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Home My WebLink About937-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z 6.56 Date Jtlne 15 GO THIS CERTIFIES that the building located at Map No. ~e* Block No. *** Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated December 14 19.5...9...., pursuant to which Building Permit No. ~ 937 dated December 14 ~n 59 ...................................................... ,7 ........ , was issued, ond conforms to a~l of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ................ '~I~AT~ ON~ FAMILY DWeLLiNG This certificate is issued to .....~.~.~[~,~..,~.~g~.~.~,...9...~.~. ........................................................... (owne. r, lessee or tenant) of the aforesaid building. Building Inspector FO~M ~o. 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 937, Z Permission is hereby granted to' .............. ~ld,....~,X, ............................... to ..~.~.~...~.~..~.~..~..~..~..~.~;.!~g ..................................................................... at prem,ses located at .tJ/~....J~I~..~Z'.I~Dx'..~,~ ....................................................................... .............................................. ~.¢V..~.!..~ .... ~.,~., .................................................................................. pursuant to application dated ...................... D$~-~.~,~e~'....~ ................. 1.~9. ..... , and approved by the Building inspector Fee ~.;...0~.. ................. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTJ~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved .~,~.(.~4~¢~?,.,~..~ 19.,¥?'.~//Permit No. Disapproved a/c ............ 7..~.. ......... ~~ ..... Application No.....~..(..~ ............... APPLICATION FOR BUILDING PERMIT Do,e ............. ....... .............. , 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, 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 be.fore 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 ava.liable for inspe.ction throughout the progress of the work. e. No building shah 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 oil applicable laws, ordinances and regulations. ....... Lb...r. ............................ (Signature of applicant, or name, if o corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate, officer) 1. Location of land on wh, ich,,,/,/~ ~., ~/ ~ /~- . ,J~ ~pr°p°sed work will be done. Map No: ..... ...'~........~.~.......~'. ......... 'Lot No:./..~.:..~ ....... Street and Number ..~/....'~.......~.....~.?.~..~.....~.~T;..?...~..%?..~...: .................................................. Municipality 2. State existing use and occupancy of prj~nises on, intended use and occupancy of proposed construction: o. Existing use and occupancy ....... t~.~% ....................................................................................... b. Intended use and occupancy .......................................... ..~...6~.,~..Y~....k~...~..~....~ ..................................... 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ..........(....~?,..::......:.':?. ............................ Fee '.....~...! ................................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling un,ts.....(? ................... 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: Fron .......... f~ ................ 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 /-I Rear ~-1 Depth Height ............................ Number of Storms.....~ ........................ 9. Size of lot. Front ............ : ............... Rear ............................ Depth ............................ ]0. Dote of Purchase .............. /....5....c..( ........................ Nome of Former Owner ........................................................ Zone ar use d,str ct in which prem,ses are s,tuoted ........ "'"./'C ........................... ]2. Does proposed construction violate any zonin§ law, ordinance or requlation> ........................................................ 13. Name of Owner of premises .............. ~¢1 ............... Address .......................................... Phone NO Name of Architect .................................................... Address .......................................... Phone NO ..................... .................................................... Address .......................................... Phone NO ..................... Name of Contractor ' ' 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. STATE OF NEW ~YORK , ¢ ) S S COUNTY OF ..~e~l.,,v~t,..,~.,-K')" ...............................H,,, '/" . ~, ,/"'2~,~.,~.'......~,...~(:~...,.,.....~:_~..,~.....,.~.,~eing duly sworn, deposes and says that he is the applicant (Name of individual signing a¢~lication) ~ above named. He is the ..................................... (;~.~:h ......... ~ ....................................................................................... (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 this application are true 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 ~ ~ ~o. 5~.0~9~3. s,f[o~< co,~t~ ,."']'/~/~, '/ Notary Pubhc ~. .'.~.. ~,,,~ (Dgn of apphcant)