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Home My WebLink About5714-zFOi~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMEN, T Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z~61. ..... Date ..........0Cl;OD®I~ .18~ ..... , 19.7-3. THIS CERTIFIES that the building located at ...~l&in .Ba~yView..Rea~t .... Street Map No... }~ ....... Block No...~ ..... Lot No. ~. ~ghO$d .................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... Feb.,..18~-.., 19. ~2. pursuant to which Building Permit No..~7~Z. dated ..........Feb-,..~8.~ .... , 19. ~2, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...Priv&te. (aeees.so~y.)..gre~ouse- ~l~ing ....................... The certificate is issued to .. A~$~ed--E,. ~t ........ ............................. (o~ner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . ...N~ ............................ UNDERWRITERS CERTIFICATE No.. ~{'.~ ......... ~ ............................. HOUSE NUMBER ... 2~5 ...... Street .... ~a~.~$9~ .~9D~. ................. ................................................. ~VSD9~4 ..................... ; Building Inspector ' TOWN OF SOUTHOLD ~ BUILDING DEFAI~TMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: .......................................................................................... ~.~.~..T.~/..~.~..~.. .................................. pursucm~ to application d~ed . .................................................... , l g.. d opproved by the Building Inspector. Fee .... Building Inspector FORM NO. 1 TOWN SOUTNOLD ~UILDING DEPARTMENY TOWN CLEP, K'S OFFICE~ SOUTHOLD, N. Y. Examined ..F. abr. u~.~ ........1.~., ...... 19...7...2. Application No..~.?.~.4. ..................... Approved ..........': ..................... ': ....... , 19....':... Perr~t'7~....5.?.1.4,..~ ............ Disapproved a/c ............................................................................................ - ~uilding ~nspectorJ 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 p~an showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giving a detailed description of layout ofproperty mt~st be drawn 6n 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 ~ Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the pt:ogCess 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. lding Departmen issuance a Building pursuant to APPLICATION IS HEREBY MADE to the Bui t for the of Permit the/ Building Zone Ordinance of the Town of Southo d, Suffo k County, New ~ork, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or aJterations, or f~or removal or demolition, as herein described The applicant agrees to comply with all applicable laws, ordinances, buildihg code, housing code, and regulations. ,~.,.),.,, ,~ ..... .' r/, ,, ",~ ' ........ i~'i'~'t~atur~'of applicant, or name, if a ~'~)'~)'~2'~i;~'i ........ (Address of applicant) '" State whether applicant is owner, lessee, agent, architect, engineer, genergJ contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No ......................... Street and Number ........... ..'~....~.../,~-.~.. ........ _/~..../I.../...~,. ........ ~6. Z...,..~..(.~.../~.. .......... :...~...O..~..~ .......................... Municipality State existing use and occupancy of premises and in,~ended use and~ occupancy of proposed construction: a. Exisiting use and occupancy ........ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building -- A~d ..................ition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ Estimated Cost o~- O ~ ~ Fee ~'/~ ~ (to be paid on filing 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, 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 ............ o~ ~ Rear ~'~' Depth / Height .......... ~ ......Number of Stories ...................................................................................................................... 9. Size of lot: Front .......~..'~....~.....'~. ........ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Nome of F9f~m~f Owner ........................................................ 11. Zone or use district in which premises are situated ...................................................................................................../~ 12. Does proposed construction violate any zoning law, ordinance or regulation? /~' O 13. Name of Owner of premises /~ ~/z~ '.~...~..'..~....~-....Address~/~/lt/ ~i'~yr, zEl~/ '~ No.~.~...~...~.~.'..~....~...~. .................................... ~:O.tj.~/~fl.o.L~.~ ......... Phone 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 according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW(C(~OR~, I/ COUNTY OF ............. ..................... .~..~,.F....~..~~D ............... ~....~..'..~....'~... ..................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is 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 ~ke and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this ........................ ay of ...................................... , 19 ....... Notary Public ...... County pplicant) No 52-812o8 , ~ qn 9~ Term Expires