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Home My WebLink About303-zFOlh~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, CERTIFICATE OF OCCUPANCY No ...... Z..786. Date ...... ' ~-'41;I,~..21, .. , 19.~0' THIS CEP~TIFII~S that the building located al .Bl~ ~.~en~..~..~....~.tI[..~10~.~ ..... Street Map No. I~ilOt'18 d~rCek No. **~ Lot lng.~ conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ~.y & , 1958. pursuant to which Building Per, mi~, No .... "tated .............. ~ 1. ...... , 1~.~8,, ~as issued, and conforms to ai}~of\the requirements of the apphcable provisions of the law. The occupancy for which this c~'tifiegte is issued is This certificate is issued to ~1~'1~o~o~"~ & C'i~,iI~:i.~ ~111~I1~I;/~ (owner, lessee or tenant) of the aforesaid building. "~ FOTM ~0. g TOWN O~ $O~THOLD 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.° 303. z Perm ~ssion is hereby gronted to: ~l~,m,, ..... ltm,~ir. ............................................ ........ 9~,~9 .... ~...~ .............................. .......... q~,,~..~.~.n.~g~,, .... ~,.z., ................. to ..... ~_.i~ii....~ue~e_~..ho~e ........................................................................................................... at premise~s located at -"~t~'"' ji?ir-~j ................................................................................................... ................................................. ~~e~ ..... ~,'~, ...................................................................... pursuant application dated ................................. &~L'~'Z ..~0- .......... ]9~**., and approved by the Building ~spector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ................. ~ ...... Approved ........................................ 19.,)......Permit Disapproved o/c ..... :. ~.:.~. ...... ::.~2 ........... ~.~:'~.~. ........ ~,..~. ............. ~, ............... ......................... ~..,: ..................... ~;,~-: .......... ~ ......................... ~: ......... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ....... f..~. ,../..~1...(.'.. r~.. ...... :~'. ..................... 19.~L.~..... 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 port 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 hove 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 o corporation) , ~ ,. D. ;~ .., .l;~-~ ,~'~ (~'J /~l/ '(/~lO ,~ . ~~/~ ~' . ............. ........ ......... (Address of applicant) State whethe~pl.icant~,_ is owner, lessee, agent, architect, engineer, general contractor, elec~rican, plumber or builder. ................... ~. ~.~:~ ............................................................................................................................................. Nome of owner or prem ses...~..'.....; ................... ~ ......; ............. ~.4..~ ....................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~ . ,.. /, J. Location of land on which proposed work will be done Mop ..,~.....,~X~, :~,,~;~.::. =,,,mb,r ..... 2. State existing use and occupancy of premieses and intendea usa and occupancy of propo~}d constr~tiOn: a. Existing use and occupancy ....... ~.~ ................................................................................................ =,, ....... ....................... . 3. Nature of work (check which applicable): New BuildingS......... .......... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ....~..,/...,,..f2...~'..~ ...................... Fee ...~.~ ./6' /"--:~ /'' (to be paid on filing this appli~'~i~'n) ........... FEES: / · / 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 ............................ Number of Stories .............................................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth. ....... :: .................... Height .............................. N~mber of Stories ................................ 8. Dimensions of entire new construction: Front ...... /.. ................... Rear Depth Height .............. /.....~...f ..... Number of Stories ............. 9. Size of lot: Front .../..~..~.L..?.~ ........ Rear ....~.~:t.~.?.' .......... Depth ...J.~?.~....~:...:~?' 10. Zone or use district in which premises are situated ................................................................................................ ! 1. Does proposed construction violate any zqning law, ordinance or regulation?: ....... ~...~. .................................. 12. Name of Owner of prem ses~" ~:r ~.~' '~,~lress~. ~' 7-~.' ~/~.!ff.~'~..~.i[~,( ~0· ~/:! ........ .~.~?,~_./.~,,~z'...... . ........... Name of Architect ............................................. ..[. ...... Address ............................................ Phi:~e 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 lij:it, t.--~ive street and block nu,m, bers or d~s~ription according to deed, and show street names and indicate whethert~rjDr~or corner lot. ~P,k~ ~ ~3~ R/~.__~. ~: . STATE OF N~YO~ ~' .~.~ ~ng duly sworn, deposes and soys that he is the applicant (Name of individual 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 Jn the manner set forth in the application filed therewith. Sworn to before me this ....... ~....'..~.... .... day of ....~...~: ....... ~. 19..~...~,.~. (Singature of applicant)