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Home My WebLink About4788-zFO~M NO. ~ TOWN OF SOUT140LD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..... R/.~..C~;~...p.~Ot~;LO...]~..R~.ti~ ......... Street Map No....~ .............. Block No .....3~ ............. Lot No ......ZZ ....... ~,13~.e'1 ....~[a~.~ ...................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................. ~'.1~3~ ......... 3 ........... , 19..~.0.. pursuant to which Building Permit No. if.~j~.~ ..... dated .................. ~[~lZ~e ....... ~ .................. , 19...~.0., was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ......... ....................................................................................... The certificate is issued to ..... ~J~Z'.t;.l~..&.:Ld.(~:~. ........... .C)lf~e~ .......................................................... (owner, lessee or ter~t) of the aforesaid building. ~[ouse ff 11~0 TOWN OF $OUTHOLD BUILDING DEPA. RTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISE~; UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 788 Z Permission is hereby granted to: .............. ~,~e..~o~-.,.~/~-....~a.~*~.ia-.ei~o~, ..................... ~q~"~o'~k ................................ to ....... ~ ~d...a~..a~i~o~..¢r~..e~tJ~.~.. ~?.4~ ~ ~i~ ....................................................... at premises located at .................. t~//~.....]~,~e~...~a~..~ ....................................................... pursuant to application dated ................................ '~,~t~ .......... ~,..., 19..~., and approved by the Building Inspector. Fee $...~, .00 ........... Building Inspector NO. I TOWN OF soUTHOLD BUIbDING DEPARTMENT TOWN CLERK'S OFFICE Examined .:~. ............ Al:~raved .....~.. ....................... t.).,..:.., 19....,..~.. Permit No. Disapproved a/c ........ ~ 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 part of this application. ~ c. The work covered by this application may not be commenced before issuance of Building Permit. K 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 sh~ll be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy ~-I shall 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 ?ri 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, housing code, and regulations. ~ ........ E~e~e..l[e~t,e~ ....................................................... ~) (Signature cf applicant, or name, if a corporation) (Address of applicant) State whether appllcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................. ....................................................................................................................... Name of owner of premises ......... ~la..~;.~.~n..~,4~o~ ............................................................................................................. If applicant is a corporate, signatu're of duly authorized officer. (Name and title 'of corporate officer) Location of land on which proposed work will be done. Map No.: .......... ~ ......................... Lot No.: ....Z~.. .................. Street and Number ..................... ..~./...~.......~..?.~.O...~..~..¢....~......~...~..?.~.. ............ ..~..~..e..~.. ................................................. 7~ / ~ / / ,~ ~ ' ' ;' Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... .~....1~...]....]:.~.~.[ ......................................................................................................... b. Intended use and occupan?'. ............... S~J~,..¥~l,~,~.a,..~l~..~l,d,~t,~Ol~ ........................................................... 3. Nature of work (check which applicable): New Building .................. Addition ......... :3~..... Alteration ........ 3~ ..... Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ........... ~)~(~.....'1'. .................................. Fee ~.eO0 (to be paid on fi!ing this application) 5. If dwelllng, number of dwelling units ....... g.~.~. .............. Number of dwelling units on each floor tf 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 .................... H~ight ........................ 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 ............. 2~, .................. Rear ...... ..2..~. ................. Depth 20 Height .................... Number of Stories ................ DZLe. ...... 9. Size al: lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ! 1. Zone or use district in which premises are situated ........ ~.....d4~B~ ......................................................................... 12. ~Does proposed, construction violate any zoning law, ordinance or regulationS. ........... N~I. ......................... 13. Name of Owner of premises ....~..?....~..~.~...O..Z'. .................. Address .......... ..~.....l~....e..~.. ................... Phone No ..................... Name of Architect ...................................................... Address ............................................ phone No ..................... E. Hot%on Il. Suffolk Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locote cleorly ond distinctly oil buildings, whether existing or proposed, and indicate all set-lx~k dimensions from property ~ines. Give street ond block number or description aocor_~g, to ~Jeed, and show street names and indicate whether interior or corner Jot. :~ ~1~,~.~ : '_ f STATE OF NEWeY__~I~,~ ~, t .. COUNTY OF ................................ ..................................... ~,~l~i3~..Ror.t~o~, ............................ being duly sworn, deposes and soys that he is the applicant (Name of indivicTual sig'ningapplication) . : , . above named. He is the .................... ~.O~t~Z'~,g.t,~;~. ................................................... j~ ....................................................... (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 aretrue~to the best of his knowledge and belief; and ti,ar the work will be performed in the manner set forth in the application filed therewith. Swam to before me this ' fla. 52-8125850, Sulfolk Term Exp~es March 30, 1