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Home My WebLink About803-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPART,~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the. building located at Mop No.N.i~.~.B.t/..-D.~. Block No......~.?...~. ............. Lot No...:kg,1..&...~..~,.Q3. ...................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......................... .~...~.9'..g:~..~....1...~. ........ , 19...5..?.., pursuant to which Building Permit No..~......8...0.] .............. dated AUgUSt 13 59 ...................................................... ] 9 ......... was issued, and conforms to ell of the requirements of the opplicable provisions of the Iow. The occuponcy for which this certificate is issued is ................ PRIVATE ONE FAMILY DWELLING This ee~tificote is issued to ...~.r..~..:..._M..o...r.t..~.m.~.r.._~.t_~,.....o.~.~ .................................................. (owner, lessee or tenant) of the aforesaid building. Building Insp~ector ~OWARD M. TERRY 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.° 803, Z Dote ................... A~,~.t~...;13 ................... 1959 .... Permission is hereby granted to: JoseT~b .-~,e ey']~o ~?.'~....A/C-.~-:t,~..(~hu%e .................. .................. ~.~t~.t~.k~.... ~,,X ............................... to..B~zXid., am. addition. ~n, ~...e:~..~,~u~..d.~etli~g ........................................................................ at premises located at .....~./.~....Y~s~..~.~t..Roa~ ............................................................................ ............................................................... gt~h~e~.....~.-~-~.. .................................................................. pursuant to application dated ............................. .~T~S~-...]:~ ............... l~g....., and approved by the Building Inspector Fee $5,00 ................ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town CLERk'S OmC SOUTHOLD, N. Y. xamined .................. ~ ............................ Approved ........................................ 19 ........ Perm t No ............................... Disapproved o/c ' (Buildin~ lnspector) Application No. (~ C~ ~ APPLICATION FOR BUILDING PERMIT Date ......................................... 1 9 ........ INSTRUCTIONS a. This application must be completely fl[led 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 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 alterations, or for removal or demolition, as hereir~ described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) ............... ..h. ........................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises ....... ~ . .~a.~ .......... ~{~.~Y2%:¢~.~;-w.; ....................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~,h ~h nrono*,,4 *-o~k ~ II he ,4~ M,~, klo' ..~.'..(_~...¢~40.~._. ~ ..... ,/~L o~ 1. Location of land on .. -.. ,- ,- ..................... ,- .............................................. t.of mo: .................... Street and Number ............................................. ; ...................................... f; .......... & ...... .¢f..~.....T.....~ .......................... Municipalffy 2. State existing use and occupancy of pr, emises and it~ended use and occupancy of proposed construction: a. Exisdng use and occupancy ........... ~'.'.... i..~..~.t...~..~...~....Yk ......................... ~ ......................................... b. Intended use and occupancy ................................................. ~..~. ............ .~.......~.*.'...~.....~..~..?:....: ................. 3. Nature of work (check which applicable): New Building .................... Addition .....X,.. ............. Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... Cost....kl~). ~..(~. f~-- -- ........................................ Fee 4. Estimated . G'?..4-,,'~¢... ............................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ........... cpn.,,,,.~, ....... 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 ......... ..'~..71a~.. ....... 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 .......... t,.?~,,~.. ........ Rear .......... /....'~r~,, ......... Depth ...~. ....................... Height ............................ Number of Stories ..... ~ ...... ~ .~?,-,,Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase .............................. '....,:..x.'. ............... Name of Former Owner ......... ~:-~.,,¢..~..,. ................................. 11. Zone or use district in which premises are situated ..................... ~ ....................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............. ~ ................................. 13. Name of Owner of premises...~J.]/.L.;(h'''~'~?.'7''.'~'~''''~'''J~'''¥'Address'' ~ --r~ ~ ...... ./..V..~.~.:..::.:...L~...{ ................ Phone NO ..................... Name of Architect .................... x, i ........................... :' ' i ........ Address ........................................... Phone NO ..................... ....... ). ~...:...'.'...Z ...................... Phone NO ..................... Name of Contractor ........ ;~f;:: ..~:....~:;':!.. M...~.t.:.:.~...~.':-:..... Add ress PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from proparty lines, Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. I I STA'I'E OF NEW ~.Y..OR~ . .)(:: ) S S COUNTY OF ....~.,.~r~4Lt.'......) ' ................................. !'!.!...%,~ ......... ..~.l~.~..~:./...f~.. ....... being duly sworn, deposes and says that he is the applicant (Name of ind'(icj/ual signing application,)., above named. He is the....¥.... ........... ~.~-..~ .............. iiii~i .......................................................... (Contractor, agent, corlborate 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 ali statements contained in this application are true to ;l, hg best (Se his,, knowledge and belief; and that the work will be performed in the manner set forth Jn the al~licat~l~ f/l~,d, Sworn to before me this ~ ~) )~/~ ..................... ~' dqgl of ...,~T..; .......... ~..~ ......... 19.~.]. .... ~ / (Signature of applicant) Notary Publ.c, .~...~.(.~...~,~..~...'~...~.'.~.~..~'"~" .............. County