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Home My WebLink About268-zFORI~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y. CERTIFICATE OF OCCUPANCY No.. .yl! ...... Date ...... THIS CERTIFIES that the building located a, Rey..do.n. D~..i.~..?.~.....8...O~.....~h. ?.!.d.. .... Street Map N~ydon..~lo~ck No ..... .*..*..*.Lot No ...... i11.,. ~.2, $;~ ...................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ .A...p..r..ii 8 19.5.8 pursuant to which Building Permit N~ 268 ~ated ............. ,....A.p.~.~.~.....~.. ....... 19.58, was issued, and conforms to ali of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is PRl%'ATE ON]~ FAMILY II~ELLIN. G This certiflcaie is issued to .. ~ a L!~n ~1~.. ~.~ .................. (owner, lessee or tenant) of the aforesaid building. Building Inspector TOWN OF ~OUTHOLD BUILDING D ,E?ARTMENT 'rowN C L RK'S O ZCE SOUT~OLD, ~. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Perrmss~on ~s hereby §ranted to: pursu~nt~to spphcohon dated ................ ~t~... 8 ......................... 1~...., ond ~pproved by the Budding !nspector FORM NO. 1 �.�o TOWN OF SOUTHOLD " ' v S� BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined......C` .............. ...19.��r Application No. .... ... ............ Approved..................1.t...................19... .....Permit No. y(0 .............................. Disapproved a/c ................... _ ,_...- .................. ............:,... ...... ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date......................... .................... ........19..5...`r .. 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. 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) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................................................................................................................................................................. Name of owner of premises...... .......i.. ....�.0. `ti....... ...... .+............................................................ If applicant is a corporate, signature of duly authorized officer. ................................................................................................ (Name and title of corporate officer) (�Q 1. Location of land on which proposed work will I= done. Map No: te .. .. Lot Noo: . 13/3 Street and Number .....! $ '...... ........................... .. .......... ..... . .....` .......P�..-!`. l f Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: vl - a. Existing use and occupancy......................... ... a. ...../ .......................................................................... b. Intended use and occupancy.....................................................'.....8.................................................................. � 3. Nature of *«nk (check which applicable): New Building.....k .—,...Addition .......—..Alteration .................... Repair ..........Rernnvo| ....................Demolition....................Other Work (Deschbe) �� ..—.,..... 4. Estimated Cost.—�� O�(��(�,..��.........—..—.Fee ��<�.� ',..—.._—.� ~ ' — --� ....,~................,.. (to bepaid onfiling this application) 5. |fdwelling, number nfdwelling units..............0_.Y`.� Number ofdwelling units uneach floor............................ Ifgarage, number of cars...........................................................—^^^^^^^~^^^—~^^^^^^^~^^—`^^^`. 0 If business, commercial or mixed occupancy, specify nature and extent ofeach type ofuse.............................. 7. Dimensions nfexisting structures, if any: Front............................ Rear ............................ Depth ............................ Height ..............Nurnber of Stories ...........—.........—..........^—.,~.~...^....^.... Dimensions of some structure with alterations or additions: Fnont ....—....~—~.. Reor ..,..........—.. Depth .............................. Height ..............................Number ufStories ................................ 8. Dimensions of entire new construction: Front .....A,�—....... Rear ... .�~....,.. Depth ..�-�'��.��` �^ Height ............................ Number nfStories .........^.,.. 9. Size of lot: Front .......9.J�... Rear .... ...... Depth ..P..' 67. � lO. Dote of Purchase ..... �,��^�...........,....Name of Former Owner '& ` U ll. Zone or use district in which premises one situated....��........ ................................................ 12. Does proposed construction violate any i low,� ordinance orregulation? ... ...,,,, i� l3. Name of {}wner nf prennises.��f��....�,��./\J6ress .��:.��v�~~,.^�!��-..,-Ph -- ��' PZ«G.:.A!.A.<;�. Nome ufArchitect —.. .—/\66ress .—....... ........Phnne NO. .................... Name ofContractor... . ..��x��ress . ��^^..,.Phnne �4/`J�J��°J��^. 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 orcorner lot. ^^ 10 � / � , �TkL-tT STATE OF ) M� 53 COUNTY �� N ................. ..........................—........6eing duly sworn, deposes and says that he is the applicant (Name nfindividual signing application) above named. Hoisthe................................................ �� . � � � �. —o~1...f . ..- [bntnoctoogen��coq`pn.oeof..c.e�.etc.) — .... �.......�.�........ of said owner or owners, and is duly authorizedtal T ion are true to the best of his knowledge and belief; hperformed the said work and to make and file