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Home My WebLink About900-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y. CERTIFICATE OF OCCUPANCY No ..... ~ .~7~. Date .... ~U~y'. R~ ..... 19.60. THIS CERTIFIES that the building located at ~/~ P.i.ll~, .,'1~e.,~O~(l¥ C~l~e~-~lo~ree~ Map No. 'N~B~ ' Block No. ~ .. Lot No. ~12"& ~ Of ~,I ....... conforms su~'~ntially to the Application for Building Permit heretofore filed in this office dated ............ NoV.?~...1.6.., 19~9 . pursuant to which Building Permit No... .Z...~..0...0 ..... -lated .............. N~.~..I~ .~6.. , 1959 , was issued, and conforms to all of the requirements of the apphcable provisions of the law. The occupancy for which this certificate is issued is .............................................. ~&~g "O~" ~¥"~r~'~'~ ............. This certificate is issued to .......... ~]~r.t ~X~a~ ~e~ ............................................. (owner, lessee or tenant) of the aforesaid building. Building Inspector FORM NO, 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 900 Z Date ....................... ]~lgt~.~.....~. .......... 19~.... Permission is hereby granted to: l~1~ert. 11o..0,.~- ....................................................... ... ~melmetm.....ll.~. ............................................ to .J~a;LJ~..~J~.J~u;~Lt,.~.s:o~,.lt~..J~;zJ~t~ .,J~1~,~,~ ....................................................................... at premises located at .l~%.~..~.~..~..]~l~t..t~l,...Jlll,lLJ~.~'l~ ....................................................... ..................................... ~J~...'/~m~...~ ,....~.~.. ~..e..,.... ~:7...,. ......................................................... pursuant to application dated ....................... JJgli~llll~llt.....~,~ ................. 1c~....., and approved by the Building Inspector Fee :J.~..~ ............... FORM Mo, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ~ .~~~., 1~..~.. Approved ~../~...., 19~..~...Permit No...~,~..~..~.. ........... Disapproved a/c ApPlication No ..... . .,~.C~..C,~. ............... APPLiCATiON FOR BUILDING PERMIT INSTRUCTIONS a. This application must be cbmpletely filled in by typewriter or in ink and submitt&d in duplicate t6 the Building inspector. b. Plot plan showing location of lot and of buildings 6n premises, relationship to adjoining premises or public streets or areas, and giving a detailed descripti6n of la,out of property must be drown on the diagram which is part of this location. c. The work covered by this application may iq0f 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 a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner Name of owner of premises...~oZ~r.t..0~a~ If applicant is a ear, rate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. M~ No: ...~.~..~.:'.~ ................. Lot No:,.[~..~..~ Street and Number ...~/.~.....~...T.T~.~...~9~.~.....~gg~,..~.~.: ............................... ~ ...................................... Municipali~ 2. State existing u~ o~ ~cy of ~emises a~ intoned use and ~cupancy of pr~osed construction: a. Existing use and ~cupan~ ..... ~.?.~.~ ........................................................................................................... b. Intended use and occupancy ............ ~.?~g..~..F~ ............................................................................. 3. Nature of work (check which applicable): New Building .................... Addition....XX[ ......... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe} .................... 4. Estimated Cost .~..~.0.~.0..~ ........... ~ ................... ; ........... Fee ...~.....0..0.[: ............................................................................. (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 ....... .2..6. ..................... Height ............................ Number of Stories .9.p,.~...&...~. ........... i .............................................................. : .................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ....... ].2 ................. Rear ............ ].2. ........... Depth .....~f~ ................... Height .......................... '.. Number of Stories......o..n..e. ..................... 9. Size of lot: Front ..... C).Q ................... Rear ............. .9.91 .......... Depth ....~.(~. .................. 10. Date of Purchase ......... ~..'/.. ....................................... Name of Former Owner ....~.~.n..k..l..e.~ ....................................... 11. Zone or use district in which premises are situated ....... .~!.A.)! ........................................................................................ 12. Does proposeJJ constructiomviolate any zoning law, ordinance or regulation? ................. ilo ................................... 13. Name af Owner of premises.Robe~t,..O=sm ................. Address ....... C~t4~la4~D~ ................ Phone NO ..................... Name of Architect ......................................... : .......... Address .......................................... Phone NO ..................... Nome of Contractor ....A.:.~.e..1.,1..1.~....&....B. ......................... Address ......... ..M~.....t..~..i..t..Rg..~.: ............. 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. STATE OF NEW YORK ) S.S. ~OUNTY OF ...... .~.~..~.9.:~-~ ...... ) Robert Oram ......................................................................... . .......... : ............. being ~uly sworn, deposes and says that he is the applicant (Name of individual signing application) ' above named. He is the .................. ~e.~. ............................................................................................................................ (Contractor, agent, corporater officeG 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 }rue 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 Notary Public, State of New York No. 52-0344963, Suffolk ~un~,~/ ........................ day of ............... .e.....?.~ ............... lg...?.X..... ~ - No, tory Pubhc~ .fl~.~,,~.....~. C~,,,ty 7' -;S,~nna~;i~'of-x '--.-"-applicant) CONSTRUCTION CO., INC HIGHWAY CO--ACK, N. Y. 11725 ZEf-T ¥