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Home My WebLink About906-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No .Z...,,~6. .......... Dote ..................... ApI'.:;L1..,.~ ............ , 19..60 THIS CERTIFIES that the building located at .... ~l~...S¢.~.3,]~,~ez,...Ave ................... Street Map NoH[~.~.e.}J.~I, ...... Block No ...... ~ ............Lot No. ~.,~'~f~ ....... conforms substantially to the Apphcation for Building Permit heretofore filed in this office doted ......................... ~gl~ll'~...,?,.~...., 19.~1~i,., pursuant to which Building Permit No..~..~0~ ............ dated ......................... J~o~e~'.,.~,~.. 19.~..., was issued, and conforms to oil of the requirements of the applicable provisions of the Iow. The occupancy for whsch this certificate ~s issued is ................ ............. ~:~:L'~.~,.~...one..~amil~...~w~lling ................................................................................... Tbs certificate is issued to .... ~..~U~T~eJ~ ........... ~..~)~tlrte~) ................................ : ..................... (owner, lessee or tenant} of the aforesaid building. ~ ~ "~Buildirtg InspeC"c'dr"" FORI~ 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? 906 Z Dote ................. ~.~...e.~.~r....~? ................ ~9.S.~ .... Per.mission is hereby granted to: ~.~tia ~m m ~,,.,A~,,..,.~...~,e..,k. .................................... ...... ,tle~..~, ~ ~ ~....~ :.T.... .............................. to . ]Jui.T~..uw..¢~...CaII~LIF.. ~lx.e,-kt~)~ ............................................................................................ at premises located at ,T~o.f~...~.~..,l,~,~. ...... IIl[~.~.~.~l~. ................................................................... ........ ~.~L1~.~.~.~r.. A~.~ ...... ..0.~.~....~.. ~.... ~.:7.-. ...................................................... pursuant to apphcatton dated ..................... 1~.~1~......~ ................. 19.~.~...., and approved by the t3u~lding Inspector Fee $.Z..q...~ .............. I~ORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ....... .~ ,~~/~ 19.~...~'.. Approved ..~..~., ,9...~...Permit No ..... ~...,~...~....~.. ......... Disapproved a/c ----~ ......... ~ ......~. ........................................ ............................ APPLICATION FOR BUILDING PER/~IT INSTRUCTIONS a. This opplication'must be completely filled in by~l~pewriter 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 port 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. Atlantic Homes Const. Co. (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. ................................... ................................................................................................................... Name of owner of premises ......... ~Q..,~.~'3~,g~.~l~ ................................................................................................................. 'If applicant/is a corporat,¢I, signature of duly authorized officer. :. ~'. ........................... Pmea. .... -' (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ...... 'Z. 3J3 ............................... Lot No:.~.~.&...~z~., southerly half of Lot #~ Street and Number ...................................... ~u~ho~,...Sout2~ald ................................................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............. lg, O~e .......................................................................................................... b. Intended use and occupancy ...... PD. ffi..~B.l~i].~'....l~.Pffi...~.Q~..d~.~]-l,~,J~ ....................................................... 3. Nature of work (check which applicable): New Building ..~r ............... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost .~..8..9...Qfi).,.(~g. ....................................... Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units...~T~e. ............... 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 same structure with alterations or additions: Front ................................ Rear ................................ Depth ................................ Height ............................... Number of Stories ................................ 8. Dimensions of entire new construction: Front ............. ~J~ .......... Rear .....~ .................. Depth ............................ Height ...... !.~...~...'. ......... Nu_m, ber of Stories.....~.'~ ...................... 9. Size of lot: Front ............ ~..?.~. ......... Rear ..... .7...~..~...7. ........... Depth ...)~..0..~...~ ........... 10. Date of Purchase ............}~.O..v..~...~k~...~,.9..~..9.. ............. Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ........... ~i'. ...... .~. ...................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... ~.O ............................................. 13. Name of Owner of premises..~p...~.¢.~..~.~ .............. Address .~.~...,P..~Le.~Q~..~.~ ..... Phone NO. t;~..-.~L~5.. Name of Architect .................................................... Address ..n.~..~....z~..§.~...°..n....~..~..a'.~..z..°.r~oln~e'~l~) ..................... Name of Contractor ~b~`f~`t~$.¢.~&~Cn~J~*..~dress~..~...X.~.~.7.~.~..~.D..~.~.t~..~"~h~ NO. A..~.6...-..9.....(~...0... 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. x~-- Io -f STATE OF NEW~YOJ~K~ o~ ) S S ' .............................. (f'~. -~.~"~.~ ...................... being duly sworn, deposes and says that he is the applicant (Name 6f indw~d~'ual si~.'ng a/~licatio~ above named. He is the ....................... ~....'~..~Z..~ ......................................................................................... (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 t,h,.is application are true to the best of his knowledge and belief; and that the work will be performed in the mann~.~etTfcstlllt~lin the application filed therewith. N'ota~ Pubhc, State of New York Sworn to"~ ~:)bef°re,~] ~ ' / ..'---'" -/-///me this ~X,"~v'~ Camm,ss[onr~°' 52-3344~B3,~o~.?~i~¢sSuffolk~[~t3 County30& ~// j -e ~.~~~,~~ ........................ day_of ......... ./ ........................... ,~ ............ . Notary Pub'ic, .~~~ . {"L~,JIy ~'~'/ (Signature of applicant)