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Home My WebLink About4748-z~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No~,~8~O .................. Date ....................... ,ZI~, ....... 22 .......... , 19..~.0.. THIS CERTIFIES that the building located at ..~..~i~1.11,.~¢S .................................... Street Map No. ~ .......... Block No ......... ~e ......... Lot No .... ~ .......Peeot~4e....~¥~ ..................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................. t4~' ......... '1'3 .......... , 19r~)... pursuant to which Building Permit No. I¢,~1~ .... dated .................... ~1~ .......... 1'3 .............. , 19....~Q 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 ........ .......... ~a rm.. ~ta~d.....,, .. a.g r~ cuttxm'~ 'l...bu~..l~l ~.~g ................................................................... The ce~f~cote ~s ~ed to,~o~w~..~...~..~,o~in?;;.~.;.[j.i;;~e,~i .............................. of the aforesaid building. -- Building Inspector House ~ ~0~ 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) N.e 745 Z Permission is hereby granted to: Dote I to ~JJ,A~..Jl~.. ~l~.**q.T.e,~.~ ~.a~ Bt, and at premises located at ..................... ~.....]J~.J~JJJll~ ..................................................................... .............................................................. ~.e~oll,;J,a. ............. ~1,,.~.¥ ......................................................... pursuan¢ to application dated ............................. )/.e:~' .......... %.~ ......... , 19...~1, and approved by the Building Inspector. ,Fee $ ...... ~*0~ ........ TOWN OF soUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~xamined ~"~ 19..~..~.... Permit No. '~ ? /-Y~ ~ Approved ........................................ , ............................ Application No .~...'~ .?. ~'~ C.... Disapproved a/c ...... ~.~..~. APPLICATION FOR BUILDING PERMI'T ........... ............... INSTRUCTIONS a. This application must be completely filled In by typewriter or in ink und submitted In duplicate to the Building Inspector. b. Plo, t .pi.an sho. w!nfi I.oc.ation o.f. lot ?.nd of buildings on prom!sos; relationship to adjo n ng premleee or public streets or areas, ana g~wng a oetailea aescript~on at ~ayout o? property must be arawn an the diagram whlch Is part of thio 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 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 Department for the ssuance of a Building Permit pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other appllcab a L.awl, Ordinances or Regulations, for the construction of buildings, add t OhS or al.terat ohs, or for remove or demolition, os herein de~crlbed. The applicant agrees to comply with all applicable laws, ordinances, building coc~ housing code, and regulations. ,f ........ (Address of applicant) State whether applicant ls owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bullber. Name of owner of premlses ~/~'PH ~../~///V '~ /Y "/'"I /',/ 0 If applicant Is a corporate, signature of duly authorized officer. (Name and tltle'of corporate officer) ~ 1. Location of Iond on which prapo~ed work wlH be done. Mop No.: .................... ~ ................... lot No.: ........................ ~ Street and Number ~>~' ~- ~ ~ ~/~ ~CO~/~ ~ Munlcl~ll~ ~ 2. State existing use and ~cu~ncy of promises and Intended use and occupancy of prop~ construction: a. ~lstlng u~ and ~cu~n-,, ~ ~ ~ ~ ~ 3. Nature of work (check. which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal c~r.ts..C; ....... Demolition .................. Other~e.~_~ (Describe) ........................................ 4. Estimated Cost ............................................................ Fee .......................................................................................... (to be paid on fi!lng this application) 5. If dwelllng, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, spec~ature and extent of_~ch type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth ~ Height ........................ Number of Stories ....................................................... ,~.~./ ................................. [ .................. Dimensions of ~aj~e structure with olteratiq~ ar additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... N ~9~ob~' +of Stories ........................................................ ~'~ D'~"-~-- ............................................ 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of~Form~)~u~e~,,, ,. ---- ~,- ....~t.....~.~.~. .............................. 11. Zone or use district in which premises are situated ..................................................... ~ ........................... 12. Does proposed construction vi~t~, a~y ~n/~/n~./l~jwb ordinance ~l:~J~iJ~tioi~._~cr<:......~..e. .............. -,~,.~4/....~z~).~.~ 13. Name of Owner of premises ........................................ Address .......... ..?'..~.'~..C..O...~..../.~ ............ Phone No ..................... Name of Architect ...................................................... Address ............................................ 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 ,hlo K ~r ~d~cril:lti.on gc~o~'din tg..~eed, and show street names and indicate whether interior or corner lot. ' ' STATE OF NEW YORK, J ,c ¢ COUNTY O,.~12.~/=.pFt .............. '/~ ?"1/V 0 ................................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing applic~lo above named. He is the (Contractor, agent, corporate officer, ere,) of said owner or owners, and is duly authorized to perform or have perfOml~.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 tha~ the work will be performed in the manner set forth in the application filed therewith. ........Sworn t~ before me thisx~l/)' ~'-6~ / JF/''~'~... !~ ..~..~ ........................... · Nota [blgnature of oppJ~con-t) NOTARY PUDL L: ~[a[e ~o. 52.8i25550, Suffolk Co~i~/~ :~rm Expires lliatCh 30,