The URL can be used to link to this page

Home My WebLink About4829-zl~Ol~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, CERTIFICATE OF OCCUPANCY No. z$8.~.~ ............... Date ........................ J.ul~. ......... 21 ........ , 19..2.Q. THIS CERTIFIES that the building located at 15./~S......~eke..~_~ri~,e .................................. Street Map No. ~,~ ................. Block No..K~I~ ................ Lot No. XX .......... ~Otl~'h~l~ ........~v'~'.v .................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................................... ~ttt'ze'"2~- ......... , 19...r~o pursuant to which Building Permit No..~,9'z... dated ......................... LT~u~'e'"'"29' ........... , 19.....7~ was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ............... ee~e~so~y...~ez'a~e-)...~,u.l.~i.~mg ............................................................................ The certificate is issued to ..~,er~,~zr~f.r~..[~ert.;[~m~.p.~..&..,~'.;L~'e ............ 0~'l~z~$ ............................ (owner, lessee or ter~t) of the aforesaid building. liouse ~ t+O~ FOIL~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? ~829 Z Permission is hereby granted to: .... · ~l.ee~m....m~..R ..................................... to ......... ~..mm.eeeee~..~etee~..lm~e)~ ...... ~ .......................... at premises located at ............... ~...../~lll~r~..~l~ ........................................................................ ............................................................. ~ ......... ~.,..x...*..: ................................................. pursuon¢ to application dated ................................... ~l~llll~..~- ....... , 19.,~0., and approved by the Building Inspector. ~ Building~f'~pector k. ~ 19......~.. Permit No .... Approved ...? .................................... , Disapp ' :roved~~ ~~ (Building Inspector) APPLICATION FOR BUILDING PERMIT (_.~ . INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adioiniag premises or publ c 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. 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 wurk. 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 Perm t pureuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York and other app cab · Laws, Ordinances or Regulations, for the construct on of bu Idings, additions or a terations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Signat~e cf applicant, or name, if a corporation) .... ( dress of applicant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................... Name of owner of premises ............................................................................ If applicant is a corporote, signature of duly authorized officer. (Name and title 'of corporate officer) Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ........................ Number..~..~.J....~...~.g.l.~..~.....~..~....~'.. J~ .~..' ~ . . - , Street p~ ~ . ~. ............. ~.,, ........ . .~.~.. ........... Municipality -- .... State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .~.~..~...~'...~ .................. ~ ....................................................... ' Intendeduseandoccupanc,' .~'~..~.~...::..:..:~.~/I ~.~.~?..k. ~ ~ b. 3. Nature of work (check which applicable): New Building ~....~ ....... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition ............ C)ther~Work (Describe) ................................. (to be paid on fi!lng this application) 5. If dwelling, number of dwelling units ..... ~ ........ Number of dwelling units on each floor ............................ If garage, number of cars .................................................................................................................... ~ ................. 6. If business, commercial or mixed occupancy, spec!fy 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 ..~-~..O. ................ Height Number of Stories ~ 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Narr~ of F~ormerx~)w~n ....................................................... ! 1. Zone or use district in which premises are situated ................~:: .......... ~ ....................................................... 12. Does proposed construction violate any z~:ting law, ordinance or r, eaulat on? ....... ~ ............................. Name of Owner of remi · ..~ i~'~A" /~-~--,-,4~- ,. . ' ...... 13. P :..~..-~ ......... ~none r~o ..................... 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 ~et-back dimensions from property lines. Give street and block number or de tio ac _lng tcn~eed, and shaw street names and Indicate whether interior or comer lot. d~ rio a~ ~~ STATE OF NID~O~~ J S.S. COUNTY OF .~~. ....... ................. ;: .................. :....~'./~.....~~g duly sworn, de,oases and says that he ,, the applicant above named. He is the ............................ ~,~. ......................................... '~L ............................................. (~ntmctor, ~t, calorie officer, ~c.) of said owner or owners, and Is duly authorized to perform or have perfo~ the ~ld work a~ to ~ke ~d file this application; that all statements contained in this application are t~ to ~e Nst of his ~l~ge a~ be ef; and ?at the To~ will be ~erformed i~the manner set fo~h in the oppllcatl~ f~ ~lth. ~wom to ~tore ,