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Home My WebLink About547-zTOWbi OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, bi. Y. CERTIFICATE OF OCCUPANCY Date J~ne ~L5 19...6...0.. THIS CERTIFIES that ther building located at ..3;l~,~e.~..l,3~ve.,...,,~1~ll~ ............... Street Ced~l~' Be~ch Map No. Block No. e~'~ Lot No ........................... ~.~.7... conforms substantially to the Application for Building Permit heretofore filed in this office dated D~cembez 29 ] 9~.~....., pursuant to which Building Permit No. dated Dec~mber 29 58 ...................................................... ] g ........ , wo,s issued, and conforms to ail of the requirements of the applicable provisions of the law, The occupancy for which this certificate is issued is ................ PRiVAtE OAT~ This certificate is issued to (owner, lessee or tenant) of the aforesaid, building. FOR.M NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 547 Z Date ................. Permission is hereby granted to: ~tobt. ~Iya%'t '"' '~./C'" · '$'te ~h~t-r · ~i'l'3: ....................... .... S'~U~OTd'~'"'"N'; T'; ........................................ to..~u.i, lc~.., at~....~c~ c~.i .t,i.o~ .. ~..~n...ex.i ~.t i~a g...d.~;e.%l i~ g. ....................................................... at premises located at ~[~'l'~t~ ])~ ~ad~r ~St~!~t ........................................................ .So.uthold~.....N JO-. .................................................................... pursuant to application dated .............])e~e~' ........ .2~ ................... 19.~.., and approved by the Building Inspector F~e SF-..O& .............. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUT,OLD ,. ¥. ApproYed ........................................ ]9 ........ Permit Ne ............................... Disopproyed a/c .............................................................................................. ~' (Building Inspector) J APPLICATION FOR BUILDING PERMIT ate ........ ...................... INSTRUCTIONS a. 'This application must be complet, eIy 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 Certiflcat,e 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 ail 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. Name of owner of premises. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) of land on whicb proposed work will be done Map No' .~.<.~..~,.~(~c~_ ~42~_~.~f~ ..~.~..~ot No' /.. '? ~ 1. StreetL°cati°nand Number .~........~..~.~.~......i i i~~'ii~ii ~..'ii' iiiiiiiiiiiiii i Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: .. ~ a. Ex~stmg use and occupancy ............. : .............................. ).,~ .................................................................................. b. Intended use and occupancy ........................ ~..~. ............... -v.~.x...?....~...~..~, ............................................................... 3. Nature of work (check which applicable): New Building .................... Addition ...... .~.............AlteratJon .................... Repair .............. ~...Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ...... '.~.~....~....0.. ........................................... 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......?7.....~. ...........Rear.....?....~.....~ ........... Depth D-O ~ 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 ..../....O.. .................. Height ............................ Number of Stories ....¢~ .............. 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 ]. Zone or use district in which premises ore situoted .............. : .................................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation? .................................................... 13. Name of Owner of premises.~...}.~.....Address ............................................ Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor.......~.:...,U...~...~ ............... 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. STATE OF NEV~YOJt,~, ~ ) S q ..................................... ~~.~:.....~.~.~-~.~ .............. being duly sworn, deposes .and says that he is the applicant above na~;m~e ~ ti~e~.~.~..~.~.~..~ ................................................................................................ (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 ~ ~orth in the applicatio~ed therewith. _~ Sworn to before me this ~ ~¢~c~ ~,~',~..~;'~-fl /~. ~ ~ ...... ~ .~, day of ..... ~ ~~ 1~;:~..,. ,~.,, or~ ' (~%r~ a~iZa~;)/ Notary Public, .~.~..,..~.~ty ,'-,'~,~ ?~) z~, ~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD; N. Y. Exam,ned ...... Approved ........................................ 19 ........ Permit No ............................... Disapproved a/c (Building ~nspector) Application No. '-~"~'"'Z .......... APPLICATION FOR BUILDING PERMIT [~9 , ~- ~ ¢ Dote ........ :.~..~..-: ~ : ?.~:Z ~....~.. ............................ 19./..~. .... INSTRUCTIONS o. This application must be completrely filled in by typewriter or Jn 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 o detailed description of layout of property must be drown 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 pui'pose 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 a Iterations, or far 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, less, e~, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises .............. .~w.~,4~.lt);.h'..~...~,*- ......... L.~&~ ................................................................................ If opplicont 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: ..I..~.f;.M.:;,;:-...~.kf...:.;..:>..~!..: ~k~t No: /...~..~ ......... Street and Number ~'~"'[' ~:"¥.,' ..................... ~:k6.;'~/>~;d....~. ....... x~xk..: .................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ~. Existing use and occupancy ................... b. ntended use and occupancy ............................................ '.... '...~.~ .............. 3. Nature of work (check which applicable): New Building .................... Addition ....... ~..Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ....... 7..~..f) ........................................... 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 ....... ;,~.:~-,'...r .......... Rear ...... f:..:( ................ Depth .,.~,,,~..:~ .............. Height ............................ Number of Stories ..... .O~....~...~,~. ........................................................................................ Dimensions of some structure with alterations or additions: Front ................................ Rear ................................ Depth ............................... Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front.....j....~,~ ............ Rear ......... /...;~.,,~. ......... Depth ..../.....) .................. Height ............................ Number of Stories ..... ~;:....'r:~ .............. 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are s tuated .............. /r.',~.~.....~,~,,~.~..4 ................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? .................................................... 13. Name of Owner of prem,ses.~,~,L~,...k'L.,.,.,~ ...... Address' ~ ~ ~ ............................................Phone NO Name of Architect ........................................................ Address ............................................ Phone NO ..................... ') .-b~j : ................ Address ............................................ Phone NO ..................... Name of Contractor...,..~-.....j. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate ali 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 STATE OF NEV~,Y,C)~,J~, ~. ) S S COUNTY OF ..~.,.~;~Z,:~:KC~..~),):'...) ',, ~ /~-~- J~ ~ ben du sworn de osesandsasthath ,the ,' t ...................................... ~.,z::.~:..~ ............... ~. ........................ g y , p y e app ~can (Name of in~vidual signing qRplication) 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 [~pli cation are true to the best of his knowledge and belief; and that the work will be performed in the man~.~Et~9~,'cfdFt~',i~r~e application ~d therewith. ~ Sworn to before me this ~ '":" ~ '": '~'; '.}' ~;~'~ ~ri;/~ ~ ~ ~-~ .......... ~...~. dov of ......... ~...'~..'...'~...~;;..'~.....,-~f~91:~.~.,:. ~, ~'' ~oture ot applicon) j