The URL can be used to link to this page

Home My WebLink About184-zFOItM 1~0. 4 TOWN O1:' $OUTHOLD BUILDIN~ D£PARTM£NT SOUTHOLD, 1~. Y. CERTIFICATE OF OCCUPANCY No. E 978 Date ~Tanuary !8 51 ............................................. 19 ..... THIS CERTIFIES that the building located a~.~.eP...R.o..~,.D.~, :..l~...~.~.i..tu..~.. Street Map No .......... e..~.*.... Block No ...... .?.*...~. ....... Lot No. ~** conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... ~.o..v._m~ .l~..~....2...5.., 19..5,.7.. pursuant to which Building Permit No.. ............. Z ~84 dated ......... ~C~..~.e.~ .$5. ., 19...5.7.., was 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 . .1~..I~.....'~.... tiff .E..~ .A~.....2~...~ .D~..N~. ,~.~Z~.~ ....................................... This cevtlficate is issued to ........ .R..~.n.d..l~.? ..Wi~..t~.., ...o~..e?. ......................... (owner, lessee or tenant) of the aforesaid building. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES ~i/~Ir~i~I~T~F ~~:~-~~i,~lf:~l~r~(~i~ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to ~Lteh~el.....~e~.~t..~.~.. ~a~ohd..~i~th .. · .~ep..B~4~. DmXv. e ............................... ....... ~.ttit~31:, ..... N~ ~. ...................... to ..]~,t~d..an.a~itio~ .~o ez&s.tin~..d~eZ]-~ ................................................... at premises located at .~)eep ~.~e i'~','1~4B .............................................. ............................ ~t $i~uek.~ · N,¥, .............................................................................. pursuont to apphcat~on dated ...... NOVeI~. ~,.~'. .............. 19. ~7', and approved by the Building inspector. Fee $.~.~....(~... ............. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ...................... ~.i ............... 19.~......Permn ................................. Disapproved a/c ............ ~..~..i .~-' , :; '...~"---~ ..:.:>: ............ :.:: ..... : ..................... ............................... ........... :-:::..'.. ..... (Building Inspector) Application No....(...~....L~. ............. APPLICATION FOR BUILDING PERMIT 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 drawn on the diagram which is part 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 o 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 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 oll applicable laws, ordinances and regulations. (Signature of applicant, or nome, if a corporation) Deep ~ole Creek ~., Ma~ti~ack, ~. y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. 20'T T.~EJt Name of owner of '~rem ~ ~y~oncl. p. Wirth 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 ................................... Block .................................. Street and Number 2. State existing use and occupancy of premieses and intended use qnd occupancy of ~)roposed cOnStrL~tion: ~si~ence o. Existing use and occupancy .................................................................................................................................. ~si~ence 3. Nature of work (check which applicable): New Building .................... Addition ......... ..~. ........ Alteration .................... Repair ....................Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ~1~500o00 Fee (to be paid on filing this application) FEES: 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................................................ 6. If business, commerical or mixed occupancy, specify nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front........e~.....~.~.; ........... Rear ............4~......~..... ...... Depth ...... ~.?...~;. .......... Height ...... ~.?...~.". .......... Number of Stories .......... !. .................................................................................................. Dimensions of same structure with alterations or additions: Front ....... ...~?...~.~..* ............. Rear .........&.~..~.; ............ Depth 4]. f~, Height ........ .1.?.....~J.... ........... Number of Stories 1 8. Dimensions of entire new construction: Front......~...~.~.? ........... Rear ........ ..~.1....~.~.?. ....... Depth ...... ~..~....~e..;. .......... 17 ft;. 1 Height ............................ Number of Stories ............................ 9. Size of lot: Front '....~.0...~...f.~?. .......... Rear ........ ~..~..~...:~J., ....... Depth .,J~. ,~.~...~...%~...~.....~...~...ft. ]~J%% [l~e J~,5 ~. 10. Zone or use district in which premises are situated ............. /~...~..: ................................................................ 11. 12. Does proposed constructkxn violate any zoning law, ordinance or regulation? .................................................... Name of Owner of premises. A~r..~,c~..~.e....~.:J~'.l;~ ...... Address ..~J...e.~....~..°.~.e.....D~...*.~.....]~..~.a..llJ~one NO ..................... Name of Architect ...................................................... Address ............................................ Phone NO ..................... Name of Contractor...]~'..?.~.?e.?'.....i~...?...m~..n..?~ ................ Address ..D?..e.~...~.°.~.e.....i~...'.~.....~..~..~PJ~one NO.~L~J;.~.,...~I...-8.?.I~0 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 ~to deed, and show street names and indicate whether interior or corner lot. ., (.~,,_~/c.-- _ STATE OF NEW..YQR~, ~' ) above named. He is the ............ e.....-=_.,~..~.-~..~..~.e~..; ........................................................................................................... (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 hls knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. (Singature of applicant)