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Home My WebLink About7-zFOt~M NO. 4 TOWN OF SOU?HOLD BUII..DING DEPARTMENT TOWN CL£RK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at -~/~-....~O(MI~..~.~...DI?~'~'~B ................ Street Map No...Ne$.%v~.ew .............. Block No ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................. M~N"'"'"~'""'19'~"~'" pursuant to which Building Permit No ....~..?. ................ , doted ............................... J/~t..~....8,/ ........ 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 ............ .................................................... PR.I,V A.,'t: ~ -DWEI,A..I'NG' ...................................................................... This certificate is issued to ....... .~Tat~le~..~i.~...~].e,i.rl. .............. 7..(....~,,~le~....) ................................... Lowneh essee or TenanT) of the aforesaid building FO~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPAETMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c ............................................................................................ (Building rnspectbr) APPLICATION FOP, BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplic__~at_~e, 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 occbpied 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. ~ applicant, or name, if a corporation) /,Address of applicant) State whether applicant is owner, lessee, agent, 9rchitect, engineer, general contractor, eJectrican, plumber or builder. Name of owner of prem sea James H, K[e;[n and Do,:Is J. K][e;[~ 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 ~alll; ~lda O~ Woodo~./'~ D~,Ve 2. State existing use and occupancy of premieses and intended use and occupancy of proposed construcHon: a. Existing use and occupancy .................................................................................................................................. occupanc ~estd'~ce b. Intended use and _ y ........... - ....................................................................................................... 3. Nature of work (check which applicable): New Building ....... ~.. .......... Addition .................... Alteration .................... Repair ................ Removal ................... Demolition ................. Other Work (Describe) ............ 4. Estimated Cost ....~r~tOOJ0eO0 ................................ e ....................................................................... (to be paid on filing this application) FEES: ~-''2c''' ~- ¢ ~'''''' 5. If dwelling, number of dwelling units.....O~O ................ 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 ............................ 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 ........ ,~,.I .............. Rear ......... .~2.I. ............ Depth ....... ,~.~.1 .............. Height ............................ Number of Stories ....... Ol:~u~ ............. 9. Size of lot: Front ....... ],0~1. ............ Rear ......... ],0OI .......... Depth ........ ~.~0.I. ........... 10. Zone or use district in which premises are situated ............... ~ ..........~.....~ .................................... 11. Does proposed constructio~ violate any zoning law, ordinance or regulation~ J~"0 ~Jam.e~ ~.. ~.le.in and ~'.ast Le~on. A~e~.r~ze ' 12. Name of Owner of ~rernises~/~.x&~d~'k~.X~.~Address~t~Lt*~.~`w~h~ne NO. Name of Architect....J01~li.~].~tl~..W~ol~ ..................... Address ....,R~/~;~l~.lllld .................. Phone NO ..................... Name of Contractor..,.:!i~lll~rJ~o~.. ~111;I~1;~ Address ....~[a~,~t,~O,k .................. 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 OF ...~,~£o.l,k. ....... ) ..~'~LI~..t'C.....~[~,[~...a~..~D~J~t..~.,...[[~I~];]~. ............. being duly sworn, deposes and soys that he is the applicant (Name of individual signing application) above na reed .:ll~l~.. ·..~b~T .. ll.l,e...j i,,tl ........................................................................................................................ (Contractor, agent, corporate officer, etc.) ~t~l~jl~t~l~trz~owners, anda~j~°duly authorized to perform or have performed the said work and to make and file this cmppJication; t~at all statements contained in this application are true to the best of his knowledge and belief; and that the work w~ll be performed in the manner set forth in the applic~er~i~h. I~ ' Sworn to before me this "' ....... ......... ........ .................. .... Nora Public, ry ~:,~. 52-J759000 Approved ~,~6/(.,cc ~ 19 ~ ~'Permit FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved o/c ............................................................................................ (Building I nsp~ APPLICATION FOI~ 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 iot 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 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. ~oture of applicant, or name~ if o corporation) .......... ................................. f/,~ddress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. Name of owner of premises ...... .~..~.~..~.~e..~...?I*.~...~.K...~..~..q..~..~..c1.....D...~..z'..~.8.~..~.:....K..~.e..~..~. ............................................................... 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, ...... ..~.fl.f~...~.zk~.e.....o..~....W...o.g..cl.g.~.~.....D..~,~.¥..e. ........................................................................... 2. 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 ........ ]~..,~ ~c~e~0~ .................................................................................................. 3. Nature of work (check which applicable): New BuiLding .....~.. ............. Addition .................... Alteration ................... ..'~ Repair .................... Removal .................... Demolition .; .................. Other Work (Describe) .................... 4. Estimated Cost ..... .~.~.~.,..0..0...0......0,.0. ............................... Fee ..~...O..~...~ ..................................................................... (to be paid on filing this application) FEES: /~m~.Z ~-~' 5. If dwelling, number of dwelling units ...... 0z~e ............... 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 ............................ 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 ......... 5.2,,.I ............. Rear .......... ~..2..! ........... Depth ........ 2.6.I. ............. Height ............................ Number of Stories ..........O..~..e,. ............ 9. Size of lot: Front ....... .~,0.0.! ............ Rear .......... ~...0..0..I. ......... Depth ......... .]-.~...0..I ........... 10. Zone or use district in which premises are s~tuated ................ ~. .............. /~.f.~:. .................................. 11. Does proposed construction violate any zoninq iow, ordinance or regulation? ............ ~....~.. ............................. , ~ James H. Klein and East Legion Avenu 12. Name of Owner of premises.....D..O.~.~.s....~.?...~.e...~..~....Address ~.a..~..$.~..q.q.~,.....~..e...w....~...°.?..~hone NO ..................... Name of Architect.....~..~..a..~.e...s.....W..o...o..c] .................... Address Rivez~b. ead ............................................ Phone NO ..................... Name of Contractor ...... t~.~.~.o, fLd...~.8. T~..o.~..c]. .......... Address .....?.Ia.~..2.~.q..~. ................. 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 OF .... .8.g,:~;('.9..~.~; ....... ) S S.,~ ...~¢,~j~,~...[i.,...~[4,~.;E~...ftT~....;D.C.,(q~¢...C..*...~.f~...~.~ ............. be ng duly sworn, deposes and says that he is the applicant (Name of individual signing application) above no reed..,%'Y~j~:~ ·....~ h,e~r.., a,~e...~ b,e. ....................................................................................................................... (Contractor, agent, corporate officer, etc,) ~~wners, and~2uly 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 apiarian filed therewith. Swam to before me this ........ .7.~ ........ day of ......... (Singatur¢of applicant) Approve~ by ildlng Inspector ~ May 9, 1957 ~ 0 r ~ ~- ~ Z o m 0 Z Z