The URL can be used to link to this page

Home My WebLink About4924-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE: OF OCCUPANCY THIS CERTIFIES that the building located at .JJJ[i~l~,O..~:lS, d, .......................................... Street Map No. ~ ................ Block No..~, ...............Lot No. ~ ......... $la, t,f~,t,~s~ ............................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................................... ~ ....... ~,.~. ........ , 19..70.. pursuant to which Building Pea'mit No...~2.~.. dated ......................... ~!~ ............ ~.~' ....... 19...~(~, 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 ........ · .l~lvato ..one.. feat~t~.. 4wo.l.:lda~g ............................................................................................... The certificote is issued to .. l~.(...]~l~p~,O]~, ......... ~ .................................................................... (owner, lessee or tenant) of the aforesaid building. House # Building Inspectol FOK~ NO. ~ 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) No. 924 Z Permission is hereby granted to: to ..... ~!~...~.~.. ~2 &~..~.~..~..~.~ ~.~. c~el!iz~ ................ at premises Ioceted et ............ ~.,~,ClJ~...~ .................................................................................... ........................................................ C~t~a~, ........... ~X. ............................................................. pursuor~t to application dated ........................ ~ ......... .~.~ ............. , 19..~c~., and approved by the Building Inspector. ' ~.~`.~.~.~.~.~"~.~.~.~Building Inspector BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. App,, t,on ........... Di~pproved a/c .................................................. APPLIGATION FOR BUILDING PERMIT ~ .................................. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted in d~pltcate to the Building'~ Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship ta adjoining premiees or public streets or areas, and giving a de,ailed description of layout of property must be drawn an the diagram whlch Is part of thle oppllcation.~j 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 inspection throughout the progress of the work. ' e. No building shall be occupied or used in whole or in port for any purpose whatever until a Certificate of Occupancy,~l 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 Law~, Ordinances Regulations, for the construction of buildings, additions or alterations or for removal or demolition, al herein de~crlbed.~m~J The applicant agrees to comply with all applicable laws, ordinances, ~ng ~tlons. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .................... .' ......................................................................................................................... If applicant is a corporate, signature of duly authorized officer. .Name and title 'of corporate officer) 1. Locat,on of land on which proposed work will be done. Map No.: ........................................ Lot No.: ...., .............. ..~,. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: 3. Nature of work (check which applicable): New Building ~ ................. Addition ...... ..~'~:......... Alteration ............... Repair .................. Removal .................. Demolition .................. ?~her Work (Describe) ...................................... 4. Estimated Cost .... : ........... .~.....~......~... .................. Fee ..... ~...~ ...................... ~ ................................................ (to be paid on filing 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 ~pe of use ............................ 7. Dimensions of existing structures, if any: Front ...........,~'..~.. ......... Rear ................................ Deptl~./ ................ 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 ...................................................................................................................... - - /-0~ 9. Size of lot: ~-rom' .............. ~. ........... Rear .................................... Depth ........ L.~...°....~. ........... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ I1. Zone or use district in which premises are situated ....................... ~'.~....:i ................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? .............. ~ .................................... ]3. Name of Owner of premises ..~.........~...~...~....~...~..~.. ....... Address ............ ~....~,~... Phone No ..................... Name of Architect .................. ~: ....................... Address ............................................ Phone No ..................... Name of Contractor ..... ~ ....... '' --.../~..~...~.....1~... ................. Address ....~~.. ................ Phone NT~ .~..:.-.....'~.A..~.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all 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 comer lot. ...~X''/ST/ ~¢~-"- STATE OF NEW YORK, tS.S · ~_ COUNTY OF ................................ S ' ........................................... , ............ /...r.r...:./ ............................ De,ng duly sworn, deposes and says that he is the applicant (Name of individual signing application) ................................· . ........ . ................. above named. He is the ...~,.. (Contractor, agent, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or hove 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 that the work will be performed in the manner set forth in the application filed therewith. , Swam to be_fore me this _ __ ~ t , ~ . .~. day of ... ~ ~/~T_ 197- 0 ~J ~./..~ ~/,), ~Jt~,~/l,~/~ Notary Pub I ,c ~;~.: .~ ._... ~: ...~~...Z....~ou nty .................. ~' ~c' "~ ~'~'~; ' ~ ' ~'~ii~'~;";~ ............................. NO. 523233120 Suffolk Countv~ T.rrn Expires I~rch 30, ~9~