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Home My WebLink About4693-zNO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE: OF OCCUPANCY No.~.~.. ........ ......... Dote THIS CERTIFIES that the building located at ..... ~l~.....~:.~....]~. ...................................... Street Map No~ ......... .'.~ ..... Block No.....:~.. ................ Lot No...~ ....... ..~.~h..?...~........~..?..~..? .................. conforms substontialtl/ to the Application for Building Permit heretofore filed in this office dated ................................... ~..~....-....~.. ....... , 10.~...0... pursuant to which Building Permit No...l~....~_... ..... doted .......................... !..,~..~w~. ....... .~.,, 19...~..., was issued, and conforms to ail of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ The certificate is issued to .~...~..~...~..~.~.,~..~...~....]~....~.. ............ ~ ................... : .................................... (owner, lessee or ter~nt) of the aforesaid building. Z[Ol f FOB, M NO. 2 TOWN OF SOUTHOLD 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) 4693 Z Permission is hereby granted to: .............. ~.,..e...,....~.e.Z.s..~..,.~ ........................... to .............. JliL1~..~..ad~Lt Lt.~..aiL.mrd~t~ ..(J1~%3,Ll~,..f,..~O~) ............................. at premises located at ................ JJ~.....~t~..]~J::~LV.e ........................................................................ ........................................................... Jmtt, be;IA ......... Bo~., ................ ~ ............................................. pursuon¢ to application dated ......................... .~J~;L~, ....... JJ~ .......... , 19...~.0., and approved by the Building Inspector. Fee $...~....~. ........... ' ~J Building~ Examined ~ (~ ^pproved °' ~9..::.... Permit .o ................ .~.........~.. ........................................ , Disapproved a/c '~~'t'~"'~'- (Building Inspector) I TOWN OF SOUTHOLD BUILDING DEPARTMENT T~ CLERK~ MFICE INSTRUCTIONS APPLICATION FOR BUILDING PERM" ~ .................. './. ...................................... , ,,..Z.°.... a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is port of this application. c. The work covered by this application may not be commenced before issuc~ce of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Oocupancy/~ shGII have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descr bed The applicant agrees to comply with oil applicable laws, ordinances, building c~e, housing code, ~nd regulations. ($!gnature o{ applicon, t, or name, if o corporetion) (^ddr--,~ o{ applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of prom ses ................................................................................................... If applicant is a corporate, signature of duly authorized officer. ,~ (Name and title of corporate officer) I'- 1. Location of and on which proposed work w be do,q.e. Map No' ~ . · Lot No' ~ .. .,_, sis ............................. Street and ~urnD r .......... ~,,,~,, ................. ; ................................................................................................................. 2. State existing use and occupancy o~intended use and occupancy of proposed construction: o, ~isting~seondocc,,pa~....~..~~ .............................................................................................. · ~ panc'V ....... :.,,~ .~:r....~ ....... :~....~... ........................ ~,.~M ................................. 3. Nature of work (check which applicable): New Building .................. Addition ......~ ..... Alteration ...~.~ ............. Repair .................. Removal .................. Demolition .................. Other 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 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 ................. ./....~.~ ............ Rear ...... /....~ ............... Depth ....~:....~.. ............. Height .................... Number of Stories ......... ~...~~ .................................................................. 9. Size of lot: Front .........ef..O..:,~.,....../'Lf.~/~,ear ..... ~--.~ ............... Depth ..../.../..~'./....~....~...? 10. Date of Purchase ........................................................ Nom~..~ ~orm.~..~ ..... ..~~ ............................. 11. ?'one or use district in which premises are situated .............~ ......... ~7..7_.~ ......................................................... 12. Does proposed construction violate an~Lzonij~g I~w, ordinance or regulation? .............. ~ ..................................... 13. Name of Owner of premises .~......'...~:~.....~ddress ............................................ Phone No ..................... Name of Architect ...................................................... ^ddress ............................................ 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 indicate whether interior or corner lot. (Name of individual signing application) ~ . /~ above nQrneo, i-le s 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 am 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. Sworn to be~me this ('~L,4'~?.~t,~' ' Notary Public, . ................................................. ~ ......... County (Signature of applicant)