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Home My WebLink About131-zFOR~.~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...J~...~'...~.~e'~L..~Ol~ ....... '. ............. Street Map No.~....][~/.e~l, ...............Block No ......]/j~.].)~ ...................... , Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................... ~.~)¢~e~'"'"~. .......... 19.~2..., pursuant to which Building Permit No ...... ',Z.....~,,~. .......... , dated ...................... ga.~C~b.C~Z'.... ~....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 ............ ........................................... :P ~{.I.¥ .~ ~. -~E,LL t.~*~ ............................................................ This certificate is issued to ....~.~.],.]:..:j:~l~.-.~e~:.'l.~ .......... (o~t~,eP.)..: .................. ' ............................... ~owner, essee or renant) of the aforesaid building. Building Inspector ,j FOt~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDI~4G PERMIT (T~I~g~~T~-~~ WITH ONE SET OF ~P~P~v~~~~ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No ....... ~,....~.,~ 1 ·. · Date ....... 0C.~be:.....3 ........................... 19 .%2... Permission is hereby granted to: Wiltiem....-~fel-ls ...................................................... ~.a~e~...~.e., ...................................................... .... .~a~.~g-. S$¥e~ ~.....~f.-¥-. .............................. to ...... Comve~.~,.,. exl. s ~i. ng..Aa eeso~..bu.i.ld$~ .. ~o .. Dwel 1.ing. ............. i ...................... at premises located at .~/~....~...~.~L~.~/..~O~¢] ................................................................................ ................................................. SOU~hOld~-..-..~..~' ............................................................................. pursuant to opp{ication dated ..................... (~be'~'""~ ...................19~.~...., and approved by the Building Inspector. Building inspector l' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT ~FOWN CLERK'S OFFICE SOUTHOLD, N. Y. xo ,ned ...... ......... ^pprov,d .................. ................... , 9,.,:'....Perm,t ....... Disapproved o/c ...................... ~';~.i~ ....... M'. ................ '.~ ................................. ................................... ~y .............. ¢ .............. z .................. ?~ ..... ;'~'/"U' .............. , , // ~ ~ ,/~'~, '~'-~ ...... ....... ....................... I I ,~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No / '¢ / /5*2 Date October ~,~, ~o 57 INSTRUCTIONS a, This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Insp~ect_or. b. _Plot plan showing location of iot and of buildings on premises, rela?~ionship to adio~!ning 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 o 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 a~plicant, or name, if e corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electriccn, plumber or builder. Owner Name of owner of premises William Welle , ~. If 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 .................................. Number~/~"' '>'~ ///~~ c . ~:.v~:~...~.~ic~' x ~ Street and .~..../'.~......-(~...~.,.....~..........~...2:.'z,4.*':..:.', ........... ......................................... 2. State existing use and occupancy of premieses and intenq~ed use and occupanc, y of~ proposed construction: o. Existing use and occupancy ..P. ol;al~o ~o~se . b. Intended use and occupancy ....... ~.~.1..¥.'~-.~..e.,....~..l.e..~...1..t_~.~. ...... :..'~,.....~:..~,......:.~: ................................................... .................... Add t on .................... Afferahan .................... 3. Nature of work (check which applicable): New Building ' i --'xx Repair .................... Removal .................... Demolition. ................... Other Work (Describe) .................... '~ 4. Estimated Cost ...~.~.0..~..0...0..0..,..0..0. .................................. Fee ....~.....0...0. ........................................................................ (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 structu~s, if any: Front ...... .~...~.! ............. Rear .....6...~.~.! ............... Depth ......b..~..~.~. .............. 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 ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ....~.~ ................ Rear ..... ~.~.~ .............. Depth 10. Zone or use district in which premises are situated ............. ~ ................................................................................ 1 1. Does proposed constructio~ violate any zoning law, ordinance or regulation? ....... ~ ........................................ 12. Name of Owner of premises...~2~&8~..~.~ ...... Address ..~.~.~...8~X~.~ ............. Phone NO~-.~¢.