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Home My WebLink About385-zFOI~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY ~urel confol~s subst8ntially to the Application for Building Permit heretofore filed in this office dated ............ ~.~ %5, 19.5~. pursuant to which Building Permit No..~..3B5 ........ ~atefl .............. ff~. %5. ...... , 19..58, w.as issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this ce~icate is issued is ~A~ O~ F~Y D~LL~G This certificate ~s issued to ............ Gildo ~ti, 0~.9~ .......................... (o~ner, lessee or tenant) of the aforesaid buildinE. Building InspectOr 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 385 z Date ................ Permission 15 hereby granted to: Gtldo .... Xm~e~&.t~ ......................................... ......... 8,,ga.i~oed.. ~z ................................ to ...... B~_ ~t~l .am-.a&di-tlen..~r~..m_ak~..a~ .a-t~e~at~en. an-.au~..e~t~t~ng..41welltng ct prem,ses Iocated at .-B~,.-.~..]ga~-~e.~ ]l~o~nl~ ~4r-.~r~ ................................ ..................................... Z~a.t~ .17..&..~&..Ls~r~l .~a~k ......................................................... ................................................................... ~umel~ .... N,.Y-, ................................................. pursuqnt to apphcat~on dated .............................. J~i]~' -'~ ....... ~9.~., and approved by the Budding Inspector Fee $.~0~ ............. Building Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined....~..L..~.. ........... 19......0~.. ~-- Approved....'/..'../... ............ ~..'. ................. ,9.:.:....Permit No....~..?....~....!. ..... Disapproved a/c ~ .......... ............................................... (Building Inspector) Application No ............................. APPLICATION FOR BUILDING PERMIT pt CL._0, lC- o e ............. ~ .~...-....'Y~. ............................. 19 ............ INSTRUCTIONS o. 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 /V~DE 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 alterations, or for,~moval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ord i~/.~/~~~l~re~l~lations. _ -"u'~'-'~'-""' (Sign~';:'~'~[-c~'~ame, 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 prem,ses...~.l. ................... J.'"~' .l ....... ~'~" ............................................................................................. If applicant is a corporate, signature of duly authorized officer· ....... (Name and title of corporate officer) ................ ~ /'t ,~ , .~ , ............................... ! .......................................... c Z MuniciPality ~ ....... 2. State existing use and occupancy of premises/ ..and int~d use and occupancy of proposed construction: a. Existing use and occupancy ...............~..I,.~..I.~...~......1...~...~U.~....I.~..~...5. ....... ' ..................................................... b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition ..... ~ ....... Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... Cost ~. 0 o ~- 4. Estimated .......................................................... Fee ..~ ...................................................................................... (to be paid on filing this application) ! §. If dwelling, number of dwelling units .............................. Number of dweUino units on eoch floor.....~.. .................... If oaro~e, number o{ cots ...................................... ~: ......................................................................... .................... 6. If business, commercial or mixed occuponcy, spoci~ noturo ~nd extent o~ e~ch type of u~ ............................. 7. D mens ohs of ex st ng structures, f any: Front .......... ~-~.....~.~.. Rear ....... ~ ................. Depth ....~ ................ Height ........... ~.~.:......Number of Stories ..... ~ ............. , ~ ......... ~ ............. ..~,~ ......... ~ ................ ~r o* ~o~,. ........ ~.. ..................... 8. Dimension, of entire new con*truction: Front ...... :~ R~r ........... t..~ .......... D~pth .....{.~ .............. Hoi~ht ............................ ~umbe~ of Storio~ ....... ~ ~" ~. s~o o~ ~o~: ~o~ ............ ~ ...... ~ ........ ~.~ ......... ~, .~.~..--'~ ............. ,0. .......... ........... o, ....... ...................... ~. zo~o or ~ ~,~ ~ ~, ~ro~. or~ *,~ ......... ~.....1~.~~ .......................................... ]2. Do0s proposed con*truct on'v o oto ony x~ n~ Iow, ord nonco or reoulotion? ............... ~Q. ............... ~omo o{ Architect ........................................................ Address ............................................ Phono MO ..................... Controctor .................................................... Address ............................................ ~hone ~O ..................... 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. STATE OF NEW~OP-~ /~,. ) S S COUNTY OF ...~%e,,~,'~,J~.~..) ' ............................... being duly sworn, deposes and says that he is the applicant (Name of individual signing applicatibn) 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/ar/d to make and file this application; that all statements contained ir~his~oplication are true to the J~s.t ~of~_i.s~ ~howledge and belief; and that the work will be perf~r, med in the manh~,,~Lin the application f,~l'~VtJ~16~,rwitl~./ Sworn to before me this ~ \ n ~ ~.~i,~'~,, ,~_'~'aYO.~ ~ ~ ,...~ ,,.4. _v.. "' ~,,.-. ~;~,~_i~_~"'~- ~//"/////,~ ......... /....%,~....~,~.. day of .......... ,~.~ ........... '1'~!.~.~._~ ~lt~ ,4Si~Crl'~/-,a~laf~,~bolia6nt) No,a,, Pub,e, ;. ,. - '/