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Home My WebLink About947-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF'OCCUPANCY No...~...~...2. ......... Date .......................... .~. ~ .e.,.. _ .2..~, .............. 19,~,0,. THIS CERTIFIES that the building located al .~/S...l~s~,a.ll...P. ai~a~;..Eaa~l ............... Street Nassa%% Pt. Pron Map No ....................... Block No ..................... Lot No. ~.~ ....... .0.1!.~.~h~g:i%95.......~..,.;~, .......................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................. l).~.~...~ ............ 19~.9... pursuant to which Building Permit No....Z...9..~.~. ....... 4atecl ................. .D..~..(t..,....3.~ .............. 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 ........... P~:l~.a.te one £amll~...d~el,li~l~ ........................................................................................... This certificate is issued to ~.~,~..I1..~i~.el%........(Ol~ltel~.) .............................................................. (owner, lessee or tenant) of the aforesaid building. Building Inspecto;~ FOBM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 947, Z Permission is hereby granted to: !I. heh .. · ~.~] · .~4;~,Ar, d..l rlle~ ................................... to ..... JJg*J,l~.. &~ .lCld4~. ~. ~,. 4]r4ldt tN~l~i. ~ll,1,].J~ .................................................................... at premises located at ..... ~l~t,.~/r..~.S...Jtl~,&g..Z~t,.~l~&l. .............................................................. pursuant to application dated .............................. ~l~..-~e....3.~ ........19 ........ , and approved by the Building Inspector Fee $.~,~ ............... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. Examned ......~.*.~...~ '~/. . 19~'~ Approved ................ !.! ..................... 19 ........ Permit No..~ ....... Application No..~ .......... APPLICATION FOR BUILDING PERMIT 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 promises or public streets or areas, and giving o detailed description of layout of property must be drawn on the diagram which is port 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 P~rmit to the applicant. Such permit shall be kept on the premises avoileble 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 hovo been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuonce of o 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 o corporation) .......... ............................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electricon, plumber or builder. Name of owner of premises ............ ~. ....... ~ ..................................................................... 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. Street and Number ......................................................................... . State existing use and occupancy of premieses and intended use and occupancy of proposed constructlon:. a. Ex sting use and occupancy . ~ ~ ~' b. Intended use and ~cup~nc~~.~~~.~`~..~...~.....~...........~...~...~......`~.......~...~. .'~ ' 3. Nature of work (check which applicable): New Building .................... Addition ...~f~ ............ Alteration .................... Repair .................... ReiT~/¥al .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ../ ......J....~..,/...~..:..~ .................. Fee ...~... ................................................................................... (to be paid on filing this application) FEES: 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................... 6. If business, commerical or mixed occupancy, specify nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front .......... .~...~. ........... Rear ....... .-~]....~).. .......... Depth ...... .~......?.. ........... Height ........ ~ ............. Number of Stories .................. / .......................................................................................... Fr Dimensions of same structure with alterations or additions: ant .......... 0 .................... Rear .....~. ......................... Depth .....~..~ .......... Height .......... ~ ........... Number of Stories ............ 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ........ ./.~. .........Rear .......... ./..~ ....... Depth ...... .~....~...0.......~....1~ 10. 7one or use district in which premises (]re situated ........................................................................................... 11. Does proposed eonstructia~ violate any zoning law, ordlnonce or regulation? ........ ~i ........... i ................. 12. Nome of Owner of blame of Architect.................. Address ............................................ _ Phone bio ..................... NQme of Controetor...../.~.....-~../...~.t:.:.*~q,,r~.....~_....~' .......... Address ...d~/~..~ ...... 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 NE_W~.O~R~ ) S S' (Name of ' dividuol 'g ' g opp icotion) above named. He s the ............................... ~k?...~:~ ......................................................................... (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 knowtedge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ~.~. ........... ~......~]... day of .......... 19...~'., .~. .... Notary ]~ ~ (Singature of applicant) N'otarv Publ c, State of New York ,,L, '~2-O:-F,,!',lfi'~, Suffolk County FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exa ne LC~L~ ~ ~ / ~'~ ~ m' d .................. ;]; ................... 19 ........ Approved ........................................ 19 ........ Permit No ................................. ................................................................................... ........................... .............................. ................................ Application No ~Tg~ 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 before issuance of Building Permit. d. Up.on 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 issuance of o 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, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) ............... ............................... State whether applicant is owner, lessee, agent, architect, engineer, genera[ contractor, electrican, plumber or builder. Name of owner of premises ........ ~....~~ .......................................... · .................................... 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. Mop No...,.:.:.....: .................... ~locl< .................................. Street and Number ...................................................................................................................................................... State existing use and occupancy of premieses and intended use and occupar~cy of proposed construction: a. Existing use and occupancy ........... ~.~ .............................................................. b. Intended use and occupancy ./ ~ . , . 3. Nature of work (check which applicable): New Building .................... Addition ...... .,,g~ ....... Alteration .................... Repair .................... Remov~l~ .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost .......... ~_J.c~.:/,..~..~.~ ................... Fee .....~... .................................................................................. (to be paid on filing this application) FEES: 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................................................ 6. If busin~ess, commericol or mixed occupancy, specify nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front ......... ~.~.O.. ........... Rear ....~....~. .............. Depth ...~ ........... Height ...... ~:?L) .............. Number of Stories J Dimensions of same structure with alterations or additions: Front .......~...~. ................. Rear .~...'~...?. ................... Depth .....,,0.8 ........... Height ..~ ................. Number of Stories ..../,~..~.~..~ 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front .~.....~...~::~C) ......... Rear .......... ~..0~.. ....... Depth ......................... ]0. Zone or use district in which premises are sltuoted ........................................................................................... 11. Does proposed construction~.~, ~,~,~ .vi°late any zoning law, ordinance/~. ,/~-~. oar regulation? ...... ~.~ ..................... 12. Name of Owner of premis~~Address .....~..a ........ 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,.-¥ORK, COUNTY OF .~.....~.-.~;~.~..(......) .............................. /.'/......~.~.....i.....~?.,,~'.~...~:.~.~;:'...k:~c.. ................... being duly sworn deposes and soys that he is the ~pplicant (Nome of individual signing opplicatj.pn) above named. He s the ............................... L'cx:~'~f'~::';.~.::;Z~'~. ............................................................................ , (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly quthorized 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 ............. C'~....~. doy of Notary Pub c, ( ingature of applicant)