The URL can be used to link to this page

Home My WebLink About935-zFOP~ 1~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT 'I'OWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ..... Z 9G~ .. Date .......... ti .,7~U&:L'~r. I~S.., 19 .61 TH~S CERTIFIES that the building located a~l/'m l~ark..~,, lLagt~tUCk Street Map .N'o. . ..*...*.~.... Block No ....... .*..?...* ..... Lot lXfo. *.*..*. ............................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... D~. ~.r..13.., 19.~.9.. pursuant to w.~ich Building Permit No ..... Z .9.35 dated .......... Dec.e~.e.r 1.~..., 19..5...9..., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is ~ssued is ................. .l~.:~V.~,.~.......O~......r..~..:m.¥ ~....~[~.~ ........................... This certificate is issued to ..S.~..~.k ~.c~..i~;l~.a: ..1~. C...,..,...l~..~.:..D.:..H?.....8.a...r.k..~.~..an., p3ce~,, · (owner, lessee or tenant) of the aforesaid building. Building Inspector FOI~M 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) No. 935 Z Date .......... ~C~.. ~ ................ IC~. ..... Permission is hereby granted to. /~t~me ...~.~...~/.q......~..~.., .~...~i.e..*....~. * ............... ....... ~.e.~....~.....~.. .................................................... ........... b'~t~l~:~.. ~I.,.~., .................................. to ..... ~iZd.. ~ m~it.~. ~. ~..e~i~i~g..d~ ................................................................... at premises located at ..~.~....~,3~;..&X~ .......................................................................................... .............................................. ~.¢~Lt~....~.,~, ..................................................................... pursuant to apphcat~on dated ....................... ~:-e~.~'....~_ ............ 19,~C)..., and approved by the Budding Inspector Fee $~,.or~. ................ Budding Inspector / NO. I Examined Approved TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. 19 ........ Permit No ................................. Application No. Disapproved a/c ....................................................... ............... ............................ APPLICATION FOE BUILDING PERMIT ,te ................. ........ ' INSTRUCTIONS a. 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, end 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 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. AUTo C/ To (Signature of applicant, or nome, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, ,plumber or builder. .................................................................................................... owner of premises...f;~...~.....,.~Z.-. ............ ~..,....~..~iiii~~ii~w~. If applicant is o 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'...../~..i,.~.' Street and Number ...~Z.~,.....~.,~..~ ........... ...~.....~ .~.....c_.~,.....': :......~:..~,..; ........................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended useandoccuponcy ...........................~ '' ": ........................ :..' ..................... ~.....~.,..O?4~<k. ............................... 3. Nature of work (check which applicable): New Building .................... Addition .................. on .................... Repair .............. ,~... Remavai .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ......~....9...O........~--~.. ..................... : ............. 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 ....... ...~....~./....r. ........ 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 ......... ...~....~. .......... Rear ......... ...~....:. .......... Depth ......./'..Z..~ ........... Height .....Z.~...~..../.! ...... Number of Stories ....... ~ ........ 9. Size of lot: Front ........... ~ ...... Rear .......... ~...~.. ..... Depth ....... ../-~.....~.......'~.. .... 10. Date of Purchase ................ ./...~....~'....~...Z ..................... Name~,of~Form~er ........................................................ 11. Zone or use district in which premises are situated .............. ~ ......... .~;.z...-. ................................................................ .... n I ' r r I',on;~ 12. uoes proposea construction violate any zoni ~ aw, orainance o egu at' .... ........................................................ 13. Name of Owner of p rem ses..~,~..~.... Add ress '~...~....~....~...~...-~Z...~..~.F' Phone NO ..................... Name of Architect ........................ ~-~ ........... ~...,..Address .................... Phone NO ..................... Name of Contractor ~]~i...~i....Address ....~~i']i'.iii]iii Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-ba~k dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or comer lot. STATE OF NEW~.YO~I~.~//. ) S S .......................... ~..~....~ ....... being duly sworn, deposes and says that he is the applicant (Name of individual signing applica~~ above named. He is the ................................. ~...z.....:....;.~.~ ...................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have ~rformed the said work and to make and file this application; that all statements contained in this application are t~e 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 __ ................ .................. ~"~'~'-7 ~t~ ~u~, state ~ ~ ~, Nota~ PuN c, ' ~~~ ss~s,,~,~ ,sos su~,~,~ (D a ute of appl cant)