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Home My WebLink About938-zFOI~M ~0. $ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the. building located at .~./.~. G~,n :L~lle~. .~.O~t.~.o.].d~. ~.~. ~lol'kStreet ........................ , Map No.~'...~l~.~'~. ...... Block No. ### Lot No .......... ~.~ ........................ ~ ........ .~ .................... conforms substantially to the Application for Building Permit heretofore filed in~thisx~ ~:ffice~ dated ..................... .~.ggf~]~'..~ ............ , 19.,~.~..., pursL~ant to which Building Permit No. ~..~.8, ................ dated .................... .D..e..~..e..~.b...e.E..~. ........... 19..~.~..., wa,s issued, and conforms to afl of the requirements of the applicab]e provisions of the law. The occupancy for which this certificate is issued is ................ George l~eron, owne~ ' This certificate is issued to ..................................................................................................................... (awne. r, lessee or tenant) of the aforesaid building. Building Inspector FOEiE[ 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? 938 z Date Decer~b~,r ......................................................... Permission is hereby granted to: %'iL!!~m ~e11% e/c George Heron .~:~.q..~y..e:~ ......................................................... · ~..~.L.~.~...~ .................................... to bu~.ld a~dition o~ exi~in~ one family ~ell~ · at premises located at ~q~.,...~]9~...~.,...~..~:~ .............. ~....;. ................................................ pursuant to application dated .......................... ..~.~..~.~..~.~..~.....]t.~ ........... 19..~.~.., and approved by the Building Inspector Fee $.~.....0~.....~.~.~..~.. (~he.k) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, Examined..~.../.~<....~. 19.~,~..~. App roved. ~.../'...-?.~-.. 11 ~9.~,~/;~... Per mit No ........ L~/~....~.....~. · Disapproved a/c ............. ............................ ..................................................... ........................ ..... ................ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a~ _Zhios application must be comple~t.e!y ~fi~lled in by typewriter or i~n ink and su_bmi?ed 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 coYered 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 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 all applicable laws, ordinances and regulations. (Address of applicant) State wheth,er applicant is owner, lessee, agent, architect, engineer, general contractor, efectrician, plumber or builder. B~t].d. ez- .................................................................................................................. Name of owner of premises.....~..q..O.~....~[fl~.~..O...~' .............................................................................. : ..................................... 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: ..~..~....~...~.~..~. ................. ~.~ fi~'~No: ...... .~...~. ......... Street and ~'~' '~h~;~/~O:]'lZ l,,,~Lrle...]~'...,7. Ha. vell~ 801.I.t,~O'14..t ~'~ .... ' ~,/_ / ~ ~-~ Municipality xo ~ ,., ' 2. State existing use and occupancy of premises and intended use on~l occupancy of proposed construction: a. Existing use and occupancy ....... .O.I~.~...~.~l~.:[~....~.~'.~.,~,It~ ............................................................................... # # b. Intended use and occupancy ....................................... ...... i ...................... :;'"i'i"i'~, ..................... ~i~'~'' 3. Nature of wore (check which applicable): New Building .................... Addition ...... ~.. ........... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Ware (Describe) .................... 4. Estimated Cost ...... ~.~.t~t.0.~.0.0. ....................................... Fee ..... ..~.~.o._~.o. ...... ira .............. 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......~.I. ................Rear ...... .~..I ............... Depth ...... ~.~..1. ............... Height .... ]l-~..I. ................ Number of Stories ............ ~1~# ........................................................................................... Dimensions of~ same structure with alterations or additions Front ~.. Rear '12 ~r Depth ..~...~./.....~....~../ , ............ Height .............................. N,u~,,~ber of Stories ...Z ........................ ' ............................... 8. Dimensions of entire new construction: Front ........... ..~.~.'. ......... Rear ......... ~,~... ........ Depth ......../.....~--ml.... ........... Height ............................ Number of Stories ..... ./.. .................... 9. Size of lot: Front .......... Z.o....o.. ....... Rear .............. ../..~.~.~.. .... Depth ......... .~/~...~... ................. · ./....'~...~ ............................. Name of Former Owne~..~ ...................... 10. Date of Purchase 11. Zone or use district in which premises are situated .......... R~I~.~,~IC~.~J, II~I, ....................................... 12. 'Does proposed co~stFuct on v o7ate any zon ng aw, ord na~ce or reaulat on~ ~I.0. ....... o g ¢~' abanp ' ,d .................................. Name of Architect ............................... ·. ........................ Address ............................................ Phone NO ..................... Name of Contractor...~l/.~,~,[~..i~....~#.~,.ll.. ................. Address ...1~..O..~.Ii~,¢~.6. ...................... Phone NO...~..0..~.~.~.~.~.~. 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. ) COUN]'Y OF ~.~.~'.~..o...,1,~ .......... ) S S. ................... ..W.~.]....~...~...iI~......~.~...~..]....I. ................................. ~ ............ being ~uly sworn, de~os~s and says that he is the applicant (Name of ~ndividual signing app~cat'bn) ~ ~ ~ ~' above named. He is the ............... ~.~.~ ...................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to ~rform o~ hove performed the said work and to make and file this application; that all statements contained in th~i~ application-are t[ue to the ~st of his knowledge and belief; and that the work will be performed in the ~nner set fe~h ~s~e application filed ~herewith. Sworn to before me this ~. ~e~~ //'Il__ ........... ~.~... day o~...~ .................. [~)~.~. 5 ' ~, t,,, ' ' (Signature of ~pplicant) Nota~ Public, /~....~~.....~m.~