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Home My WebLink About272-zFOI%~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..~/.~ ..... }...~.a...i.D... ~.Q..ad ......................... Street Map No ..... ~ ........... Block No ............ ~ ...... , ~ ..,,~p~lQ,l,¢l,.~ ...~.~.. conforms substantially to the Application for Building Permit heretofore filed in thls office dated ................. ..A.p..I'. ~......'[...0. ............. 19 ~'~., pursuant to which Bu,ldmg Permit No ..~..,,~7~, .............. , dated ....... .A~.:[ .I ..1.Q ........... 19.~. .... was issued, and conforms to oil of the requirements of the applicable provisions of the law The occupancy for which th~s certificate is issued ~s ............ ............................ !! ti · ~ ....... ~t~.~.~rxe ~ ~...b~it~ i~ ................................................................ Th~s certificate is issued to ..~fJI'~ ....~ .... ~.'k)I'/~.fS .............. (owner, lessee or tenant) of the aforesaid budding Building Inspector FOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ..~ .'t~!-~- .... Date ............ ~U. Xy .X1¥..t9~... 19 ........ THIS CERTIFIES that the building located at~./~.....bf~,:i,~ .~O&d ......................... Street Map No ... ~.X~X.'f~ .............. Block No .... X~'i.]C ...... , ~;~, ~ou~%hold.~. conforms substantially to the Apphcation for Budding Permit heretofore filed in th~s office dated .......................... O{3i:;~;"~ ...... 19~..., pursuant to which Budding Permit No '"~'"~/oR ............. , dated ................... l~.ove~abeZ, ..1. ....... 19~., was ~ssued, and conforms to all of the requirements of the apphcabte prov,s~ons of the law. The occupancy for which th~s cert~f,cate is ~ssued Is ............ ...................... ~B~ B~sl-ne~s. b'~.Id-~g ...................................................................... Th,s certff,cate is issued to "~I~"~'," MO~'~&~'~j'i~'~'~";';'~'~;~;~;~;d ................................................ of the aforesaid building ' Building Inspector f FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. E /KT / xamined .......... ~ ............... 19......¢. ,r -- Approved ........................................ 19 ........ Permit Disapproved a/c ...... ~~:., ............ ~~....~.__.~_ ............ ........... (Building Inspector) Application No ........j.....~...~.... APPLICATION FOR BUILDING PERMIT Oct. 29 I~67 Date ...................................... 19 ............ 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 f(~r 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) Southold, N. Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electricon, plumber or builder. Mary Sweeney Morris Name of owner of premises ..................................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Location of land on which proposed work will be done. Map No. ~ Block Street and Number M ain Road Southold, N Y. 2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction: a. Existing use and occupancy ............... S,ho.w...znoom-,~l.n_d...s.t,o.z~ge ................................................................ b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition ....................Alterahon ............. :;.... Repair ....................Removal .................... Demolition ......; .............Other Work (Describe) .................... 4. Estimated Cost .,..~,.~..0...0..*..0.,0. ...................................... Fee '~'~' (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..~.~...°.~.~e. ............. 7. Dimensions oflexisting structures, if any: Front ............................ Rear ............................ Depth ............................ j~ o~e Height ............................ Number of Stories ..... ~ .................................. ~..~.i.:.w~.l.;. ................. a.~.~ ........................... _ ~ ~u ~og ~ ~U'2 ~ Dimensions of some structure with alterations or additions: ~ront ..;: ............................ Kear ................................ 50~ <o ~' .... O~e Depth .......... ;. .................. Height .............................. NumDer of Stories ................................ 8. Dimensio~ of entire new construction: Front ............................ Rear ~01 /~01 He~ght~Z ........................ Number of Stor'es ............................ ~5~ ~5~ ~00~ + 9. Size of lot: Front ............................ Rear ............................ De~th ............................ 10. Zone or use district in which premises are situated ...... ~. ................................................................................... ~O 11. Does proposed constructi~ violate any zoning law, ordinance or regulation? .................................................... · ~ 8wee~ev Mo~n~ ~o~o~ ..... 12. Name of Owner of premises ............................ ~. .......... ~res~ ............................................mane ~u ..................... Name of Architect ...................................................... Address ..... B~O'~ .................... Phone N~.gD. ......... Name of Contractor .................................................... Address ............................................ Phone NO ..................... PLOT DIAGRAM Locote clearly ond distinctly oil buildings, whether existing or proposed, ond indicote oll set-bock dimensions from property lines. Give street ond block numbers or description occording to deed, and show street homes ond indicote whether interior or corner lot. Shaded area is 20'~0t extension. , cou~ o[~.....) s s... ................................................................................................ be[n~ duly sworn, deposos ond soys th~ he is the oppllcont (~om~ of individuol sionin~ opplicotion) ~bove nome& Ho is me .......................................................................................................................................................... (Controctor, o~ent, cor~rote officer, etc.) of s~id owner or ownors, ond is duly outhorixed to perform or hove p~rformed the soid ~ ond to moke ond file this opplicotion~ that oil stotements contoined in this ~pplicotion ore ~rue to the bost o~g knowled~o ond belie{; ~nd th*t the work will be performed in tho monner ~t forth in the oppHcotion filod thorowith. Sworn to before me this Public, State of New YoI~ Residing in Suffolk County (Singature of applicant) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUT. OLD, N. Y. Approved ........................................ I9 ........ Permit No .............................. Application No ..... .~,~....~.......~..'i ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ........................ ~.....J....~..... ] 9...~...'.J~..... ~,~ INSTRUCTIONS applicotiP~ must be completely filled in by typewriter or in ink and submitted in duplicate to the Building This Inspector.~.., b. Plot plan shaw'lng location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a de',ailed description of layout of property must be drawn on the diagram which is part of this location. c. The work covered l~y 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 issuanoe 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. nd regulations. The applicant agrees to comply with oil applicable Jaws, ord ina~~ ~~ (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, ~r, general contractor, electrician, plumber or builder. Name of owner of premises ...... i~...~...~......~....~......~~ ......................................................... If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) 1. Location of land on which proposed work wiJI be done. Map No: ............................................~ot No: .................... Street and Number .....~.~. ........~ ........................... ,. ....... :...::..;:J. ...... ~ ........................ ~ ............ ~'tunic~pa,t~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy ...................... ~ ................... ~ ......................................................... b. Intended use and occupancy ................... ~.......~. ..................................................................... 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ~ Repair .................. Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ...... ~ .................................................... 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 ............................ Rear ............................ Depth ............................ Height ............................ Number of Stories ............................................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Nym. ber of Stories ................................ 8. Dimensions of entire new construction: Front .......... ~.:..-nm''~ ......... Rear ........ ./..'~.. ............ Depth ...?...?....: ............... Height ............................ Number of Stories ....~....:...' .............. 9. Size of lot: Front .......... ..'(-~..~..~.....~.. Rear .......... .,~'.L..e..~....~... Depth ....... ~...~....O....~.--... 10. Date of Purchase ..................... ~: ........................... Name of Former Owner ........................................................ 1]. Zone or use district in which premises are situated ................................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? .................................................... 13. Name of Owner of premises.~J...~.~xfl,...~.Address ...... ~..~.. ............ Phone NO ..................... Name of Architect ...........~'~.~...~ ........................ Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly oil 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~YO~.K, I, ) S S COUNTY OF ...~ ....... ) ' .............................. ~...-..~.....~........~.:....~t~....~ .......... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) ~_ . ~ / 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 ~ ~st of his knowledge and belief; and that the work will be performed in the ~nne~ ~ in the applicati~le~ the~with.~, _~ ~ Sworn to before me this · -, ~ .~ -~ ~ --~lf r ........ L~..~.~.. day of ....... ~....~.~,~.~: ~ ~~ ~ca~~ rTM ' Nota~ PuN,c, ~(~...~:Co;n~~''~ ~:~ ~ r,~ ~ 'J