The URL can be used to link to this page

Home My WebLink About751-zFORWi 1'¢0. 4 TOWN OF SOUTHOLD BUILDING ~EPARTMENT ·OWN C~RK'S OFFICE SOUTHOLD, N, Y. CERTIFICATE OF OCCUPANCY No ........ ~.-1O0~- Date ...................... 3anuar.y...k9 ............ i9._6X TH~S CERTIFIES that the building located at ,~.~.]¢..~.~..~.0..k..a....R.~..?, ~....~a...~.~.~.t~.~.kStreet Map No ............. ~.~... Block No ....... ~.*...~. .......... Lot No. ~*~ conforms substantially to the Application for Building Permit heretofore filed in this office dated .................. ~..~.~.,.~ ................. 19.~..~... pursuant to which Building Permit No. .................... I~ 7~1 dated ................ ~.~...~.~...~ .................. 19,..~...0.., was issoed, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ~ O}]]g ~{kl'~l]~Y ~'I~,I,~];l,]O '/'his certificate is issued to ~.O.~.l,..d....~..,....~ll..~....¢~..O..~.e.~.~..?....~..,..H~:~..d.~h.~.~!...~$ (owner, lessee or tenant) of the aforesaid building. Building Inspectort BUILDING DEP~ME~T TOWN CLERK'~ OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 751, Z Date ................................... .~.~ .~.~. ...... ~. ..... 19...~?.... Permission is hereby granted to: .............. ~a~t~oka..R~ .................................... .................... .~:~:H:t:~:~ ~.......~Z ~. .......................... to ~.A~..~$~fl~..~.,~L~.¢~..~[ .......................................................................... at premises located at ....'.¢/~..~;.'~..¢.9~.~.~ .................................................................................. ................................................ .~&f&~.~,.....~ ................................................................................ pursuant to application dated ............................... ~ ....... .~. ............... 19.~***, and approved by the Building Inspector Fee $ .. ~..,..0..0. .............. d..../ TOWN OF $OUT~OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. [xammed .......... .~ ........................ ]9 ........ Approved ....... / .................. ~. .......... 19 ........ Permit ~ ................... (Buildin~ InspectOr) Applicotion No ..... Z ..~..(. ............ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and su/~mitted 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 issuanc.e 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 described. The applicant agrees to comply with all applicable laws, ordinances and regulations. .................. (Signature of applicant, or-tramex, if a~corp-crratio-n) . .. ..?Z: :¢::: ::... .. './. .<. . .. (Address o¥ applicant) State wheth.er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......... .............................................................................................................................................................. Name of owner of p ......................................................................................... ; .......................................................... corpora ture of tho r. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............... : ............................ Lot No: ...., ............... Street and Number z~ ~c,-~ , ~' ~ ::-~'~ Municipality 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ~.~ffff.~ff,. ..................................................................................................... b. Intended use and occupancy [...~.~. ~. ....................... ;: ................. ~. ...... 3. Nature of work (check which applicable): New Building......%.....~. ........ Addition'~.0~:~..~.iL.Alteration%~?;%..l¢..~.~..~. Repair ..... ~ ......... Removal ~¢.~..¢~...}...~.>:..~Demolition ...... ~ ........Other Work (Describe) .~...~./¢~>.,~ 4. Estimated Cost.....~..cT:.....~ .......................................... 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.......'7~...~ .............. ~ ........................... .~ ................ ...~...:: ............... ~ ........Z..~, ......... 6. If business, commercial or mixed occupancy, specify nature end extent of each type of use ...... ...~.....~.......x%... 7. Dimensions of existing structures, if any: Front ....... ,~.~....1~. ......... Rear ...... C.~....'~ ......... Depth ..... .'9...( ....... Height ......~..~..t. .............. Number of Stories ........ ..~..: ............................................................................................... Dimensions o,f same str¼cture with alterations or additions: Front ........ ~)'..~....~...~.~.¥.~..,)Rear ................. ..~...~?.*.~) , ,' I ( ' Depth aT~.~.q~..~.rJ..¢~..'!...~..). Height ..... .~ I.~..~?.~M¢:). Number of Stories ...... .~.......~...Cz..~..T.'.~:~:).. , 8. Dimensions of~ entire new construct.on: Front.....~ear ..... ~ .................... Depth ....> ..................... Height ....~..' .~....~..~ .......... Number of Stories ..../;.~ ..................... 9. Size of lot: Front ...... ~....~..~.....~..'. ..... Rear ...... .~....?'..?..~...~.L' Depth ...~..~t.....~...~.:..:...../.i.~dT'/~/~7 10. Date of Purchase ..?..)..~.~z.~...~......&...!.).....I.?..~.~./..: ........ Name of Former Owner 11. Zone or use district in which premises are situated ....... ~ ........................................... ;~ .......................................... 12. Does proposed construction violate any zoning I,a,w, o/'dinance or regulation? ....... ' ............................................. ~3. Name of Owner of premlses~..,.~..~?.C~..+.~.~...~..e:~../.C.}.(,.~.~;~(Ic~ress .~21:l~.f...c~...~:'..~.~.:.&.~......g'..~.:...Phone NOJtb..~....f...~'./.~~' Name of Architect ....~.~,u ........ =/4:~ty¢.$-~...LCu~Lr, c,E~... },.~.t~,~ ~_~,¢,,~ ......... ..~ho, e ....... .t8 ..... 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 name and indicate whether interior or corner lot. FLORENCE E HILD£SH£1M Notary Public, State of New York Residing in Suflolk County ~o. 52-$895850 Commission Exptres MI~h SO, 19§~ STATE OF NEW YORK, ) S S. COUNTY OF ............................ ) .~. ....... ~.¢.(,c. ......................... h~..?.;: being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He'~s the. ~E¢¢'~. ........................................................................................................................................ (Contractor, agent, corlborate off cer, 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 in the manner set forth in the application filed therewith. Sworn to before me this Z:~/~ o f . .(~Z. ~~...,rr;4~,.. 19t,~,~. ~ ~ (Signature of applicant) ............ ,....-. ...... dw, ..., .............. : ......... : Notary Publid,~-~.~'.~Z.------------------~'.~: ..... County /~/~;~¢4t:ZZ~L/~ 0 /~' -'? ' '