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Home My WebLink About82-zFORM NO. 4 TOWN OF SOUTHOLD BUILD,biG DEPARTMENT TOWbi CLERK'S OFFICE SOUTHOLD, bi. Y. CERTIFICATE OF OCCUPANCY October ~, 19%7 No .....Z.. 23 .......... Dote .......................................................... 19 ........ THIS CERTIFIES that the building located at~/S....,tJoJ:~r.t..Ro*~l ............................. Street Mop No ..................................... Block No ..................................... , ffi~tt~l~ '~Ot~l'ttlo~d'$'"'"~'~'~'~, conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................. Aug,~s.t.....~t...19.~;?..., pursuant to which Building Per, nit No ........ .Z..~.2.. ............ , dated ................... A.~gl.~S$....s~'1 ............. 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 ............ ....................................... ~R .~.A-T.E. · DWE LJ~ ~. MG ................................................................................. This certificate is issued to ..~e~,---.~or.b;l,~...J'r- .......... ~...O~AeZt..) ............................................... (owner, lessee or tenant) of the aforesaid building. FOP.1V[ NO. 2 TOWN OF SOUTHOLD BUiLDiNG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. BUILDING PERMIT WORK AUmHOR,ZEO) z 8~ Dote .......................................................... 19 ........ Permission is hereby granted to: John ~auer ~/~ pursuon~ to app[icotio~ doted ................................................................ 19 ........ ~ ond op,proyed by the Building Inspector. Fee $ ........................ Building Inspector F01~,~ 1~'0. 1 TOWN OF SOUTHOLD Town CLER ('S OmCE SOUT.OLD, ,. v. Approved ........................................ 19 ........ Permit Mo ............. Disopproved o/c .......................... ~,~,..- ........ ~.~rz ..................... ~ ............... ................................... ................................... .................................. (~uildin~ Inspector) Application No ............................ APPLICATIGN FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or m ir~k and submitted in duplicate to the Building Inspector. b. Plot plan showing Iocqtion 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 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 or alterations, 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)/ ,4' ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. .......................................................................... ................................ : .................................................. Nome of owner of nr~m s~s ,_o}.,z ~., ~,,~ ~.,(,¢ })J.o[ ']Z · If applicant is a corporate, signature of duly authorized off.]car. (Name and title of corporate officer) Location of land on which proposed work will be done. Map No..~..~...:..zm¢~,..w:,;~..~,~pc]~ ....... Street and Number ...................................................................................................................................................... State existing use and occupancy of premieses and intended use and occupancy of prOposed construction: a. Existing use and occupancy .... b. Intended use and occupancy .......... : ................................................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition .X. ............. Alteration .................... Repair .................... Removal ~.~z,~.~....Demolition ....................Other Work (Describe) .................... 4. Estimated ('n~t¢/~ ~ ().~...'.~...C...~ .......... F e ~ ~ .... /,.... ...................... e ............ ................... FEES: 5. If dwelling, number of dwelling units.....~rrl¢~... .......... 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 exist any: ' ing structures, if Front....J..~..f.~....'~. ......... Rear ..../.~.!~..~ ........... Depth .~..L.~.. ................ Height ...... ~...~./.: .......... Number of Stories ........... ./ ................................................................................................ Dimensions of same structure with alterations or additions: Front .......... ./,?,r..,~.., ......... Rear ................................ Depth ......... .~..(...r.~..~. ....... Height ...... ~...~...: ........... Number of Stories ......... /. .................... 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front .........~.,~.~....d..~... Rear ........ ~.~.../.~..¢.... Depth ..../..~..-~.....t..~....~ ..... 10. Zone or use district in which premises are situated .............. ..~...~ ........................................................................... 11. Does proposed constructiot~ violate any zoning law, ordinance or regulation? ........ /.~ ......................... 12. Name of Owner of premises...];.:qka.zT..~....~.~.,..0..9.~.b. 2:g.~Z~lress l[ob~tz"b L-tQ.~o~ !J:~o:Lct Phone NO~.*.~...q.~..~.. Name of Architect ...................................................... Address ............................................ Phone NO ..................... Name of Contractor..,.~..z~¥~.....,c,~....~kz,~¢~ ............ Address ~:.'Z~.)~.,~.~.....~...: .............. Phone NO.~.~..~.~..,?~.... PLOT DIAGRAM / -- Locate clearly and distinctly all buildings, whether existing or proposed, and indicate ~11 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 NEV~YO~RK,, ./)_ ) S S COUNTY OF ~....) " .....~.......,~_..'.....~...~-t¢f.4~.../..~'~ ~ ~'-- -- ......................... being duly sworn, deposes and says that he is the applicant f/ (Name of individual sign'ng~i~ 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 make and file this application; that all statements contained Jn 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 · ...... r-~..l .......... day of ........... ~ ............... 19 ...... /.,. Notary Public,..~..M~... ~.. ~ Zof applicant) FOR1V~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. D sapproved a/c ............ ~ ................ .~ ................................................. :- .... ....... ......................... (Building Inspector) Application No ~.~.'. ~ 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 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. Up,on approval of this application, the Building Inspector wil~ 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 Deportment for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the mown of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for remeval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ....... ....... .......................................... ,~ignature of apphcant, or name, if a corporation) ....... (Address of applicant)// State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. Name of owner of premises.....~.[e.,z~.r:~...]~;..".....C.~..b..J.-.~....Z...zq.', ................................................................................................ applicant is o 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 ...~ .................... Lot /,~15 and half' of Street ond Number Hobart Road State existing use and occupancy of premieses and intended use and occupancy of proposed construction: o. Existing use and nc~unon~v ~'~'~ b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition ....~,... .......... Alteration .................... Repair .................... RemovalS.. ,~.r.~.gemolition .................... Other Wo__rk (Describe) .................... 4, Estimated Cost .~...ff..O...~..~, ~..~i.. Fee ........... ~...f.~; ............................. / (to b~-paid on filing this application) ............... FEES: 5. If dwelling, number of dwelling units,,,g,~¢~. ....... Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................................................ STATE OF NEW YORK, ) L..._ . 'J --. ~COUNTY~_~/' //" ' ~QF~,~"'")..-~"9 f'~ S '~S7~ - ~ ...... ............. be,no du,y sworn deposes and says that he ,s D,fName of individuo sign ng applicet on) 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 make end file this application; that atl 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 flied therewith. Sworn to before me this ....... ~"I .......... day of ..... ~..~.., .................. 1 9..',~..Z. , Notary Public, ~.~.-~J~..,.. ,~ (Singature of applicant)