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Home My WebLink About175-zFOII,.~[ 1~O. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT '1OWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z 933 .... Date ............ N~.e~e;[..2. 5 ...... 19~..0. ·H[$ CERTIFIES that the building located at. ~,/~ "Pa~'k '~Ye, ~:~::[~:Uck Street Map No .... .*.** .... Block No. .~*.* .... Lot No . .*.~? .......................... conforms substantially to the Application for Building Pc,mit heretofore filed in this office dated N~r~be~ .16 .... 19..57. pursuant to which Building Permit No .... dated ......... N~/~-l~,e~ I(~ -, 19 5~., wa~ issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is ~ssued is ............... ~r~'~,~ OKE F~ D~q~..~'l/~ ................. This certificate is issued to ~eo~e ~y~'el$,~ ~'r~e:~ ................... (owner, lessee or tenant) of the aforesaid building, FORI~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES ~6Ji~e~Jjd~,~T,~IF ~~Ji~Ii~,SJ2~t~-~Ii21~xJi~UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No Z .1.~/~'.. Date ........... NGvembez~. :L6 ..... 19 ~... Permission ~s hereby granted to Josel~h Deez'kosk.~. ~ · ~o, ......... ~.t t.$t~k.¥ ..... N,.~, ....... to .... ~t~..~.. ad~i.ti~...to e~ls%i~.-dwelling .......................... ct p~em,ses located ct ~ P~k 'A~e'~ ........................................... .............................................................. ~%~. .... N.,.~, ............................................... pursuant to cppJicahon dated .... NO~ ........ .~ ............. 19.~ , and approved by the Bu~ld,ng Inspector Fee $.. ~,~0~0 ......... Building Inspector FO~M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ....... Approved ........................................ 19 ........ Permit r~o ................................. Disapproved o/~__ ............................. - ....... c~/.~._ ~L.;:~ ................. --~ .................................. ~- . .... ...................... (Building Inspector) Applicotion No..../..17......~... ........ APPLICATION FOR BUILDING PERMIT Date ............. ................. ,*.S..? ..... INSTRUCTIONS o. 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 drown on the diagram which is port of this location. 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 work. e. No building shall be occupied or used in whole or in port for any purpose whatever until a Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with oil applicable lows, ordinances and regulations. (Signature of applicant, or name, if o corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electricon, plumber or builder. Name of owner of premises ........ ~~.. ......... ./.~...~ ............... L/ 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. Mop No. - Block .................................. Street and Number ¢/.'~.. ~'/~/~' ~ .~.._~... ~....~..Q.~. 2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction: o. Existing use and occupancy .......................... ~..~ .................................................................... b. Intended use and occupancy ....................................................................... Nature of work (check which applicable): New Building .................... Addition ....... ~...Alteration .................... ' Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost . . .: ...... ~ ............................ Fee ..~... . ................................ (to be paid on filing this application) FEES: If dwelling, number of dwelling units ............. ! .............. Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................................................ 6. If business, commericol or mixed occupancy, specify nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front ......... ..~......1~. ......... Rear ....... ..)~...~.k. ........... 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 ......... '~.~.L. ........... Depth ......!i...O. ................ Height ............................ Number of Stories ...~ ......... 9. Size of lot: Front .......... ~ .......... Rear ............................ Depth ~ 0/J ~ 10. Zone or use district in which premises are situated ...... ~..:. .................................. : ................................................. re ul t' :) /~D 1 1. Does proposed construction violate any zoning law, ordinance or g a ~on ....... ~...-. ......................................... 12. Name of Owner of premises./~.........~../..~... Address ...~..~.~.~z:f:'.....~...4.~ ....... Phone NO ..................... Name of Architect~ .................................................... Address ............ .~.~:~ ...... i .............. Phone NO ..................... Name of Contracto/.~....~ ....................... Address .;]~k~~..r. ............ 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 numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ) COUNTY (~~....) S S.' ~..~'~..~......~~~ ............................................... being duly sworn, deposes and says that he is the applicant (~ ~' (Name of individual signing application) abo~ve 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 make and file this application; that all statements contained 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. Sworn to before me this ........ /....~.. ....... day of .......... ..~.~..: ........... 19..~7.. Notary Public,....~..~.~,.%K'.. .........o~ntC u y EL01SE BOWDEN ~ota~/ Public, State of New York Residin~ in Suffolk County Commission Expires p,~arch 30,