The URL can be used to link to this page

Home My WebLink About4704-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..]JJIiJlI&~I..P..O~llI.~...]~t[ .................. Street Map No. ~l#~.,...~..~...(%~ck~l ..................... Lot No. ~..-~. ...... .~..~..O.h~J~;J,~ ....... :...W:e..~..~. ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................................... &p~ ...... ~,...., 19......~.. pursuant to which Building Permit No.....~.~. dated ........................... AJ~t~ .......~...., 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 .~ ...... The certificate is issued to ....~l..~.~b~,~l~l,.~l~l;.~.~l~'..j~. .............. ~ ................................... (owner, lessee or ter~nt) of the aforesaid building. House P 1 .99 FOI~M~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMEN'I! TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 4704 Z Permission is hereby granted to: ..... .~.,~.,.~.~.~....~...~.~.~...[~.....i.A...~.....~..~..~a ~x~ce~ S~ ................. .~.~:~.~..~. ...... .~.-.~,,..! ...................... at premises located pursuan¢ to application dated ..................... .~.~ ....... ~ .............. , 19...~, and approved by the [~uilding Inspector. TOWN OF SOUTHOLD BUILDING D E PA RTME NT, ~'"/~.~'~ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .... ~ ~'..~..., 19 Approved ........................................ , 19 ........ Permit No. ~/704-/ ~ Disapproved a/c ............................................................ '' APPLICATION FOR BUILDING PERMI'r Application N o. ~.....'~....~....% .......... ~' INSTRUCTIONS o. 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 part 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 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 s~ll be occup[*ed or ~sed in whole or in port for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment 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 described The applicant agrees to comply with all applicable laws, oral!nonces, building code, housing co, cie, and regulations. .......... (SignOture of applicant, or nome, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ~.~.~ ........ ~.~.~..,~,~.~./.-.,~.,~. ........................................................................................................ Name of owner of premises ..~.,~.; ...... ~.~).,...~g:.:.~,~.,~...~...~/~.......~..~ ................................................... If ~pli~nt is a co~orate, s~ature of duly authorized officer ........ (Name and title of co.ore.officer) 1. L~ation of land on which propped work will be done. ~ap No.: ........................................ Lot No Str~ and Npmber~~...~...~).....~ .......... ~~.~.~. ~ ~~' Munici~li~ 2. State existing use and ~cuponcy of premises and intended use and occupancy of pr~ construction: ~. ~stina ~ ~nd ~u.~.~ ....,~/~.~~ b. Intended use and ~cuppncy ................. ~ ........... ~.~'~.....~..~~ ......... 3. Nature of work (check which applicable): New Building .................. Addition ....... .~.. Alteration .................. Repair ...; .............. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ............... .~j.~2.~,.~:L>,.....';~..... ............ 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 oar .~.....~/..~-~ 6. If business, commercia~ or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front .......,~,~_,.X~. .....Rear ...... ~'.'~.~/~ ......... Depth ......~.~'..'.~. Height ..;....~.~...'~.. ..... Number of Stories ............... ././~, ................................ ~ ................................................. ~ ..... Dimensions of same structure with alterations or additions: Front ..,.~e~'./.~,-~ ................. Rear ...~.././'~. .......... Depth ......~.~Z). ................ Height ....... 'Z~.-~.. .......... Number of Stories ............... ./.~'..,'~,,, ..... 8. Dimensions of entire new construction: Front ............ ~'.~ .................. Rear .............. ./.~ ....... Depth ..... ~.4~. ........... Height ....... ~.~,~..... Number of Stories ./~ 9. Size of lot: Front .,.,~;~.~....'~.., ....... Rear ........ ~,~..~...~,,. .......... DePth ............ ,~..~....~..i'.'.~.'... 10, Date of Purchose~,~i~;~,. ......... /,,~Z2. ................ Name of Former O~ner .. ,,x~,'~.Z.$C~_..~.....,~.,,.,/,~...~...~. 11. Zone or use district in which premises are situated ...................~.~i~-,,~..,~.~'.,4~.s~,. ..................................... 12: Does proposed construction violate any zoning law, ordinance or regulation? .......... ,,,/~,, ....................................... 13. Nome of OWner of premises~3~.~//4~o~.~J;~)~3Address,~;~.4)..~.~.~.~..r~..~/,/l~one No ......... : ........... Name ~f Architect ............... .~./~.A~..,~. ................. Address ............................................ Phone No ..................... Name of Contractor,~gJ.~..~..~.~.'~.~...~asdress ....~. '.~...~'..~-/Z'..~....~....~ ......... Phone No.~.n.n.~.~/.~, PLOT DIAGRAM Locate clearly and distinctly all buildings, whether exisfJng 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 NEWYYO~,K. i 1' t e ~. COUNTY OF~ ....... ~"~"~' P~"'~..~;~4/l~. ~ ~ ................................................................................................. ~i.~ duly ~om, ~es o.d ~y~ t~t ~ i~ t~ opplic~.t (Name of individual signing q~lication) { ; above named. He is the ........ ; ......... ;.. ~ '~' ;~ZZ;'; ;;;;~];;[';;~"~ ............... of said owner or owners, and is duly authorized to perform or h~e performed the said work and to ~ke ~d file this application; that all statements contained in' this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner ~t fo~h Jn the applicati~ fil~ therewith, Sworn to ~fo~ methis ~ . . /' :'2Z 'Z Z .... · .................. .................. .~ * '~Z~.XNN.~.~. Coun~ (Signature &f applican~ ' N:3TAR' ~IBLIC, ~, of Raw York -- ~IDING IN SUF~LK ~U~ No. S2-Sl9~900