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Home My WebLink About921-zFORi~ NO. 4 TOWN OF SOUTHOt. D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z 6~2 Date JU~,e ................................................................................ , 19 THIS CERTIFIES that the building located at ~.g .~..:1~:~,...~.~.~0,~ .......... Street Map No ........... .*..?.?. ....... Block No ...... ,e¢.~,?. ............ Lot No ........................ .?,~.? ................................... conforms substantially to the Application for Building Permit heretofore filed in th~s office dated ....................... .~...o.?.~...m?...e.~....3..0......, 19...~.?., pursuant to which Bu,lding Perm,t No ...,.~....~..1. .......... dated ...................... ..~...e.~.e..[....2. ....... 19.5..~..., was issued, and conforms to all of the requirements of the applicable prowsions of the law. The occupancy for which th~s certificate is issued is ................ gRIVATE O-NE FAMILY SUMMEI~ lh,s ce~t,ficate is issued to ................. .~..?..~..~...~..~......~.~..~...~.~...~.e...~. ........................................................ (owner, lessee or tenant) of the aforesaid budding ~OI~d~ 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 921, Z Date ..................Ilh~ ..... ~ ........ 19.:~... Permission is hereby granted to: ~t,~.l~..c....e~fa...~..c.....~...z~..~...~.~ ................... ...G~em~T~oz~ ,,....~,.! .......................................... to .. ~.~. ~..~. £~U,~...~l~mlllng ............................................................................................... at premises located at .~rlr,..lR, O,~R,,..~/l~.llor.tlz.l~o~ ....................................................................... ................................................. ~Id~,--.t~-I~ ................................................................................ pursuant to application dated .............................. ~l'....;~ .......... 19.~;1.., and approved by the Butlding Inspector Building Inspector 1~0~.~ NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ,, ', Approved ........................................ 19 ........ Permit No ............................... Disapproved o/¢ ........................ (B r) APPLICATION FOR B~ILDING PERMIT NOVF-~BER 30, Dote ............................................................ ..... 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, reloNonship 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 port 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 dr Jn part for any pui'pose 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~'c~m---~ion, as herein described. The applicant agrees to comply with all applicable laws, ordi~~ ' ......... ATTORNEy AT L/,VF (Address of applicant) ~43 MAiN STREET GREENPORT NEW YOl~g, State whether opplicont is owner, lessee, ogent, architect, eng neet, gerrerm contractor, electrician, plumber or builder. Name of owner of premises HET,~JT....H~_..S..S.. ..................... . ................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number ................................................ SO.U.~HI;IT~Ti...(Jt~SI:Lk.I~IOItAI~TJ~ .............................................. Municipality 12. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy .......... .V...~.g...J~.,..~. ............................................................................................................ b. Intended use and occupancy....~..~...~..~.~.A..?..~.....O-...I~...-...~-..J~...~.~...Y.-...S.~.R-...~.S.-.~..D.~'~-''C''~'; ................................... 3. Nature of work (check which applicable): New Building ....... ¥' .......... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost.....3.(~t0.0 ....... ~e, ll..D4-31~' ............... Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........3, ..................... 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 .............. 2JB.! ....... Rear. ........... 2~.t ......... Depth ...24,! .................. Height ........... l~. ............ Number of Stories ............3. .............. 9. Size of lot: Front .......... 5.0.! ........... Rear ...... 5.0. ................. Depth ....125..~. ........ : ..... 10. Date of Purchase ...~E~..~1.3.~...],9.~.{~ ....................... Name of Former Owner .W~,...l~T.(~H}~D~i'I)...e.t,..~rzo ........ 11. Zone or use district in which premises are situoted....B.~rS~IN~S~ .......................................... 12. Does proposed construction violate any zoning law, ordinance or regulation.;) .... ~.0 ........................................... 13. Name of Owner of premises}~.I~Tbl'~..HAS.~(] ...... ~ ...... Address ~z.!~I~.I~,~D.R.T......~I'...y, ....... Phone NO. Name of Architect......~.Q~)'~ ........................................ Address ............................................ Phone NO ..................... Name of Contractor..~.L....]~...T....~.S...~ ....................... Address ............... .It ........................... Phone NO ............. !! ...... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil 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. The premises are on a private road known as Carole Road running south from the Nain North Road opposite the Southold Town Beach. The building to be erected (shell) will be identical ~ith others on the road as to size and specification~ and on same line. STATE OF NEV~.YQP~I~,... ) S S. COUNTY OF .~.V.-~:,~'.~.~.~. .......... ) ........................... .$. ~ ~1'~.~.... ~.. ~...~..Q~ .1~.[ ~. ........................... being (Name of individual signing application) above named. He s the AGENT (Contractor, agent, corpar~;z~ officer, etc.) of said owner or owners, and is duly authorized to perform or have pe~ecl~the said work aj~ckt~ m~,ke and file this application; that all statements contained in this application are frue ~r~the best of his ~n~ledg~and belief; and that the work will be perfOrmed in the ~nner set fo~h in the ap~ filed therewith.{ Sworn to before me this Notaw Public, '~'~~"~¢~o 52-0344~63 Com~ion Co duty sworn, deposes ond soys thor he is the applicant /