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Home My WebLink About4994-zFOKM TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ~[..Jl~9 .............. Date ........................... ~O~ ....... 1.0 ......... , 19.~.J~.. THIS CERTIFIES that the building located at .~ga.~.ow...~.&..~-..C~t~e~..S.t, ............. Street Map No..:j:~ ................ Block No ......~1~ ............ Lot No..~r,z ........ J~.t~.~.~t~l~k. ....... JJ~.~ ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................. 0'~'~, .......... 10 .......... , ]9..~). pursuant to which Building Permit No ..... dated ............................. Oi3t; ....... ~ ........ , 19...r~10, 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 ........ ................. ~'~'~t~'~"'ii.~'~lt'~J'"('~t,~'~e')"l~'T~ng ......................................................... The certificate is issued to .,..Jj12t, J~..&..~&el-.J[ai%J.le~....;..,-.0%~l~.~li-.-.,: .............................. [owner, lessee or tenant) of the aforesaid building. i~ouse f IOFO ~ungalov La Cente~ 8t Building Inspector/ TOWN OF SOUTHOLD BUILDING DEF~.RTMENT TOWN' CLERK'S, OFFICE $OUTHOLD, N. Y~ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMIsE~ UNTIL FLILL coMPLETION OF THE WORK AUTHORIZED) N? 499] Z Permission is hereby granted to: .............. ~,c~..~,~. ........... ~ ................ ............... ........... : ................ ~..~,~.....~t~1~ ............ ~ ................ ~o . ~a.~.~;~. ~,~.~.~.,.~....t~°r.~.~.)...~.~ti0~.: ......... i. ...................................... ~t premises located ot ....... ~l~r~t..4~...~.~t~;e~-,,~'~,;? ................ ;,. ...................................... ......................................... ; ...... ~t~ .......i.~,~....:,...?..!!.., ............. .~!.., ......... ,....,....., ............... : ~' ' ~ 19...~ and ~pproved by pu[suor~ to application doted ..... ~...~ .................... ~...,..~),~.,.~..:.,, the Buildlnn In,nectar. ' , : IFOBif ' NO, ! TOWN OF souTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥o Approved ........................................ , 19 ........ Permit Ho ............................. APPLIGATION FOR BUILDING FERMI~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted In d~pllcate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premiees or public itreets or areas, and giving a detailed description of layout of pmparty must be drawn on the diagram which Is part of Jhle 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. 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 part for any purpoee whatever until a Clrtlfl~ato of Occupancy shall have been granted by the Building Inspector. B ~P..PLI_C. ATION !S HEREBY.MA_DE to the Building Department for the issuance of o Building Permit ~muant to the ,u, a~r~.. Lone. O~nance of the/own of Southold, Suffolk County, New York, ~.nd other applicable Laws, Ordinances or .~he~eU~atlons, tar the construction of buildings, additions or alterations, or for removal or demo t on, Il herein deecr bed · applicant agrees to comply with all applicable laws, ordinances, building code, housle code, ous~ng co and regulations. ( ~lon) /~'~/ ,, (Address of al~/Icont) State whether applicant is owner, lessee, agent, architect, engineer, general contractor,/electrl~an, plumber or builder. ............................ .............................................. i ............................................................ Name of ow~r o{ pmml~ ..... ~ ............... ~ .................................................. I{ applicont Is a co,orate, signature of duly authorized offlaer. {Narr~ and title 'o{ corporate offlaer) 1. Location of land on which pro~o~:l work will' be done. Map No~: ........................................I~' Na.: ........................ Strm and umber ..... .................................................................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of prppaesd construction: a. ist,ngu, a occupancy ....... ............... ................................................ use and occul:,an? . .............................. ~... ~, ~. ........................................... b. Intended 3. Nature of wink (check which applicable): New Building ~ ................ Addition ................. Alteration ............. Repair .................. _Removal ...~. ............ Demolition .................. Other Work (Describe) ................................... 4. Est mated Cost ~,.~...~.~ ........... ~ee ......... ,~,,~,..~ ............................ (to be paid on fi!lng 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 ............................ 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 ...~ ......................................................................................... 9. Size of lot: Front ........................... Rear .................................... Depth ................................ D ......... ~k. ,~ ~ .......................... Owner /-- 1 1. Zone or use district in which premises ore situated ...... .~.~ ............................................. ~.. ]2. Does proposed construction violate on.0.y zoning Iow, ordinonce~or reg~tion? .......... ..'~.~.. ......................................... i3, Name of Owner of premises ..~..~.~.~,..Address .~.e**~**-.~.~.~....i~-~ne No.~..~.~.~ Nome of Architect .................................... ..(~....,~... ...... Address ...~..~......~.~... ........... Phone No Name of Contractor ............ Address ................ ./.~ .~..'....~Z....."~..~'/'~ ...... Phone No. . PLOT DIAGRAM Locote cloorly ond di~inctly 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 indicate whether interior or comer lot. STATE OF N~ YORK, tee ............ ~~~ ...................... b*in~ duly ~worn, d~mes ~nd ~y~ t~t h~ i~ th* ~pplic~nt t~ame at in~l ~~n) above name. He is the ......... ~~ .............................................................. '~ ..................................................... (Contractor, ag~t, comorate officer, ~c.) of said owner or owners, and is duly authorized to perform or have perfo~ed the said work a~ to ~ke and file this application; that all statements contained in this application are tree to the ~st of his knowledge and ~lief; and that the work will ~ perfo~ed in the manner ~t fo~h in the application filed ~er~ith. Swam to ~re ~ ~is ...... ............................................ , ............................ . Notae/Public, . ........................................................... C~n~,''''~