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Home My WebLink About1255-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY TI-I~S CERTIFIES that the building located at [~/.S.....M&irt..Roa/I ........................ Street Map No. ~.~J~o~.d ...... Block No....~, ............... Lot No...X~Y~ .........lqotl~d ........................... conforms subsiantially to the Application for Building Permit heretofore filed in this office dated .................... NO~.e,~h~z.....~0 19..6/) pursuant to which Building Permit No. ~..~.~.... dated ..................... No~elabev.....].~19...g,Q was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is ....~'J~;I~ISS ..]M~ld;~...,*. ~;~at.. fStOl*~ ................................................................ This cert~iicate is issued to .~O~4~att.t~..~O&~..~hO~ ................. O~ne~ ............................. (owner, lessee or tenant) of the aforesaid building. Building Inspector FORM NO. 2 TOWN OP $OOTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK ^UTHORIZED) N.° 1255 Z Date ......................... x~O~l~b~.....~... ]960.. Permission is hereby granted to: O-W.~.m..t.t.~..~..~.O.~...~,.....~.C......(~],d~JLth. Boat lard ....... Southeld~--.-..g, ~, ..................................... at premises located et .S/S....~a.$n..~load~...,.l~outho.]d.j...-.-~;y~. .............................................. pursuant to application doted ................................ I~I~'~11~G1~.....~.~'...19(~(~.., and approved by the Building Inspector Fee $~,,.~ ............... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Examined ....... ~(...../.....~... ......... 19.~.Q... Approved ........................................ 19 ........ Permit No .............. Disapproved a/c ............................................................ Application No..!...~...~'~~. ........... APPLICATION FOR BUILDING PERMIT Date... ~/'~ ~O ....................... /.. ................... 19 ............ 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 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 part of this location. c. The work covered bv 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 $outhold, 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 regul, ations./ (S'gna u e~of app ~cant, or nareS, if a corporation) ............... .................. State whether applicant is owner, lessee, agent, architect, er~gineer, general contractor, electrician, plumber or builder. Name of owner of ............................. // . .................................... If applicant is a corporate, signature o,J duly authorized officer. (Name and title of corporate officer) 1. Location of land on which~'~,~ ~ ~ proposed,work will be done. Map No:,,¥.....~--~--...>~~_,/~ ~,-~(~'~7 ........... Lot No: .................... Street and Number ...... .~..~7..,¢~c........~-~...., ......... .~~..~ ............................................... Municipality / 2. State existing use and occupancy of pr, emises and intended u~se and occupancy of proposed construction: a Existing use and occupancy . _~ ¢r::~~~i.~..~..~.?../ /J'..~...~..~ . . . /! b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building....l ............... Addition ......,f~.............Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ............ ,~..~...-~ ....................................... ~ee ...'~.~ ..................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ................................ Number of dwelling units on eoch floor ............................ If garage, number of cars ........................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use...~..-'r..*..~,,..~....~¢.'.~... 7. Dimensions of existinfl structures, if any: Front ........ ~.~..~ ......... Rear ...... !..~.~ ............ Depth ..... ~.~Z~ ............. Height ..~ ............... Number of Stories .......................................................................... Dimensions of same structure with alterations or additions: Front ...~.~.~ ............. Rear ....Z~.~ ................. Depth ..~..~ ............. Height .~ .......... Number of Stories .........~ .................... 8. Dimensions of entire new construction: Front ...... ~..~.~ ............ Rear ....~...~.....~ ......... Depth .~.~ ............... Height ..... ~.~ ............... Number of Stories ............................ 9. Size of lot: Front ....~ ........ ~ear ..~.~¢..~. .......... Depth ..Z.~.~ ............. 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated....~~ ................................................... 12. Does proposed construction~~ ~~ ~vi~ate any zoning law, ordinance or reg~ation?~ .~.~.~ ....................................... 13. Name of Owner of premises~~..~~...~.Phone NO ..... Name of Architect ........................................................ Address .......... ~ .............. ¢ .......... ~...Phone NO ..................... Cont racto r..~.~ ~ ~.~. ~~dd ress Name of ...~....Phone PLOT DIAGRAM Locate clearlv~d disti~qctiy all buildings, whether existing or ~op~e~d~i?~-~l~t~te~ba~ deimensions from pFoperty lines. Give s rc~umbers. ~ription accord' g , m s and indicate whether interior or corner Iot.~ ^UN 'E OF ) SS ~~....~..~...~~ ........ being duly sworn, deposes and says that he is the applicant (Nome of individual signing application) 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 fife this opplicatJon; 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 ~a9p~'F~ ~ ~o~n the application filed therewith. Sworn to before me this ~ ~ "~'" ~,n, State ol New Yor~ ........... ~ ........... ~ .... ; '~ ..... ~' ~ / , - ~