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Home My WebLink About699-zFOl~f NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOW'N CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ....P...~..n..e.....P...1..a..c...e.~....~..a...s...t.....M~....r.:...C. rD. ......... Street Gardeners Bay ~.states Map ~o ......................... Block ~o ......................... lot ~o ......1~5..A...1.~6 ....................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated June i 19....5...9., pursuant to which Building Permit No. Z 699 dated .................... J. un.e..1 ................... 19..,.~, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occuparncy for which this certificate is issued is ................ ............................................... ................................................. This certificate is issued to ......A.~.....R..~....S..~.g,qI~D.~j....~...wD.c.r ................................................................ (owner, lessee or tenant) of the aforesaid building. Building Inspector FOR~ 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 699 z Date ........................... ~e--..~, ................. 19,f~ .... Permission is hereby granted to: H.A,Cl~z'k ~.~..~,' ....~/.C... A,l~..Smmu~..~ ................... ......... .~.~m;.;~ ~..~, ....~,.~.q ...................................... to Build an addition on at premises located at ~,.9.~#..~...~,.~,...~..~.....~.~.~.~'.~..~l~Z...~.l~..t~...e .............................................. .............................................. Zl,u~. ~ce, ~... ~ ~.. ~et~l,.~.... ~1.,~.,. ................................................... pursuant to application dated ........................... ~.~.z~e..~ ......................... 1~....., and approved by the Building Inspector FORI~ NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined.....-~.~.../.. ...... 19 .~.."~. Approved.....~....,~.......19.~'~ermit No ...... ~.....~fT~.. ..... Application No ........~..~ ...... APPLICATION FOR BUILDING PERMIT Da,e .......... ........ ! ..................... .... 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, 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 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 issuanoe 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) ............... ......................... ~',~i~iress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............... ........................................................................................................................................................ Name of owner of premises ....... .~..... R~......~..J~.~ll..J~./~.~bl,.~ .............................................................................................. 1. Location of land on which proposed work will be done. Map No: .~*((..0.{~.~4J¢l~...~.{~r.~.~".~fiot No:. ,.-,--,.~.~..~.~.. Street and Number ...... .~.~.~......]~.~..~..~.. ....................... ~..',.....~..~. .................................... Municipality 2. State existing use and occu~ncy of~mises.and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... A~}.~..~..~.~I~ .............................................................................................. b. Intended use and ~cupancy ......... I]l~.~.~.L~.~ ............................................................................................. 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ............ ........ Repair .................... Removal .................... Demolition .................... Other Work (Descr be) ................ 4. Estimated Cost .................. ..~.~t~) ............................... Fee ................................................... (to be paid on filing this application) .5. If dwelling, number of dwelling units ................................ I 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 ........ ~..i~...'.~ ......... Rear ....~..1....-...~. ............ Depth ..... ..4. ................... Height ....... t~.~. ................ Number of Stories ..................! .......................................................................................... Dimensions of same structure with alterations or additions: Front ......... ~.~.:.~,. ............ Rear ...~..?...'..(e. .............. Depth ............ ~.~ .............. Height ........... ~ ................ Number of Stories .............. ~ ................. '1 O" 8. Dimensions of entire new construction: Front.......~....~..~.(¢,.~ ....... Rear ....... .'~,...'l..'-...~.". ....... Depth ' Height ....... [.~..~ .............. Number of Stories ......... ! .................. 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ...... t~..~.~...~.. ..................................... Name of ?)rmer Owner .;..~...~..~ ...... ..~.~..1~..~.. ........................... 11. Zone or use district in which premises are situated ................ .~.~.%.f~.t.0..~,.~.?..H~.~..l~_~ ......................................... 12. Does propOS~nde construction violat~ any zoning law, ordinance or regulation;~ ..... ...f2~.....q ............ 13. Name of Ow r o prem'ses..~,.[(.~,~.l,A&N.~ ........ Address ..~&~T....l~.lM.~.t, tl.i~.~.Phone NO ..................... Name of Architect ...... 't't'"~"~ .......... :'"¢ ......... f ......... Address .......................................... Phone NO ..................... Name of Contractor...~,.¥1....~..l~fLl~.~.~ll~N.S...~..~...C,...Address ..~.!.~..,..~..qP~[¢...~., ............ Phone NO..'/.T...O...O...i~... 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 YORK, ) S S ' COUNTY OF ............................ ) ' .... ..J~..'~.a..M ....... .-~.,.......~.~...c..&.i%.lf~,..&'fl,..:.¥; ................... being duly sworn, deposes and says that he is the applicant (Na~e of individual signin~ a~plication) above named. He is the ..................... ~.~l.~.O.~ ................................................................................................................. (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 ~st of his ~owledge and belief; and that the work will be performed in the manner set fo~h in the ~[¢~n, filed therewith. Sworn to befor~me thfs _,, ~. ~ ~o .............. ~...%. day of ............... ~. 19 ~Z ~%~?~¢,~¢"~ (Signature of applicant)