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Home My WebLink About4782-zFO~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No.. ~3.c,}.~.q .............. Date ........................... THIS CERTIFIES that the building located at ...~..j~'b~!~..~O~,<J ............................ Street Map No.~l.~.~.~S...~.~Block No...S~,e..II ...... Lot No..I+~)...:....G.~I~O~.t ....... ~,~., ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................. ~T.i~Jrt~.....$ ................ , 19..~0.. pursuant tolwhich Building Permit No..J~... dated ....................... ~e .......... ~ ........... , 19..~0., 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 ........ ......... P.l~i.v.a.~e .. eeee ~s e~y...b~..~d, in.g .............................. :. ........................................................... The certificate is issued to ...W.,...G.~..:[.:].~J~ ......... ~t~e~,;. ....... ~...; .................... ;...: .............................. Lowner, lessee or tenant) of the aforesoid building. House Building Insp~ctor TO~'N OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 782 Z Permission is hereby gronted to: ........................ ~%~,~o-]~ ..................................... to ............,i~.~,~.. ~e~, .ac e~, m~-.e~.~ ...(.11 ~,,.e ~a.g e.)... ¢~ t.~.41~ g. .................................................. at premises located at ............... .~o~ ~ 0 ~.~v s--~: ........................................ .................. ~te ~,a..& ,~.~u~ ~ .~a~ .............. ~.e~:mge~'.t ......... pursuan~ to application dated .......................... ~:~I~......~ ............. :....., 19.....~ and approved by the Building Inspector. Fee $...~...g..O. ........... TOWN OF $oUTHOLD BUILDING DEPARTMENT "- TOWN CLERK'S OFFICE Exomined ..... ............ , 1........ Approved ~ ~ /'~.. ~'~'- ........................................ , 19 ........ Permit No ........................... Disapproved a/c .............................................................. ~........~....---. APPLICATION FOR BUILDING PER ....... ......... , INSTRUCTIONS Application No.....~.....?....~... ,'~......~ a. This application must be completeJy filled in by typewriter or in ink und subrnitted in duplicate to the Building Inspector. b. Plot plan showing Iocati.on of lot and of buildinas on premises, re at onsh p to adjoining premises or public streets or areas, and giving a detailed des. ription of layout of property must be drawn en the diagram which is part of this application. c. The work covered by this application may nat be commenced b.~fore 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 ~ork. e. No building shall be occupied or used in whole or in part fcr 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, end other applicable Laws, Ordinances or Reaulations, for the construction of buildings, additions or alteratj, ons, o' for4emoval or demolition, os herein described. Th~ applicant agrees to comply with all applicable laws, ordira, ~e. s,~ildi~/g~code, h~g cod~.~lations. ......... · ' ............................ ...... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer, rq (Name and title 'of corporate officer) 1. Location of land on which proposed work ~ bedone Mal~No.,~"~^"~/ Stre, and Number .~.Z..~..~~.~.~' 2. State existing use and occupancy of pr~mises an~ intended use and occupancy of propa~ed const~ction: o. Existing us, and =cuponcy ..... /~~.m...~(,.~.~ .................................................................... b. ntended use and occur an", .~ ~~ ~ (/~~- ' ~-~ ..................................... t..~.,.~-.z.~ .............................. 3. Nature of work (check which applicable): New Building Repair .................. Remora De - ~ ................. Addition .................. Alteration .................. .................. monfian ........... Other · 4. Eshmated Cost . ~ , . Work (Descr be) · ' ............................ Fee .. ..-~.. ' ........ (to ....... ' ' . be paid on fi!lng this application) 5. If dwelling, number of dwelling units .../v..: .................... Number of dwelling units on each floor ............................ If garage, number of cars 6. If business, Commercial or mixed occupancy, spec/fi/ nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ........................ Re .... ."".'.' .' 'D'~ ...... Height ........................ Number of Stories ... ar . · ........ pth .................... Dimensions of same structure with alterations or additions: Front ........................ Depth ................................ Height ................................. Rear .... ............................ Number of Stories .... ' ....................... 8. Dimensions of entire new construction: Front ............. ~.. ................ ' ........................... Rear. 7 Height ...~. ............. Number of Stories (., / ~ ......... Depth 9. Size of lot: Front '...-'. '/ .......... ~; ...................................... ......... Rear ........... ~..~..,~ ........ D~nth /~ ~ -? ~/~ ~ /_ ............... 10. Date of Purchase ......... ~..~...~....~...~. .. tu~_. '' ........... ,,,= of Former Owner 11. Zone or use district in which premises are situated ...............~.~.~..?.~ ~ ..~. ~ ~',~'~' ........................................ 12. ' Does proposed construction violate any zoning law, ordinance or regulation? /.: . ,- ,- /v~ ~ . 13. Name °f Owner of premise~/..~. ~-.~.z../. £ ^, ,~ ' ...... . .......... ..................... ~aaress .d' / ~, .' ....................... .................. /' ................ Phone No ..................... Name of Architect ...................................................... Address ................................... Name of Contractor..,~./. ~.- d~.4 ~ L/I I_£ .. - Phone ~No..~ .................. ............................ Addres~ ~' ~ ........................................... Phone Locate clearly and d stinctly oil buildln . PLOT DIAGRAM .roperty. lines. Give street gs. whether existln or r ;'hether,nterlor or corner lot.and block number or c~escriptlongaccorP~lopni~Ste~o,d~~1 '~ncli~ca,?~.~.ll_,s?_..~k dlmen,!ons from , - -,,~w ~rreer names and Indicate ~> ~'~"~'""~" ......... ~.~.t~ / ~ ..... ~ ~gnlng appl cation) 'e named. He is the ................ ~'~'~.;..=../,..~.c..~,.~ . ' (Contractor, ag~t, co~omte officer, ~.) ,id Owner or Owners, and is duly authorized to Perform or have perfo~ed the said work application; that all statements contained . ~e ~o~ will be performed , ...... ~.th~ application am tm *~ *~ ........ aqd to ~e ~d file , ro ~ore me ~is n t,,. ,,unner set tach in the oppllcat~- ' ' ' ' ....................... , .... . :.. ~ ~ ~ ~OTARY PUBL[~'SJate of NeW York