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Home My WebLink About185-zFOEM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .W,~.S Y..o. ttr~. ~.v.~ ..& P..~t~.~...R~.?. Street ~ou~old Map No .... ~*~.. . Block No ..... ~*, . .Lot N~* ..................... conforms substantially to the Application for Building Pcrmit heretofore filed in this office dated ........... ~ove~p. ber 27 19.,.~.7 pursuant to which Building Permit No. Z 3.85 -lated .............. NO~....~..~.r ~.?.. , 19. 57, 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 ............................ Karl H. Gru~I~e, owner This certificate is issued to ............................................... (owner, lessee or tenant) of the aforesaid building. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES ~l/~T~r~i~l~*~)~ ~I~V~P~~I~_~,I~T~ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No .. Z,...18~; ...... Dc, re ....... l~ove~,er ...,.q? ............. Permission is hereby granted to ~Toseph Bennett . ~(~.... Karl .Grupl~e ................. .... $cm,thold., ..... N,.t~, ........................... to ...BuAI¢I. ~n:. adeli.tff, en...t(~ e~t~ii-,~ .d~e11-.~g ................................................... at prem,ses located at ..~/S...~Z~_~gS ~l~e. &..~.ett:~ .]~1~ .......................................... ......................................... 8~uth~ld, .~.~ .................................................. 'pursuant to applicahon dated ............... ~4:n/~lllJ:~ ..-~7 .... 19~.7.., and approved by the Building Inspector. Budding Inspector ~ORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exa mined........~.....Q..~........~.....~· ......... 19.~o..]. Approved ........................................ 19..¥...~.Permit No ............................... Disapproved a/c .............................................................................................. Application No ........./....?.,D~~. ......... ........................ nspector) \ APPLICATION FOR BUILDING PERMIT Date ............. ........ ..... 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 a 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 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 issuanc,e 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 or a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. TR ^ e., To R Name of owner af premises ...................... : ............ ~ ................................................................................................................ 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: .................... I.V, l P -'T'FY Ro D .o. F[.'zoLO Iv.k. Street and Number ....~..:......~. ......................................................... ~'.. ........................................................... .,J ........ / Municipality 2, State existing use and occupancy of pr, emises and intended use and occupancy of proposed construction: a. Existing use and occupancy .............................................................................................................................. b. Intended use ond occupancy ..................................................................................... ; .......................................... 3. 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) 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 .......... ~.~z......~...~...~. Rear ......... ./.....~C._ .......... Depth ......~'....~. ................ Height ............................ Number of Stories .................. ~ ...................................................... Dimensions of some structure with alterations or additions: Front ........................... ~-.~....~'..~.. Rear ................................ Depth ....... 7....~...J ........... Height .............................. Number of Stories ~ Fr ' ~-' '3"-' ~- '~-- 8. Dimensions of entire new construction: ant ............................ Rear ............................ Depth ............................ Height ............................ Number of Stories 9. Size of lot: Front ...... .~......'~... ........... Rear ....... /../....~. ........... Depth ....~...~...~..~../..~....~.... 10. Date of Purchase Name of For er Owner ~tI~MI~-"/['P,.~-tMI"~(. 11. Zone or use district in which premises are situated 12. Does proposed construction v~ate~an~zonin_g_ law, ordnance or regu at on? ...... ...~......O.. .............. 13. Name of Owner of premses.~...~~ddress ............................................ Phone NO..'"'""'"'"'"" Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Controctor..'J.~.~...E.~./?.......~...~...~...~...~..T'.~. .......... Address .......~...~..?..~../2.9...c....~... ......... 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. F?~;-FT' ~ /~o A t STATE OF NEW YORK, ) S S. COUNTY OF ............................ ) ................................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing application)' above named. He i~ ,he~i ........ .~..~.O...~.....~...~...~...~..?...0..../~.. ................................................................................................................ (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 ............ (Signature of applicant) Notary Public, . ........................................................... County