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Home My WebLink About309-zTOWN OF SOUTHOLD BUILDING DEPARTMENT ~['OWN CLERK'S OFFICE SOUTHOLD. N. Y. CERTIFICATE OF OCCUPANCY No ..... ~....9.7.5... Date ............. ..~...n...u~...~..F....~.8.. .......... , 19..61 TH~S CERTIFIES that the building located a.~oW&~'..~ .~..V..?....: Mi~t~i.~.~.?.~. .... Street Map No..~..].l~..d. Block No .... ?..~...*. ....... Lot lX{o.. 5.~..-~....-.~.3. .... conforms £ubstantially to the Application for Building Permit heretofore filed in this office ,~ ~(,~ dated . . ,.l~[~.y ~ .......... 19..5...8.- pursuant to which Building Permit No. 3..o..fZ-- c~ -~ dated ~Ir 9 19...~.~ was issued, and conforms to all of the require- ments of lhe applicable provisions of the law. The occupancy for which this certificate is issued is p~I~r~Ftg Olde l~l~t*¥ I~EIJ.~It~ This certlficate is issued to ........... l~..Ob...~...~.~ .l~io~]&n, ~ (owner, lessee or tenant) of the aforesaid building. Building Inspector FO~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? 309, z Date ................. ]1~"'"'9 ...................19.~8... Permission is hereby granted to: Ya~.~g -~.ve~,.~ .... ~',.Z., .................. to ...... ~te.. a~..e~L~ti~.. ~,~eill~...to...~S:,~. lo~a~o~ ............................................... ot prem,ses, locoted ot -/aO~ -I~I1~ .... ~'J-'~' '~'!Y"~'~ ~" 1~1~'"~ '~"'~" .-~i1~. ~.Ot~lJA~ ................. ................ ! ................ ]~sxml,~...lve ....... M,~.~Aek.~ .... .~I,.Y., .......................................................... pursuant t~ application dated ......................... ,~...~. ........................ 19.~'~.., and approved by the Building l~qspector Fee $ · --~O'gOO--' -'][~[~[ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ....... I! · ....... Approved ........................................ 19 ........ Permit No. Disapproved a/c ...~.:.~'~/~'~'~'~~~"~' ~'~' ................ .............. .... Application No ...... .~....?....~. .......... APPLICATION FOR BUILDING PERMIT 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 o detailed description of layout of property must be drawn on the diagram which is part of this location. c. The work coYered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue o 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. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant)t/ State whether applicant is owner, lessee, agent, architect, engineer~ctrician, plumber or builder. If Aapplicant s a corporate, signature of duly f~thorized officer. , ( ' m ondt,t,eofco orat o-)"' ......... 1. Location of land on which proposed work will be done. Map No: ............. .?../~...~.. ................... Lot No: ~..-../..'...~.~..'...~...'~ Street and Number .......... ....~..~ ....... ~.; ....... ~(.~ .......................................... Municipality 2. State existing use and occupancy of pr,emises and~tended use and occupancy of proposed construction: O Existing use and occupancy .......................... ~.....~ ........................................................................ 3. Nature of work (check which applicable): New Building ...... ~.. ....... Addition ................ -..Alteration Repair ............... ~;.Removal .................... Demolition .................... ~Other Work (Describe) 4. Estimated Cost.....~.....~..~..~.~....~..~.. ............................... Fee .~/..~..~..u. ............................................................................ (to be paid on filing this application) §. 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, Jf any: Front ............................ Rear ............................ Depth ............................ 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 ....... ~'1~..~ ............. Rear ......... ..~...~...~ .......... Depth Height ............................ Number of Stories ............ /. ............... 9. Size of lot: Front ....... ./...6~...~..L .......... Rear ....... /...~/.~..../. ......... Depth 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 renulation? ...... ,~...~.. ...................... : ........... 13. Name of Owner of p re~is~s.~,~.....~. Add ress .~..~....~...:~i.~.t i~n~ee '~'~. '~. Name of Arch tect ..~ ..~......~......~ .............. Address .~~ ~'/,~.~ Phone NO ..~....?' Jl~?d~ · ame f "ontr t ~ ~'~'~"'~ ~/~'~ ';~,.'"~'['~r'_""~'-:,'"'~:'~/,~ ..... ~)~.-~_,~ r~ o ~, ac or...~ ......................... ~..~ ............... Address · .~.~'~..~...~...(~/m...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. % I STATE YORK, ) S S L OF NEW COU,.NTY OF .,,~'~..~-'./',~. ........ ) ' -\ ~..~. ~¥' i~ ........... being duly swom, deposes and says that he is the applicant (./ --'Z/_ _ above named. He is the....~..~.....~...(....~~.c'~.......~......~.: .............................. (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 set forth in the ~pplication filed th.~rewJth. Sworn to before me this ......... .~...~r~,.... day of ...... ~...~...%......;,,j~/ ....1 .9-~......-~...... t~/~I~l~SIIjt~[~re/l~' ~of applicant) . /~/~/~ ' . ~:~ '~"~z.~c~.........../-,~=z~:~'~ .......... County I~IOTARY PUBLIC, State o! New Notary Public, No. 52-2718250, Suffolk County