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Home My WebLink About4894-zTOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at '"'MOI'~I~"~e&"]~F~ .............................. Street Map No ..... ~ ............. Block No. 3~ ................. Lot No....~ ....... ~l~t, hO3.~, ...... .~t~ ................... conforms substantially to the Applicotion for Building Permit heretofore filed in this office dated .................................... A1;~.tt&t,.....'l.(L...., 19..~.0. pursuant to which Building Permit No....~C~.~.. dated .......................... ~,i~tt~, ........ ~O..., 19....~O, was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ .......... ~.~va ~e .. m~a .. family...d~eLl~ug ....................................................................................... The certificate is issued to ..... ~O~O.....~ll~.t~ .......... (~IOF. .................................................. (owner, lessee or tenc~t) of the aforesaid building. House f 1130 Building I nspec~gf FOR~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~1'? ~89~ Z D~e ..........~, ................. ............... ~.. Permission is hereby granted to: ' to ............................................ ; ................................................. .:....; .......................... ~.'/. .......... et premises located at ............... ...~..e..~.,,..'~.., .~.~ ...~...~.~..~, ;~ ...D,..~.../, .~..~.~i ................................................................................... ..................................... pursu~r~ to application doted ......................................... ~..~..'..id.~.,~, 19..7~ end approved by the Building Inspector. ~ Fee $.....':~... ................ 'TOWN OF sOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ............................... ~ 19 ........ ^ roved... PP ................................/.., ................ i. No ............................. Disapproved a/c ............ --~" ............ : ................ .: ......................... " ....................................... : ............................. _"~ ............ ~/'xp'": (Building Inspector) APPLICATION FOR BUILDING FIRMrT Date ....... INSTRUCTIONS a. This application must be completely filled in by t~pewriter or in ink und submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premiees ar public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram whlch II part of ~hle application. 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. S~ch permit shall be kept on the premises available for inspection 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 Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit I~reuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, or~)other applicable Laws, Ordlnance~ or Regulations, for the construction of buildings, additions or altgrotions or forcz~al or demolition, as heroin deeerlbed. The applicant agroes to comply with all applicabl, laws, ~s, bul,~z~ii~c~hou,ln, ca, and regulation.. /~..:./....~..;~.~...L.L.... .................... (Signatur~ cf applicant, or n~e, If,a corparotlon) · (Address of applicant) State whether applicant is owner,....~..j._.~_., .........~..... ,lessee' agent, architect, ~nglneer, general contractor, ............. electrician, plumber ar builder. If applicant Is a corporate, signature of duly authorized officer. · Location of land on which proposed work ~2.ll be do~, M,,op No,: ......~ ........ ~. ................. lot No.: .....~....~... ........... Sir,et and '__ ~ , ~&.~~ ~, ,~. ........... /~r~! -- //3 ~ MunlcllMllty 2. State existing u~ and ~cu~ncy of pmmis~ on'intended use anti'panty of p~ conltmcti~: ' ~ ,~,,nd~,,~nd~,,~,.,...:~ .......... :. ................. ~ ......... ~.~..2~(~.~ / 3, Nature of walk (check which applicable): New Building .................. Addition .................. Alteration ............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ..................................... 4. Estimated Cost .............. ..~,....,~')~..,,~-~... ................... Fee ....................... ~ ~.,-....~.....* .................................................... (to be paid on fi~ing this application) 5. If dwelling, number of 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 ..... '.,~...ff. .............. Depth ...... ..~..~.. ....... 7. Dimensions of existing structures, if any: Front ........... .~...~....( ..... Rear ........... ..~.../. ........... ' 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 of lot: Front ...... ,/.~.~,.,/._ ~,~ _,Rear .......... /...~....~...:. ........... Depth ........ .~-.~...~,..[;.~ _, /-~'~ 10. Date of Purchase ............. ].,.~.~..~.,.....Ed~p, A6zU, ........ Nome of Former Owner ..,...~:../....,(-f'...~...~.....~,~'-~.~.~ ............... 11, Zone or use district in which premises ore situated ............ ,~..~....? .............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? '"'~'~'~'"'~"~,l'""-"' .............................. 13. Name of Owner of premises ~/~]_n....'.~/~.~..~..Address~.~....~.~)f4ffJ....~...~.,~.JE..~.~/'~hon. No~.T..~./~../ 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 oil set-bock dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE-~YO~,~(,~ ~ t S.S COUNTY OF ~?J~ ............. J' ' .................. ~.~..~~ ..................... being duly sworn, deposes end smys t~t he is the opplicent (Ne~e of in~vi~signing opplicotion) obove nomed. He is the ................................ ~ .............................................. ......................................................... (Contrector, og~t, co,orate officer, etc.) of soid owner or owners, ond is duly euthorized to perform oF hove perfo~ed~he seid work end to ~ke end file this application; that all statements contained in this application are t~e to th~best of his ~wledge and belief; and thaz the wore will be performed in the manner set fo~h in the a~plication file~r~ith. ~ Swam to ~for, me this ~, ~ ~ ~-I~ / ,~ .... .~ ..... doy of ........ ~....~ .......... , 19.7~.. ~, ~ ~ ~~ ............................. U~RRy PUBLIC, State of New York No. 52-8125850, Suffolk Cou~ Term Expires March ~, ~