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Home My WebLink About631-zFOI~M NO. 4 TOWN OF SOUTHOLD BUILDinG D~PARTMENT TOWN CLERK'S OFFICE :50UTHOLD, No Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located au .................................................................... Map No. *** Block No. .. **~ ........ Lot · *~* conforms substantially to the Application for Building Permit heretofore flied in this office dated No .......... d~.. ............. ................ ..~.~.?..~.~....~.$ ............. , 19.~.~..., pursuant to which Building Permit ~ doted ...................... ..~.~.~.~.~...~..?t ............ , 19....~..?., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .............. ..................................... ................................................................................. This certificate is issued to .~.~.~.~....~.~.~..~,~.~}....O,,.~_.e..~. ............................................................ (owner, lessee or tenant) of the aforesaid building. ..... ~..? ...... '~'J~','~i'~'~"i'~'~o'T ................ " ....... Howard M, Terry 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) N°. 631, Z Date ....................... ~Z'.f~..... ~ .............. 19~9 .... Permission is hereby granted to: llar~..~te.~.~la .................................................... .................. F. i~.~.. S.~ .............................................. ....................... lfe~.. ~.t~ff.olk,...l[,~., ............... to ....Buttd..an..add.i.~ioa..o~.a..b~siaes~..bulldiag ........................................................................ at premises located at ~/~...~.~.J~ .................................................................................................. .................................................... tte~..Su.~c~lk,... ~.,~., ........................................................................ pursuant to application dated ............................. l~,p~t,],....ll ................. lC~.9....., and opproved by the ~u[Jdin9 Inspector Fee $ ~..,...C~.. ................ .......... t~...:::: .......... .,.(!:! ...... I::..' t.. Building Inspector .......... I ..... TOWH O~ $OUTHOLD BUILDI~ DEPARTMEHT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved .....................'.i ............ '.....19..i'.....Permit No. '¢~° 5 1 Disapproved a/c ........... ~n ............. ..~- .~.'.~ ................. ;~ ...................................... .................................................................. T ..................... ..x~....~ ............. %~. ............... ' ......... ................... ........... Application No. 0 ~ I APPLICATION FOR BUILDING PERMIT Date . .~....~?..~...x~.~: .~.. (.(. ....................19..~i~. ..... INSTRUCTIONS e. 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 ad]olning 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 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 Deportment 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 demolition, as herein described. The applicant agrees to comply with a~l applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) .............................. ~X~ ~ ;;;; ' $ ' ~i[~ ;i~j .............................. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................ ~I~¢' :~ --.~:~ .................................................................................................................... Name of owner of prem~ses......u ....... :.: .................. :.v. ............................................................................................................. 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: .................... Number ~5~/~ /~,/, ~ l J . ' ~(.~ ~ :~J, Street and .................................................. ~unicipali~'~ ............... ~'~' ..................................................... 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................... /..~x~..~/..-~..L......"~..Z: .................................................................................. b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition .................... Iteration Repair ................ ,,,.Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ...... ./..~...~.2 ............................................. Fee ....~. ..................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ................................ Number of dwelling units on ec~l~ 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 ....... .~T..:...~..i'. ......... Rear ......... .c-.~.:.~ .......... 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 .......... ~x.'....~.. ........ Rear ....... ...~...;..?. .......... Depth ......~....~. ................ Height ............................ Number of Stories ..........O~..~ .... 9. Size of lot: Front .... ..~.....~2. ............... Rear .......... i".~...~ ....... Depth .../...?......"~..~. ......... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ................ L~:~..?....../~i~..: ............................................ 12. Does proposed construction violate, q V~ ~a"n'Y zoning law, ordinance or regulation? ............. ...~....~. ............................. 13. Name of Owner of premises.l.~¢.'~)r.~......:~/..k.!fi,.~r;..~. ......... Address .....,L.V...~..~.~.~t]:~,.¢.'/...c~......Phone-- NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor ......................... i.'. ........................ Address ............................................ Phone NO ..................... property lines. Give street and block numbers or description according to deed, whether interior or corner PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from and show street names and indicate STATE OF NE'~/.~YC~RK,, COUNTY OF -~.....' ' ................. ~]~(~~~ ....... ~~ .............. being duly sworn, deposes and says that he is the applicant (Name of individual signing applicationg is the .................................................. r~ ......................... . ....................................................... above named. He ~ctor, agent, corporate offmcer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file th s a licat on; that al statements contained in this application are true to the best of his ~owledge and belief; an t~ the work will be erformed in the manner set forth in the application filed therewith. ' ....... S~.'n to before me this P ...................... .. ............ .......... FOR1VI NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE souT,O,D, N. Y. Examined ...... ~...<~..(~ ,,.~...~..'! ....... /.. !.... 19..~'.~ Approved ........................................ 19 ........ Permit No ............................... Disapproved a/c .,~;>~ ,--' -.,~..~-. ~-~ ~- ,~'~' ~ ........................................................................................ ~;::.'Z ............ ..~.? ~ ...................... .................... x ........... Application No. ~ ~ r APPLICATION FOR BUILDING PERMIT Da e .............. ~ ................. I ........................ 19..,..7. ..... 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 adioining 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 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 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 issuanc.e 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' ~f applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~remises c'~, ..... (. Name of owner of ¥ .................................................................................................................................................. 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 ~/x?5 Z ~'~" .~ .... .~..:.~'.:.~..'&x ~ :::~i'~."-. :~././.'~.~...: .... ............................................ Municipality / / .... 2. State existing use and occupancy of p~emises end intended use and occupancy of proposed construction: a. Existing use and occupancy ................. TT;.:i%.W,:';;;:..'~.? .................................................................................. b. Intended use and occupancy ................................................................................................................................ ~A 3. Nature of work (check which applicable): New Building .................... Addition .................... Iteration .................... Repair ................ ~.,.Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ...... f...u.....? .......... ~ .................................. 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 ...... ..~.l:.~ ............ Rear ......... .~.~.['..~ .......... Depth ~' ~' ' Height ............................ Number of Stories ..... .C ..................................................................................................... Dimensions of same structure with alterations or additions: Front ........... .~. .................. Rear ..?..~' ........................ Depth ......J....~....~....(¢'. ......... Height .............................. Number of Stories .~.~....~:'~.. ................... 8. Dimensions of entire new construction: Front ......... .C~.:'....~. ......... ReaF ....... _~...L?~: ........... Depth ~¥ ! Height Number of Stories 9. Size of lot: Front '3 '2- Rear "~ ~z~ Depth 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated .................. '?~. ........ ..J~.~.¥.i:.~.%.~.Z..'. ............................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? .................................................... 13. Name of Owner of premises.(!~.~.~.:....~..H...~.~M~,~ (V~ ,, ......... Address ....L'.¥...r.~...~%~..J~:'~.'~.cT~....Phone-- NO ..................... Nome of Architect .............................. ~ .¥. ....................... Address ............................................//' Phone NO ..................... Name of Contractor .................................................... Address ............................................ Phons NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock 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 NE~.RK,,~ ) S S COUNTY OF .~/~.~.....) ' .... . ...... --~_~.I~ ..~~ ................. bein~ du¥ sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He'~s the ............................. (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 app cation; 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 therewit~ Sworn to before me this