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Home My WebLink About4660-zlrO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..... j[l~l;llt..[~d..l~..O,/~..~T12.~..~l ......... Street Map No ...... ~ ........... Block No .......~, .......... Lot No...~w ..........I~l,~;~.~-tl~4~- ......... lie[e, .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................................ ~l[' ....... ~ ...... , 19.r~0.. pursuant to which Building Permit No...11~6.~... dated .............................. ~lZ' ......... ~...., 19..~, was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificote is issued is ........ ........... ~ra~e. ~s~e · · .~a~t.l.y..,et~e:~ .1.~ ..................................................................................... The certificate is issued to .......~Zt~...~;~,],B~e~.~ ............ ~F. ................................................ (owner, lessee or tenant) of the aforesaid building. I~otme ~ 80 ][rause ~ Building InspectOr FO~ NO. ~ 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.o 4660 Z Permission is hereby granted to: ................ · e~eZ~...lt~e ........................... ..................... 0.:3.~.. ~t.~e...~. &.. ~r~ee..~M ... .................. IIM:t:~tlalil~ ...... ll;~Z;~ ....................... to ......... $o ..I~a~.:L4.. ex~...mta~L.~$en...(~e~mev.) ..e~.. ®~.~.s~,t. nt ..cl~e~t.E~e ........................ at premises located at ............... ~e~....~l~..~&l ..~,~I/IIA~..~ZJ .......................... ~ ............................. ..................................................... tl~tt~ tu~k"" ~'~'~' ...................................................................... pursua:~ tO application dated ......................... ~&'~ ......... ~ ........ , 19....~ and approved by the Building Inspector. Fee $....~.,.1~,0 .......... Building I~spector f ]iN)B~f NO. 1 TOWN OF SOUTHOLD BUll. DING DIPARTMBHT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ,m ned ......... ........ Approved ........................................ , 19 ........ Permit No. O ~ Disapproved a/c .............................................................................................. (Building InspectoI ,' APPLICAYION FOR BUILDING PERMrr Bt,... ........... ............................... , 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 lat and of buildings on premises, relationship to adjoining premises or p .ublic streets or areas, and giving a detailed doscriptJon of layout of property must be drawn on the diagram which is port of thle 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 Bud ng Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. ~l~o building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shaff~ be~n granted by the Building InspeCtor. APPLICATION IS HEREBY MADE to the Buildina Department far'the issuance of a Bud na Permit ~umuant t~' *ho Bill .... " "- ........ .u d,n.g. Zone. Ordinance of ~e Town of Southold: .Suffolk County, New York, and ather applicable Laws, Ordinances or K~egu~ar~.o. ns, tar the constructton of buildings, add~ttons or alterations, or for removal or demolition, as herein described. ~ne app.cant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Signature of applicant, or name, if a c~--"~"fTon) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which prapaeed work will be done. Map No.: ........... ~ ..................... Lot No.: .~...~ ................. Street and N~u~/m~e~'~../:~,...O..i.../.~~............J~::~l]~. .......................... ~.~.i~.~ ....... Municipality 2. State existing use and 6CCupancy of premises and intended use and occupancy of prcpased construction: a. Existing use and occupancy ' b. Intended use and accupancy ................................................................................................. : ...... : ...................... 3, Nature of work (check which applicable): New Building ~ ................ Addition ..... ~ ......... Alteratibn ,...~ ............ Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... .J.; .......... '...,..Number of dwelling units on each floor ..........J. ................ If garage, number of cars ................................................................................. ~ .......................................................... , 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 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 ......... ~JJ~..~...~...*... Depth ........................ Height ...... ~ .........Number of Stories ..................... ~. .............................................................................................. / .~. 5'-o ~ Name of Former Owner ~' .... 11. Zone or use district Jn which premises are situated ..................................................................................................... 12, Does proposed construction violate any zoning law, ordinance or regulation.;) ................ ..t~....O.. .................................... Name of Architect ...................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locote cleorly and distinctly all buildings, whether existing or proposed, and indicate all set-bock 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' YORK, COUN"P,' OF ....... ..J.~..~.......~...~ ................................. being duly sworn, deposes and soYS that he is the applicant (Name of individual signing application) above named. He-4s. the ........... ~...,,.~;,;.~;;;~-. ....... ;; ........................................................................................ (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 cont~Jl~ed in this application are true to the best of his knowledge and belief~ and that the work will be performed in the manner set forth in the application filed therewith. Swam t_o J:~fore me th s ............. ....... ...... ................ : ......... (/ I[LIZABETH ANN NE'i/tLL~ NOTARY PUBLIC, State of NeW Yoa No. 52-8125850, Suffolk Coul~y. Expires March 30. 1~.~.~'