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Home My WebLink About2900-ZFOP~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CE:RTIFICATE: OF OCCUPANCY No ..... Z.....~66 ...... Date .................. JJl~lJ~....~- .................. , 19.(j~.. THIS CERTIFIES that the building located at '~'/~'""JJ'~'"J~J~/"~J~l~.~ .................... Street Map No....~J~l[ ........... Block No...~ ............ Lot No....~j~ ........... ~l~l~J~'l~Jj'""JJ¥'~& .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................................... Oet,...-ll~ ........ , 19.6.~. pursuant to which Building Permit No ..... -'qgO0J[ dated ................................. OIIte...-.~J~.-., 19...~, 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 ........ The certificate is issued to ..... ~O~h"e~t~.~l[ ........ i'~'n(~_'~'~[."~i .............................. of the aforesaid building. H.D.Approval Feb 17, 19~ bF R. Villa Building Inspector FORM NO. 2 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) Ne 2900 z Permission is hereby granted to: G.W,Smt.th..&..,~ons...Zn~....A/C.....Josaph. Seilfln~ .............. S~uthold ...................................... , ....... to . ]~uilcl..Dew...one.. £ami;Ly... dw~, 1/,r~ ..................................................................................... ct premises located at ........F~.S....,~o..~I~.~/,~e~...EC~u:I, ..................................................................... ............................................................ ~outhel4 ................................................................................... pursuant to application dated ............................ IJ~.~. ........... 1.If .......... 19.~'.., and approved by the Building Inspector Fee $. ,~,0..,0~ .......... Building Inspecto~ / SUFFOLK COu~A~.~ DEPARTMENT OF HEALTH TO ~0~ 1T NAY The sewage disposal facilities for a structure located at · ~ [Give deed location) have been inspected by this Departaent and found to be satisfactory. District Engineer District Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ~?... ! ~/ , 19 ........................................ , 19 ........ Permit No .............................. Approved " ., . ~-~ O ~ D~sapproved a/c ...;.,, ................ .~'. ............. .~ ........ ~: ........ ....... ............. ........................... (~uildin0 Inspector) Application No..~....[...~.73~. .............. APPLICATION FOR BUILDING PERMIT Date .~.....~..~...../......~.. ................... , 19...~....~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving o detailed description of layout of property must be dra~vn on the diagram which is part of this applica- tion. 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 applica~nt. 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 pa rt 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, alterations, or for removal or demolition, os herein described. The appIicant agrees to comply with all applicable laws, ordinances and regulations, j) (Signature of applicant, or name, if a corporation) ............................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premis~...~ ............................................................................................. If applicant is ~e ig, gature~ duly auth~ized officer. .............. ~a~~m~te offiC~';i'''':I~"~~~- ............. 1. Location of land o~~f~d,,~rk will be done. Map No.: ............ ~_ ~..,..~ ,~t No.: ...................... Street and Number~~....:~.. ,.,~....~.....,~r~' ................ .-~....~ ................ Municipality 2. State ii~itltingu~Sea~do~u~icy o~.~,ses and i~d occupancy of proposed conltruction. o. Ex's 'ng e p y ....... ~ ....... -~ ............................................................................ b. Intended use and occupancy .....~.~D~_~ ..................................................................................... 3. Nature of work (check which applicable): New Building ...... ~ ...... Addition .................. Alteration .................. Repair .................. Remora! .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost ..........~?-'~ ....~.~-¢:?.. ................................. 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 occupat~cy, 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 .D..~. .................... Height .............................. Number of Stories ....~ ............. 9. Size of lot: Front ...... ~..~ ............. Rear ...... ~.~ .................. Depth ..~..~. ........... 10. Date of Purchase ...~....Z.~..~ .................... Na~ of Former Owner ..~~...Z ................... ] 1. Zone or use district in which premises are situated....~ 12. Does proposed construction violate a~y~b~, ordinance or r~~~ Name of ~ner of prem~s ~.... Address ~ ....... Phone No Name of Architect ...................... ~ .......... ~ .............. ~ddress ....~.~ ...... ~ ............... Phone No ................... Name of Contractor~.C.~:..~~ Addres~....~~ ............... Phone No .................. PLOT DIAG~M kocaCe clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-back dimensions from pr~erty lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW/"YO~,I~, COUNT, ..................... ' g{ me o individu able o~ beJn'""'"'"'""~' duly sworn, deposes and says that he is the applicant a,bove named. He is the ....i...- ................................................................................................................................ (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 contained in this application are true to the best of his knowledge a~nd belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ............ · ~.'.'~..~....'~ay of ............... ~.., 19 ~'"' 'ora Pu'' /0 j~.~ ~.-~,,~ ry ............................. ~/ ~-~/'~ ~o. 52-0344963, Suffo~ County --rr -- ..... ,