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Home My WebLink About833-zF,O'I~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. CERTIFICATE OF'OCCUPANCY No ...... ~ _.6..9.7 ...... Date ............................... .J..ll.1..y..~ ............. 19...6..{). THIS CERTIFIES that the building located a~ ..~/S.. K~rlllI~..l~Qai~.,....8Ollth.Ol~l ...... Street Map No ....................... Block No .................... Lot 1N o ............................................................................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................... l}e.p..t..~.~, ~9.~.9... pursuant to which Building Permit No ........ .Z....8..3...3. .... September 5 4ated ................................................ 19..59., ~v.as issued, and conforms to all of the requirements of the applicable provisions of the la%v, The occupancy for which this certificate is issued is PRIVATE ONE FA~4IL¥ DI~LLI..N. ................. This certificate is issued to .R..Q~.e..~..t.....J.,....!{Q.~,....Q!NtI.~.r ............................................................. (owner, lessee or tenant) of the aforesaid building. Building Inspector FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS DERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 833, z Date ....................... [;ep~mbel'....~ ........... 19,~9 .... · Permissian is hereby granted to: Rebe r.t.J...~oly.~ .......................................................... ......... /~nn~:..Ra~.d .................................................. .................... ~ou~hot~l~,...~.Y., .............................. to ... ~uild..an..addit ~,on..on..an.,~xi~,~,dmelling ...................................................................... at premises located a~ ]~/,~....K~.y..}i~ad ............................................................................................... ...... ~u'~'ld'~'' "~N'Y'~ ............................................. pursuant to application dated .................... ~t~-r-.....~ ..................19.:[~...., and approved by the Building Inspector Fee $~.~?~ ................ Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........ ~......~'...,.... 19..~:. Approved ..................... :.: ................ 19...?..Permit No..~'...~....~., ........ ^pp,icatian No...~..B..~. ............ Disapproved a/c .................. ~' ~~'":.'-"" Z ................... ..................... i'~'~'i'~;;;i ................................. I c; ,v ? .~)...,. 6~,ht~l~_u[a ,~ J~-~b~' APPLICATION FOR BUILDING PERMIT c &~g ~,~tO,~'l-~,~ ~ ~ ~ , Date....~.~., .................. $ ............................. 19,.. a, This application must be c~mpletely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot c~nd 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 availab(e 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 shah have been granted by the Building Inspector. APPLICATION )S HEREBY MADE to the Building Department for the issuanc,e of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ordinances aj:u~L~egulations. (Signature of app j~ant, or naYne, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................. .~.~..e...!.-.. .................................................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~. Location of land on wNich proposed work will be done. Map No: .......................... ~ ................. Lot No: .................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: ................. ..... .C ..... .......... ......................................... / o. Nature of work (check which opplicabb): New Buitding .................... Addition .................... Afferation .................... Repair ................ ~P~emova[ .................... Demolition .................... Other Work (Describe) .................... · st moted ................................. 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 nature and extent of each type of use .................. I I l ........... 7. Dimensions of existing structures, if any: Front......~ ................. Rear ......~.....~- ............... Depth .....~.....~.. ................ HD;imgt;sions ~same stru~Nt~b~'ith°faISt~'t~;ns or ~dditio~s: Front ....... ..~.,~...~...I. ............... Rear .......-~..~.,!, ............... Depth .... ~,..~,. ................. Height ...... I, ...................... Number of Stories ........ / ...................... 8. nimensiens of entire new construction: Front ;2.0 ~ ....... . ..................... ............................ Rear ,?/~ I Depth ............................ ~ / Height ....... ~ ................ Numb. er of Stories ............. : .............. I 9,S ze of ot: Front ....... ........ Rear ............... Depth ..../..O.,.,~,.......~ ...... 10. Date of Purchase /~'~/-~' Nam of Ferment Own'er .~../~r'¢~'C¢ /~/~...~.- Daes proposed construction violate any zoning Iow, ordinonc or rag-- ti />. ~ -,.-~.-, ~'e,,,,~.~'.~'~ -~'~a ...................... ~'~'~;I" ~. Name of Owner of prem~ses.~.~.e...r~-U..,'.,..~'..q...!.~..e..C...Address ,~,',~,.~L~.^~_4~-~,~bone No~r..~/,--.~.~.Z. Name of Architect ........................................... Address ............ ' ................................ Phone NO ..................... Name of Contractor ......... /~a)l~. ............................... 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~YO, I~K,m~ ) S S COUNTY OF .......~,~:7.....) ' ................ j~.?..~....~,,.l~,[.,,.~.....r...~..O.'.~.~..~,.~,l.~....,~ ....................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ............................................................................................................................................................. (Contractor, agent, corporate officer, etc,) of said owner or owners, and is duly authorized to perfor~ or hove performed the said work and to make and file this application; that oil 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 ~-~ 4~r e~f ~ 19 ~ ~ ,~o~ s~ ~to~ ~re 9f~a~t)/~