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Home My WebLink About637-zFO,BM NO. 4 TOWN OF SOUTHOLD '~UILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. CERTIFICATE OF' OCCUPANCY Z 738 Date ....... ~aly 20 60 THIS CERTIFIES that the building located al .~./a....~.°..W~..~.a...n.o.!.,.~.9...t3~.h...o..l.~ ..... Street -Map No ......... ~..*. ...... Block No .......*..~,*. ...... Lot No ........ .~...*.~ .............................................................. conforms substantially to the Application for Building Permit heretofore filed in this office April 15 ~959 Z 6~7 dated ....................................................... pursuant to which Building Permit No ................. : ....... 4atecl April 15 19..~...9..., 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 PRIVATe, O~ PAMILY DW~LL~ This certificate is issued to Florian F~ma~lewicz, owner (owner, lessee or tenant) of the aforesaid building. Building Inspector [ FORM 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? 637 z Vote ............................ Permission is hereby granted to: Wmo Beebe ~./P~...~.lo~.].~n....t~u~kie~ ............................... ............... ,q~.C.~.b. p~,..%.... ~,~.:~.: ................................. to ...~ .u..t..z..d...~..~ .t. ~.t..o. ~...o..n... ~...e..x...t.~..t..~.~...~y..e.~.t.~g. ...................................................................... at premises located at ...~/~....~D.~'/.e.T'.~,..~9.J~e~ ......................................................................................... .......................................................... ~ .t,.~ .o.~. ,.....~.:~.: ......................................................................... pursuant to application dated .......... ..~.~.~.~........~.~.~ ............. 19~.~ , and approved by the Building Inspector Fee $. ~....0..0. ............... Building Inspector FORM NO. I TOWN OF SOUTHOLD RUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ............ ~..~..~....:19.~... Approved... ............ ~.......~....'~9~ermit No...~.~...~...~.. ....... Disapproved a/c Application No ........~...~...~.. ......... APPLICATION FOR RUILDING PERMIT INSTRUCTIONS a. This application must be completely filJed 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 before issuance of Building Permit. d. Upon approval of this application, the Bu~ilding 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 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 demolition, as herein describedl The applicant agrees to comply with all applicable laws, ord inonces and regulations. (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...../..~.~...i....~'__-'-.'__:..:J.,.:L..~...; ......... -.....'..:'.~..;.~ ....................................................... If applicant is a corporate, signature of duly authorized officer ~. (Name and title of corporate officer) I. Location of land on which proposed work will be done. Map No: ....................................... ~.... Lot No: .................... : ?' Street and Number .............................................................................................................. "2: r' state existing use and occupancy of premises and intended use and occupancy Of proposed construction: 10. 11. 12. 13. Bud n Addt.on ~ ' Nature of work (check which applicable): New ' g .................... ' ' . .............. Alteration .................... Repair ............. ~e....Removal .................... Demolition ............... ;....Other Work (Describe) .................... Estimated Cost...~..~.,J..~ ........................... ,.. ........... Fee ...~...~ ........................................ (to be paid on filing this ap~ii;;~i;~i ...... If dwelling, number of dwelling units ............. ~..Number of dwelling units on each floor ............................ If garage, number of cars .................................................................... . If business, commercial or mixed occupancy, specify nature and extent of each type of use: ....... ~ .......... Dimensions of existing structures, if any: Front ....... ..~..9..~ ............ Rear ........ ..~...o...-;.~ ........ Depth ............................ Height ............................ Number of Stories ~ Dimensions of same structure with alterations or additions: Front ................................ Rear ................ Depth .............................. Height .............................. Number of StOries ................................ Dimensions of entire new construction: Front ....... /....~., ............. Rear .......... /....O. ............ Depth ....~.....°..T...~ .............. Height ............................ Number of Stories ~ Size of lot: Front ............................ Rear ............................ Depth ...~...~.......~.....c~--~- ,.~,~.~ Date of Purchase ........................................................ Name of Former Owner ........................................................ Zone or use district in which premises are situated ................... ~ ......................................................................... Does proposed construction~- l~,.vi°late any ,zoning__~.~. law, ordinance or regulation:~ ........ ~ ....... Name of Owner of premises.~...~..,~::.;.;;...:~...-T////~,s~ddress ............................................ Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor;..~.:.~ ................ Address ................................ ....,.~.....Phone NO ..................... 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. STATE OF NEW' ¥/~P,~;. ~.,~' S S COUNTY OF~ '. abovenam(eN~mHee~/t~ed.i~idu signing a..~..i~!tion) ..................... ' (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 c. ontoined in this al~llcation are true to the best of his knowledge and belief; and that the work will be performed m the manner set torth in the application filed~therew~.__ Swam to before j~e this /~ ~---4 .... f ........... ~ ] 9 .~'.,...~... u~,v~/. ~ (Sianature o~ a cant) ............. · '" ........ ,y,x-'~'~.""~'~.~L_' "~'/;'~'"j~"~ '~"'"~,~), ~',~l.~, ~.eex~,D/~,~c "PP