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Home My WebLink About844-zFOP.,M ~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ..... .~..~..2.~ ........ Date ........................... ~,~r~,.29 ......... , 19...60 THIS CERTIFIES that the building located at .~/ll.....~.~.l¢.~...¥.~,.e:l/...~'.~¥.~.,....C.~.~.~..~rreet Map No ........... .~.?. ...... Block No ......... .~.~..~. ......... Lot No. ~W conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................... .~...~.j~..~.~.~....~..~....., 19..~..?..., pursu~'nt to which Building Permit No ...... ~[..t~J~ ......... dated ....................... .Q¢..~.¢.~.¢.~'...~ ......... 1~)...~.~ wa.s issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ................ .................................................. ~.~. ,~f~...~......o....~.....~_~,,.,z_~,~ .,~ .............................................. This certificate is issued to ....D...~.,....,~O...~..~......'~...~..~...~..Q.~..~.....Q~..e..~., ....................................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector HO~k.RD N. FORM 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? Permission is hereby granted to: Gold ~ith ..Br.o~....A/C..Dr...John..~hi~er ....................... ...~.~.¢~.~.~,....~..,~., ............................................... at premises located ct ~/.~..~0.~..~.~,9.~, .~.~.:~Y.~. ~. ~ ~S Estate~ , .............................................. ~t..~,....~/~..~.~., ......... ~&e~., ~,.~., ............................. . ~ pursuant to application dated .......................... ~e~te~be~....~6 ............ 19~9,..., ~nd opproved by the ~ BuiIdin§ Inspector TOWN OF SOUTHOLD · BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×om'ned ......... Approved ....... : .............. ff. ............... 19.....(..Permit bio. eopp roved o/c ........................... 7 ...... ./../.53. ........ .............. ............................................. (Building Ir~spector) Application No...~b....~....L ............ APPLICATION FOR BUILDING PERMIT 1 NSTRUCTIONS 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 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 Budding Inspector. APPLICATION IS HEREBY MADE to the Building Department 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 Lows, 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. .............. ~:.~.~.o.'~Z~.~.....~.~.~..,. ................................. (Signature of applicant, or name, if o corporation) (Address of applicant)- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...~/Z~. z.~.~ .................................................................................................................................................................... Name of owner of premises ...... ~.,.....k .~.¢.Z~.ZtK.~....~.*.........~.~..4/..L.~..~ .......................................................................... If oppBcont is o corporate, signature o~ duly outhorized officer. ~ (~ome ond title o{ corporoto officer) 1. kocotion of lond on which proposed work will be done. ~op ~o: ............................................kot ~o: .................... Street and ~umber ...... ~ ~_.~74~ .......... (~q{~.~.....~(~..~.~.~'.~ ............................... Municipolity 2. Stoto existin~ u*e ond occuponcg o~ p~emises ond intonded uso ~nd occuponcy of proposed construction: o. fixisdn~ use ond occuponc~ ..................................................................................................................................... b. Intended us~ and occupancy .......................... ~..~......~.~ ............. ~ .............. .~ .......................................... property lines. Give street and block numbers or description according to deed, whether interior or corner lot. 3. Nature of work (check which applicable): New Building-.-,~,~ .......... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ................. /.~.~.~./2W,,,t~.~.~ ..................... Fee ............. ~....~.~..(..'~. (to be paid on filing this application) 5. If dwelling, number of dwelling units ............. ~ ................ Number of dwelling u~its on each floor ............ ~ ............. If garage, number of cars ...........~.~ ........ ~r~ .................................................................................................. 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 o~ Stories ................................ 8. Dimensions of entire new construction: Front ........ fi, ................ Rear ...... ~.~ ............. Depth ..~.~.C.'~ ........ Height ......... ~.~ ............ ~umber of Stories ...., ....... ~ .............. 9. Size of lot: Front .......~ .... Rear ...~ .......... Depth ~.~,...~.~' 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are sltuoted ...... ~.~.~ ........................................................... ~.' Does proposed construction viobte any zoning law, ordinance or regulation? , ......... ~ ~....~...~Z~. ............. . . 13. Name of Owner of premises.~..~.~.~z~Address~Z~.M.,~..~'.~e NO.~.r.~.:~.~ Name of Architect~/~....~ ............ Address ..~.~ ................ Phone NO....~ ............... Nome of Contractor~~...~ .......... Address ,~.~.Z..~ ....... Phone NO. PLOT DIAGRAM Locate clearly and distinctly aH buildings, whether existing or proposed, and indicate all set-back dimensions from' and show street names and indicate STATE OF NEW YORK, ) S S. COUNTY OF ............................ ) 2,,2~,~ .C~.~--z:~-"~/'../~.., be ng sworn, .... ~ .................................................................................. duly deposes ,and says that he is the applicant (Name of individual signing application) above named. He is the...~...~..~..~../~...~..~ ..................................................................................................................... (Contractor, agent, corborate officer, etc.) of said owner or owners, and s 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 h s knowledge and belief; and that the work w I be performed, n the manner set forth in the application filed therewith. ,~, Sworn to~jbefore me this ~'~ ~~ ~ .............__