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Home My WebLink About115-zF01~,~ N~0. 4 TOWI~I OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ......Z...72], ...... Date ............................... ~'%_~Jl,~. J,~. ........... 19..6.0. THIS CERTIFIES that the building located Ceda~ Beach Pa~k Map No ....................... Block No ..................... Lot No .............................................................................. conforms substantially to the Application for Builflina Permit heretofore filed in this office dated ................0..~...~...O17..~.~...3. .......... 19..5_?... pursuant to which Buildin~ Permit No ....... ..Z....~5. ..... fated .............,!0C~:~t).~Z:..3 ......... , 19....5'~ was issued, and conforms to all of the requirements o£ the applicable provisions of the law. The occupancy for which this certificate is issued is .......................... L~.V~,~....Qt~.. ;~t~l~l:~l~..IIWEI~:~I~,G ............ .................................................................. This eertifieale is issued to ~.ll~....~.l~;l,~I'~...g}l~II~lt ............................................................................. (owner, lessee or tenant) of the aforesaid building. Building Inspedtor FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES *W"jt", " VFMSfll UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. ...Zr...1.:1.��!' ......... Date .......+Xepti; b..or....23....................197... Permission is hereby granted to: .S.ue....7.aleer.................................................... ............. �TJ�.... I!O1�B..�Q6C�......................... ....................X111W.111.r.....141A.......................... to ...Build..addit1ons...to..exiating..dwalli g.................................................................. ................................................................................................................................................................ at premises located at ..W/a.....«`ut aet..3Pay...................................................................................... ....:.................................... .............................................................................. .............................................. outdznfl,..) .X. ................................................................................ I pursuant to application dated ..........Sept.GP.ber....23.......................195.7.... and approved by the Building Inspector. Fee $.t5*00.......paid ........: � .. ..a... ..................... Building Inspector i a r �li ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined...~ ....... ~ ...... 19.....7 Approved ........................................ 19 ........ Permit ~o ................................. Disapproved a/c ............. ........................... (Building Inspector) Application No ......,/..,]...~ ........... 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 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. , x.. ............... ,: : .... ............................... (Signor'ute of ap,plic~p~t, or name, if o corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electricon, plumber or builder. Nome oF owner of prem.ses.....~ ...................... ~~ ................................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and tide of corporate officer) 1. Location of land on which propose, hd work will be done. Map No . Street and Number ..................................................................... %. .......................................... ~ ....... 2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction: a. Ex st ng use and occupancy ....~....~'S~...~~ 3. Nature of work (check which applicable): New t]uilding .................... Addifi ........ ~......AIt. rot; ...... ~ ..... Repair .................... Removal ';,i;, ................ Demolition .................... Other Work (Describe) .................... iX 4. Estimated Cost .........~-~..~.. ...................................... Fee ..~,~ ..................................................................................... (to be paid on filing this application) FEES: ~'<~ C~''~ 5. If dwelling, number of dwelling unfts ........ ~...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 ....~,.....~,.~..z. .............. Height ...~...~..(...:..---~.. .......... Number of Stories ..... ~ .................................................................................. Dimensions of same structure with alterations or additions: Front ...... ..~....'.~..~ ............. Rear ...~.~..~...~. ................... Depth ....~.....~..!. .............. Height ..../..~.i..~.-~.~. ............. Number of Stories .......~?.~ ............ . , ./ 8. Dimensions of eot/re new construction: Front......,~...~. ................ Rear .../...~.. ................... Depth ./.. ......................... e ,/~ / ~ Number of Stories ~' /:/~L6~o /~£':'A~,tOo~-,I~ Hight ....................................................... ' / ./....~. 0 ~ 9. Size of lot: Front .....~...O....O. .............. Rear ...... ................ Depth /.ZZ~..~.....'r~.... 10. Zone or use district in which premises are situated....A........~..~.~f...~.........~~' ................................. 1 1. Does proposed constructio~n violate any zoning law, ordinance or regulation? ........ ....~.......(~... ............................... 12. Name of Owner of prem,ses.~' ............................ ~ Addres~.~O~.~.~.. .......... ~[ ~ne NO ..................... Name of Architect ................. ~ ................................. Address ............................................ Phone NO ..................... Name of Contractor ......... ~ ......................................... Address ............................................ 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. 4Lr~'~AT~ o~ Sworn to b~fore me this ~ __ .............. / ..... ? SAMUEL NOTARy PUBLIC, Stat~ of N~W York No 30 595540~ (Singature of applicant) STATE OF NEW Y ~ ¢ S. ...,L.~.~ ~. ~ ............................. be,ng duly sworn, deposes and says that he is the applicant 'A . (l~ame of in~t'~i~al signing application) above named. He is the ............................. ~.~.. .......................................................................................... (Contractor, agent, cor~rate 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,