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Home My WebLink About4789-zNO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY o, .' ........................... Dote ................................................. THIS CERTIFIES that the building located at ....W~,II~I~IIIII~..~J~ ................................... Streef' M~p No.~..~ No ....................... ~ot No..~. .............. ~.~Z. ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. : ..................... ~.....t ............., 19..~. pursuant to which Building Permit No..~.. dated ............................ ~....~ .......... , 19.~.., was issued, and c~forms to all of t~ requirements of the applicable provisions of the law. ~e ~cupancy for ~ich this ce~ificate is issued is ........ The certificate is issued to ...~ll.t~lil...~l~Jl~ ......... ~ ............................. (owner, lessee or tenc~qt) of the aforesaid building. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PEP. MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 4789 Z Permission is hereby granted to: ................. .~%l~.t~.... ~ ~.....S.W,& .~IL...AJg]he~eZ at premises located at .............. ~.t,..~ .......... .~.a~'~,~Jl~t~, ...... 4111~..~, ..................................... ............................................. ¥1a~Mmmm~..~:~ ............ ~& ................................................... pursuant to application dated .......................... .~JI]l~......~ ................. , 19...~.~, and approved by the guilding Inspector. NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ............................ 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. Plat 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 drown on the diagram which is part of this opplicatian. 'K c. The work covered by this application may not be commenced before issuance of Building Permit. m 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 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 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, ordin noes, building code and regulations. . (Signature of applicant, or name, if a corporation) State whether applicant is owner, les~e, agent, architect, engi'neer, general contractor, electrician, plumber or builder. Nome of owner of premises ............................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~c./ ;~-~-~F/9/~'~' Location of land on which p,F:)posed work will be done. Map No.:- .~....d~.../../....../..~..~...~......'~'- '~' Lot No.:~ Stre~ and Nu~ .~~.~~..,..~~.)..~.. ~" 3. Nature of work (check which applicable): New BUilding ;;..~............ Addition .................. Alteration .................. Repair ............ ~/~ ~'~ r-~Rem°val .................. Demolition ............... ... Other Work (Describe) ........................................ 4. Estimated Cost ../.../....~...~.........-<. ................................. Fee ............. : ............................................................................ '(to be paid on filing this application) 5. If dwelling, number of dwelling units ................i ........... Number of dwelling units on each floor ............................ . If 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 .................... Height ........................ 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 ..... ...~=..~ ............. ~....'~ Rear ..... ..~...~ ............ Depth ...,~...~.~... .......... Height .../...~... ......... Number of Stories ....... ../. ............................................................................................................ 9. Size of lot: Front ...../..~...o. .............. Rear ....... ./....c~...?. .................. Depth ....~..~ ................... 10. Date of Purchase ......... =.~.....'. ..................................... Name of Former Owner ..~..~ ............... 1 1. Zone or use district in which premises are situated ........ 2~J/'. ....................................................................................... 12. Does p~oposed constrbction violate any zoning law, ordinance 13. Name of Owner of premises ,~,~,~.,..~.,~-~...~...~..~ ....... Address... ............. Phone No ..................... Name of Architect ...... .'~.. .................. ~,~-- '----J-~,'""~"-"-"~"Address ~iiiiii Phone No ..................... Name of Contractor ..~~...~....~...Address Phone N .~.~"~.....~."~..,,~..~_'_~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing 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 corner lot. STATE Of NEW~'~OJJJ(j~t~ I ~ e COUNTY Of .~JJ~ ........... ~'~' ...................... ~....~..~...~ ...................... being duly sworn~ deposes ~n~ says that he is the applicant (Nome of individual signing application) above named. He is the ............................................ ~ .................................................... . ......................... (Contrgctor, 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 are true to the best of his knowledge and belief; and that the work will be performed in the mgrmfir set forth' m the application filed therewith ~-~ Swam to before me this ' .... .......... day of ....... J . .. ?~._ ._ ~....,..,uf ~_ ~.",r~,,t.. ~ ....~:~~ .......... ,.~~..t'~: ......... Notary Pubhc~-,~.t,~?44~'..:../~'/,~Z~... County~-~'.~/~t~ (S~gnature of applicant) ~ ELIZABETH ANN NEVILLE,... ~'~ ' NOTARY PUBLIC. State of New No: 52-8125850, Suffolk Cou~ ~erm Expires Ma~*ch 30,