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Home My WebLink About750-zFO~FI NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located a~./,~...,~....~...~....~...°..e'.~;L.F,,~. ,~.~....1~..~.-~..~.~.O.,~.~? Street Map No. ~ Block No. ~ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................. ~..~ ......... , 19....~ pursu,a'nt to which Building Permit No...~...~ ............ dated ............................... ~..,~ ......... 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 ................ ~.~ O~ ~IL~ ~~ W~H ~0~-~0~1~ .............................................................................................................. ~E"~T~"~E. ~eo~ e G, Baileyt This certificate is issued to .......... ~ ........................................................................................................ (own~L lessee or tenant) of the aforesaid' building. Building mspector HOWARD ~. FOI~M NO. 2 TOWN OF SOUTHOLD ~UILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 750' Z Date ......................... ~T~. ........ ~1 .............. 19~9.... Permission is hereby granted to: pursuant to app{ication dated ............................... ~.- .~ .......... 1~....., aad approved b~ the Buildia9 Inspector Fee $..~9.*Pg ............ .................. vi. ............ t..J,d.-.~...:~..~ ............ Building Inspector FORM NO. 1 TOWN. OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ............................... - v ......... 19 ........ Permit No ............................... Application No.......~......~.... ........... Disapproved a/c ............ (~_...~i~:...:tL:..::.._.. ............ .~.:z.... 7:'.:.:. z..~. ~, ............. (Building Inspector) ~__~ (~ APPLICATION FOR BUILDING PERMIT 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 tocdjoining 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 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~?pplicant, or nome, if o corp~tiSn) ( ress of ~:~plicant) C/ State whether applicant is owner, lessee, agent, architect,, engineer, general contractor, electrician, plumber or builder. !Nome of owner of premises ...... ~~.~...~.....-~t~~ ....................................................................... 'If applicant is a corporate, signature of duly authorized officer, c~ (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No:..,~ ........................... ~ ............. Lot No: ........... "-'Z. ........ Street and Number ...........',~....~.':....~~.~..~..:.....~..~--¢~'~. ...... ~...'....~.... 2. State existing use/~occupancy of/~:t~T~i;t:~,e,d use and occupancy of proposed construction: a. Existing use and occupancy ............. .'.~~,: ................................................................................ b. Intended use and cc pancy ....... ~~ .................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition .................... .Alteration .~. ........... ~... Repair .................... RemovQl .................... Demolition......~, .. ...... ~gt~h~r-'Wo r k (Describe)~~L~--~~ 4. Estimated Cost .......... /.~...k-~L~...¢~..,.~. ........................... Fee J..(,X....../.~.. (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 .......... ~...~.. ........ Rear .....,,~..~'!~ ........... 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 ............................ Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ..........~...~_.....'.,.. Rear .......... ~...~,.....~.. Depth ..... ./.,. ,~.,~.........X 10. Dote of Purchase ........................................................ Name of Former Owner ........................................................ /rd ,, ~. 7~ne ar ~se district in which premises a:e situoted ............... /.~ ......... ~...~.....~~ ..................... Name of Architect ............. ~_.Z-.m~/ ..................... ~ress ............... ~;..~.~z ....... )Phone NO ..................... Name of Contractor~~ .................... Address ...~~one 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 ira deed, and show street names and indicate whether interior or corner lot. ~ STATE OF NEW."~.~]~ .~ S S COUNTY OF .,~,~ .................................... -~;~~.being duly sworn, deposes and says that he is the applicant (Name of individual sing ~pplication) , above named. He is 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 th s appl cat on; 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~iled therewith~ Sworn to before methis ~_ , n ~ //~' x 1/, . FORM NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TO~VN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .............. ~ 19~..,/~.~/ Approved ........................................ 19 ........ Permit No ......... ..~....~..~... Application No ....... .~...~ ........ (Building Inspector) APPLICATION FOR BUILDING 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 o detailed description of layout of property must be drown 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 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 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 Deportment for the issuonoe 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable lows, ordinances and regulations. (S gnoture ofccp cant, or name, ~f a corp~f~Fon) " (Address of a~plicont) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of prem'ses (-,~;~'~ L,,?.?,.,' .... ~'~.~ ..... ~/~..,'......+.f,,,..,,c.,~..,~.~,,..,.· ' " ........................................................................... / I~ applicant is a corporate, signature of 8u y authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No:/.,? .................. ....'-'r:-. ............... Lot No: ~' Street and Number .......................... ........ ~. ............................................................................. ~ ............ ~ ................... ..... / .' -, Mumc~pa ty ../ -%/ . ,- .... .~ ,, ~...~¢~, 2. SCare existing use ,~nd occupancy of/~r,em~ses~and ~ntende~ use ~ occupancy of proposed construction: a.Ex~stmg use and occupancy .............. ~.~¢(4~<,.,,~.,.4~..~..~;~,~.;.~ ................................................................................... .. .,. .......... ................................................................................. Locate clearly and distinctly oil buildings, whether existing or property lines. Give street and block numbers or description accor¢ whether interior or corner lot. 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .~, ............ ,~ .... Repair ................... .~,~r~oval .............. ~...De mol ,t.on.....~...:....~J~'r~/Vork ( Desc r i be)P..~.~..~....c~: .h~-'" ~~--*~ 4. Estimated Cost .......... (..~ ................................................ 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 0~,~,ure and extent of~.~h type of use ...... ~l~ ................ 7. Dimensions of existing structures, if any: Front...~;~ ....... Rear ..... :~. .................... 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 ............................Rear ............................ Depth ............................ Height ............................ _~u/~n~ ber of Stories ....... ~..,.,/ ............ /~' --~' / 9. Size of lot: Front ............................ Rear ............................ Depth ................................. 10. Date of Purchase ........................................................ Name of/Fo~mer Owr~b~ ..... ~........~., .~:2..~-~.,.~ ........................ 11. Zone or use district in which premises are situated .............. ~ .......................................... ,,~".:,. .............................. 12.. Does proposed construchon' v~9~gte' any zo~ng J~v~__ .~rdinance~*~?~.~. r,~u~l~do~? ,, ................................................... ,,. 13. Name of Owner of premise,.~::.:L:'.....'~,j.!..::,vL..:':::....:..?:/~ress .......... :.: ................. ~. .......... Phone NO ..................... Name of Architect ......................... :-,, ,, ,~', ·Address ............. ~_. ~,,... ;~.~"~*~:~'"'"'~/"Ph°ne., ~ NO ..................... Name of Contractor.{:~.~...:.'..:~: ....... :.: ....................... Address ............................................ Phone NO ..................... PLOT DIAGRAM proposed, and indicate oil set-back dimensions from ingtto deed, and show street names and, indicate I t { ....................... , . : .......... :::::::::::::::::::::: .... s s ...................................... :": .......... ;"~4 ............ : ""; ............ 7 ' ' (Name of ind~wdual s~g~m~pphcahon)_ ~ duly sworn, deposes and says that he is the applicant above named. He is 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 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 Jn the manner set forth in the application fil~ therewith. /"/ ,~r'2 ~ Sworn tobefor~ me this ~'~, . ~ ~ ~ ~ /1~ /Y~ ........................ /7 ~ , ~ ~/~ /~ ~otar~ Pubhc, State of New York ~