The URL can be used to link to this page

Home My WebLink About4855-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF occUpANCY THIS CERTIFIES that the building located at .......... ~[~....Z~a~.~,{~ ......................... Street Mop No....~ .............. Block No ....... ~,Z~, .......... Lot No. ;~ ....... ~,g~l~Ql~ ...... .~.~.t.~..t .................... conforms substantially to the Application for Building Permit; heretofore filed in this office dated ............................... J.~;~.~ ......... .1..~ ........... , 19..~.~.. pursuant to which Building Permit No....~.~.,~... dated ....................... '~IZ;[~' ..................... 19 ......... was issued, &nd conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ..................... ,P.r&~r~te...s.tl~.8~,..(.TooZ.)...shed .............. ~ ............................................................ The certificate is issued to ..... J.~se~-uh..F. all~/3~e.wsK~. .......j,,,.DwD, el*. ........................................... (owner, lessee or tenant) of the aforesoid building. House ~ 50025 FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMEN"I 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? 4855 Z Date ........... : .............. ~t~ .......'1'3 ........ , 19...~.~ Permission is hereby granted to: ................ ~.o~e_~h..F~~,....~ ................. ....................... ~o~ho~ ................... .................. to ...... ~.1.t~,.-.~,~,..a~e~e~..{~o~.~e.)-'-bu/:'l~ ........................................................ al' premises located at ............. ~'~...-.~'~J~..-~;~9~ .................... ~ .......................................................... ............................................................... ~outk~o~et ....... '~:I'~'~';'":' ......................................................... pursuan,t to application dated ......................... ~I~ ..........~.~ ........... , 19..~.., and approved by the Building Inspector. Fee $..~.e.~). ............ Building Inspftor k /OBi' NO. l TOWN OF soUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE S~TH~D, N. Y. 19 ....... '% 19 ........ Permit Ne ..... Di~pp~ a/c ......................................................... ................................................. :::: ...... Examined ~ Approved ........ ~ ....... , APPLICATION FOR BUILDING PERMrT C~ ~ ~ ....... rs;' ....... t: .......... ' INSTRUCTIONS a. 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 edjolnlnn premises or nubile streets or'~ areas, and giving a detailed description of layout of property, must be drawn on the diagram whl'ch is part of ~h 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 app cant Such perm tV 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 pureu.a, nt to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lawn, Ordinances or Regulations, for the construction of buildings, additions or alterations, or~ for removal or demolition, as here n descr bed The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Add res~"~l~' applicant) State whether applican~ lessee, agent, architect, engineer, genera,t r ~T electrledan, plumber or builder. If applicant is a corporate, signature of duly authorized officer. ..~ C~. (Name and title'of corporate officer) ~' 1.Street and Location of land on which proposed work will be done. Map No.:Number ..... ~D.~.~......~,-~q~ ~i.:i~ ~ ..... ............ ! Lot'N~ i iL .......... L,~ ~j>J -' .~O 0 ' ........ · Munic'l'~ii~' .................................... 2. State existing use and occupancy q~ premises and intended use and occupancy of proposed construction: _...~ // b. Intended use and occupant, . ................................................................................................................................ 3. Nature of work {check which applicable): New Building ~.....'~ ....... Addition .................. Alteration ~ ................. Repair .................. ,~emoval .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ............ .~..~...~: ..................................... Fee .......................................................................................... (to be paid on fi!ing this application) $. 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, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ...........~.~...~. ........ Rear .......... /..~.../. ............. Depth ....L.O../. ......... Height ......... J~!. ......... 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: Frc,nt ............................ Rear .................................... Depth ................................ 10. Date uf Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construcfion violate any zoning law, ordinance or regulation? ............................................................ 13. Name of Owner of premises ........................................ Address ............................................ Phone No ..................... 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 set-back dimensions from property lines. Give street and block number or description ac :ording to deed, and show street names and indicate whether interior or comer lot. cuLG . COUNTY _OF ~ ............. $ '""~' ~/(NoMe of individual ~'gr{/ng application) above named. He is the ........................... ~ .............................................. j ........ :. ................................. (Contractor, ag~t, co~orate officer, ~c.) of. said ~n~.r or owners, and is d~thgri~~ to perform ~h~e ~rfo~ the said work and to ~ke and file t~,s apphcat~onf that all statem~n~m th~ ~c~~e to the best of his know edge and belief; and t ,ar the work will be performed i~t~e manner ~t foden the application filed therewith. Swam to ~fore me this ..... ..... ....... .............. : ......... .. ...... ........................ ... ~ ELIZABDH ANN HIVing, . / H~ARY PUBLIC. State of N~ Yot, No. 52-8~25850, Suffolk Cou~ Term Expires Match 30,