TAELIZABETHAHvtcD/ILLEI~¥ ,UR L ~. S'tFeCffl,w ¥,,., Cpu tv__~x~ (S gnature of applicant) ................... Ho. 52-8125850, Suffolk Co.~t~£ Term Expi~e~ M~rch 30,