~. bit.et Charles Wood A44~ Wadi~ River Ph NOW~ 9-~S10 Mame of Arc .............................................................................................................. one ..................... Name of Contractor William Wells Address " .............................................................................................. Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate ali set-bock 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. N 38~ .,~,'a" STATE OF NEW YORK, ) COUNTY OF .~.~.~'.°.:']r..~. .......... ) S S.' WILLI~ ~LLS ................................................................................................ be~n~ du~y swom, deposes ~nd seys ~h~ he ~s ~he eppHcent (Name of individual signing appliCatiOn) abow~ named. He is the ................ Q9~9.~.~. .................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove 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 ~rd f October ...... Public N Pub e State of New ~ork Notary ,, ........ ~ .......................... County ~o. ~-g~ossT~ s.~fo~ ~t~:d~~ C~mmk~ion Expires March 80. 19~ (Singoture of applicant) TOWN OF SOUTHOLD BUILDING DEPARTMENT ;tOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19 ........ Permit No ................ Application No..../...,.Z.,. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. This application must be complelely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showin§ 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 opplication'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 nome, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer,, general contractor, electricon, plumber or builder. ....................... ..................................................................... Name of owner wezx8 , if applican} is11~j~[,~j~t .e~']~.~ure of duly authorized 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 pre~ieses d intended use and occupancy of proposed construction: o. Existin~ use and occupancy ........... ~g.~.~,..~ .......................................................................................... b. Intended use and occupancv ~w.~.~.~ ~.3.~.~ ,~-~-". 3. Nature of work (check which applicable): New Building .................... Addition .................... Alterationy.....~.. ........... Repair .................... Removal .................... Demolition. ................... Other Work (Describe) .................... 4. Estimated Cost . .~..~..0..$.0..0..0.*.0.~ .............................. Fee ....~..~..~.0..0. ........................................................................ (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 ...... .(~.! ............. Rear ....~..~.~.! ............... Depth ......~.~.~..~.. ............. Height ...... ~..~..I. ............... Number of Stories ..........~ .................................................................................................. Dimensions of same structure with alterations or additions: Front ..... ~.1~.~'..~ .................. Rear ....... (~.! ................ Depth .......... ~.~.~. .......... Height ............ ~!. ........... Number of Stories ...........~,. .................. 8. Dimensions of entire new construction: Front ............................ Rear ............................ Depth ............................ Height ............................ Number of Stories ...... . ...................... 9. Size of lot: Front .....~.0.~..I. .............. Rear ..... ~..0..0.! .............. Depth ....~.~.~..! ................ ]0. Zone or use district in which premises are situated. ............ ~ ................................................................................ 1 1. Does proposed construction violate any zoning law, ordinance or regulation? ....... ~.0. ........................................ 12. Name of Owner of premises...~';~i~...~.~..~ ...... Address ...~.~.~,t¢#[..~..~.~.~.~. ............. Phone NO.~......~..'...~.?.~..~.. Name of Architect.....0..~...~...~..~...~....~...~.0...~. .................... Address ...?~.~.....~......~.Y..~...~. ............. Phone NO.~.~.....~..~....'~...~...O.. # # Name of Controctor....W..&..~.~...~..~..~e~ .................. 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. STA 'E OF 4[W YOR , COqNTY OF ....... S S.. ......................... ~..~ ........................................ being duly sworn, deposes ~nd seys that he btke appllc~nt (N~me o~ individuel signing ~pplic~tio~) Contractor 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 in this application are true to the best of his knowledge and belief; and that the work will be performed in the man,er set forth in the application flied therewith, Sworn to before me this ....~..~.~ .............. day of ...... .O,,o..~ .~.l~ ~.r. ................. 19..0..? ...... Notary Pub ' ic,.......~/~.i¢:.L..~ ............. County ~0'~'~ ~. ~L~ ~ ~bllc, State of New ~ ~2-9~8875 Suffolk Cnuntyz ~mmi~q{oa Expires Mz~reh 30, (Singature of applicant)