The URL can be used to link to this page

Home My WebLink About4696-zI~B~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at '"~'~]~r~ .......................................... Street Mop No.Qe~e~l~ ...... Block No...~..Z,~,~... Lot No ...... .~.~ ......... ~&~t,..~lt~tl~....Jle~e ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated .................. ~-~1~....-.~ ............. , 19..~. pursuant to which Building Permit No..J~l~.. dated ....................... A~l~....~ ........... , 19...~1~, 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 ........ The certificate is issued to ...~)e~lt~.~E ............... -,~l~l?..: .......... :....,...~. ......... ~ .................... ~.owner, lessee or tenat~t) of the aforesaid building. ZeDe~:1~ A~ ~ 1~0 I~r ~e ~':[~.~ Building Inspector BUILDING DEPARTMENT TOWN GLERK'S OFFIGE ..................... ,19 ........ Approved~ ~. 1'~ Permit No. ~ ~ ~ ..................... ................................... Di~pprav~ e/c .......... ],.,...,~-,,,,,,..,,.,~ -.~...,,~ ........ ........................................................................... ......... ...... ............... / (Suil~i~ Intpector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 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 issuance of Building Permit. d. Upon approval of this application, the Bui!ding 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 Occupancy ~.~ shall have been granted by the Building Inspector. 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, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. , .... ............... ~' y' (Signature of appllcant~l~r name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi,neer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed ~'k wy.~edone. AAap No.:~...~...~_..~.....~......~..... Lot No' Street and 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. ' ~ExJsting use and occupancy ...... ~:~.~ ........~' ~'~.'~ ............................./~ ,,~:~ .................... .~ .......... ~ ................................... 3. Nature of work (check which applicable): New Building ..... .~r.... ....... Addition .................. Alterotion .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ........../...~.,~.~).~..~.. ................ ~ ............ Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... ~ll~ .............. Number of dwelling units on eoch floor ....... ~ ................. If garage, number of ~rs ................. ~ .......................................................................................................................... 6. If business, commercial or mixed occupancy, sp~i~ nature and extent of each ~pe of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Nu~er of Stori~ ................................................................................................................. Dimensions of same structure with olterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire n~ construction: Front ..~J..~.~.~. ............. Rear ..~.~.~.~ ....... D~th~.~.~..~..~.~ Height .....~.~ ...... Number of Stories ............~ ...................................................................................................... 9. Size of lot: Front ..... ~.~.~ ............. Rear ...... .~.~ ...................... ~pth .....~.~.~....~. ...... 10. Date of Purchase ....~.~ ....... ~.~Z~ ................... Name of Former ~ner ..~~...~....~: .... 11. Zone or use district in which premis~ are situated ..................................................................................................... D~s Proposed construction violate any zoning law, ordinance regulation? 12 ...... or ~ ............................................ 13. Name of Owner of premises__ ~ ~1~ .~'"''~'"'Address ~~....%..~.;.~ Name of Archit~t ..... ~....~ .................. Address ..~~ ............. P~ne No. ~.~.~..~.~.~ Name of Contractor /~.~..~.....A~ress~ ~['"~'"~-..~hone ~o.~]~..(~~ PLOT DIAG~ L~ate clearly and distinctly all buildings, whether existing or pr~osed, and indicate all set-~ck dimensions from prope~ lines. Give street and bilk number or description according to de~, and sh~ street nam~ and indicate whether interior or comer lot.7 . ,, STATE OF NEW YORK, ~ ¢ ¢ COUNTY ;'OF~,'f/ ~]/~ . ~ ~, .............................. ~o.~. ......... ~.....~~~ ............ :......being du~' swOrn, d~es and says tMt he is the applicant -- 1 (Name of indiv~ual signing opplic~) above named. He is the ........................................ ~.~ .............................. ' ......................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hav~ ~formed the said work and to ~ke 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 ih'th~ manner set fo~h in the application' filed therewith. Swom to before me this _ ' ~ ..................... .......... ;TH) ........ ........................... Nota~ Public, .~.~?~]~.~e~ ...... ~ ....... ~oun~ ~ (Signature of applicant~ '-Z '78.6),0 oLP / LOT 1"7,8 ,I ROM,,4RT' BL/IL~OER,S ,~ROIVT ELE~/,~TIOIV /_.~:F7- ,:'~DE EL£Y,4 T/O /V PLUMBING , DIGt-/T ,.OLDE £1-E1/,4 T/OM RE/R ELEI/,4TIOM ROMAR T BUILD_FRS ,SECT/ON ROMART B U~ L D£RS NOTE - FOR .4£.; ,SP£CIFICAI-ION.~ OF INTERIOR ,SE~ CONTI~AC~' U-R P AN ~ I I ~ Itl , ' i I , - II - ~ ~ - ----:---- ~._~ L_ L. ~ ~_~ I / ~ /1 { --. ~" __ -' I:1~ ~ ~ . ~--~ ~ -- __ T -- FOUND/IT~ON PLAN · .SCALE-- '/'4 -- ~ -o