The URL can be used to link to this page

Home My WebLink About335-zFOR~! NO. ~l TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ........ ~...~.:~. ...... Date .................... g'm'~Z~...23 ........... , 19.$2.. THIS CERTIFIES that the building located at ...~ .~.....~..O.~,.~....~..t%r.~...~.~...~....~:%,...~ ........ Street Three Waters Lane, orien~ ' O~ien~:'l~Y'~'e'~Sgm ~..~...t~.D...~ot No ......... 3. ......................................................... Map ~o ...................... ~iocK ~o .......... conforms substantially to the Applicahon for Building Permit heretofore filed in this office dated ............. ...1~....~....~?. ....................................... 19...~..$.. pursuant to which Build,ng Permit No .......... ~...~.~6 dated ..1~¥..~ ................................... , 19....E~ was issued, and conforms to all of the requirements of the apphcable provisions of the law. The occupancy for which this certificate is ~ssued ~s .......... (owner, lessee or tenant) of the aforesaid building. Building Inspector FORM NO. 2 TOWN OF SOUTHOLD 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.o 335 Z Permission is hereby gronted to' Wal%er Dote ......................... ~--'~t .......... 19..~8.. ........... J~r.~eh~ -.T~k .............................. ........................ J~ch~,. I~.~, ~ ..~,~.. ....... ot prem,~es located at ..... ~t-.~-.~-..~4~-~.~ .{ "~erxt 'B~-'~"-S~&-) .................... ............................................ ~'~ ..... ~.e~..i~t,e~-~...~ .............................................................. ............................................................. 0r&e~ ..... l~ ¥ .......................................................... pursuant'to application dated ........................J~. ~ ............... 19 .~'J~., and approved by the Building Inspector Fee $10.,,O.Q.....psJ, d Building Inspector ~ FO~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Examined .......................... [,..,,! ....... ] 9 ........ Approved ........................................ ]9 ........ Perm t No ............................... Application No. ~ '~ ;-' Disapproved a/c .................. ; .......... ; ..................................................... ., ................................ ~ ~ ....... ;..m~... ..... T... ...... Z:~:~ ............. (Building InsPector) / 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 Inspec~-or. ~ ~ 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 shah 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 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) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................ ~1...g.~t,~.~.~. ..................................................................................................................... Name of owner of premises.....T~.~.O...]-l'...O..~......~'...ODe....z~..~.e..~l.-t...T.?.~.q ........................................................................................... If a~~ of duly authorized of ricer- ...............~'~ .R~.ee~l,dant, ............... 7~--~-I~l'~r~d title of corporate officer) 1. Location of land on which prop~osed work will be done. Map No: ............. 2~ ....................... Lot No: ...~. ............... Street and Number~~...~.~.t'...~..~.~....~.~..~.e~..'~..~'.'...~...~--.-~..--~....-~- '. .ql~..-.s....~.&...~.~....' .................................... Municipality 2. State existing use and occupancy of premises and intended use-and occupancy of proposed construction: a.. Existing use and occupancy ..................................................................................................................................... b. Intended use and occupancy ............... One-F~..~r~vate .................................................................................................. res:Lde.n.9,e 3. Nature of work (check which applicable): New Building ....... .~ .......... Addition ....................Alteration .................... Repair ....................Removal ................... ~Demolition ....................Other Work (Describe) .................... 4. Estimated Cost....~.2.,~..0~...e..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 ............................ Rear..,~ ..................... , Depth ............................ Height ............................Number of Stories ............................................................................................................. Dimensions of some structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ ,3~.I. .............. Rear ......... ~:)?. ............. Depth ...... 2~.I. ................ Height ........... ],2.I. ........... Number of Stories ...... ~, ................... 9. Size of lot: Front ...~} ................... Rear .......... ~0~, ...... Depth ...;~.?,.}~ ............. ]0. Dote of Purchase ........................................................ Name of Former Owner .,]~l~..~'~nE .................................. ]]. Zone or use district in which premises ore situoted....~[c~l.deI3i3:;i.~. ...................................................................... ]2. Does proposed construction violate any zoning Iow, ordinance or regulation? ..]~¢t .............................................. ]3. Nome of Owner of premises~.O..q~.q;]n~.qqC..~A'.q~.e..~.~.~lKddress ...~,.{t~...~...~..~,~o~hone NO. ~..~.-.~... Name of Architect ........................................................Address ............................................ Phone NO ..................... Name of Controctor..~],~e~..[l~,a..~I~q~ .................. Address ~X"4,CJ3.O..,~i~,~..~e,~-~C~e.Phone NO. ~l'e..~.-.~}~.. PLOT DIAGRAM Locate clearly and distinctly oll buildings, whether existing or proposed, and indicate oll set-bock dimensions from property tines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ) S S. COUNTY ~3F ...][~,%~[ ............ ) ....................................... Jl[~l.~..~ ..................................... being .duly sworn, deposes and says that he is the applicant (Name of indivi'dua! si[jning aPpli~:atiEn) - - · ~ : ' :. · above named. He is the ........ corporat~.~f£:i~v~. ................................................................................................................... (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 application filed therewith. Sworn to before me this ': .-~.k~ M. wo~ -