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TOWN OF SOUTHOLD
BU~LDING ~EPARTMZNT
TOW~ CLERK'S OFFXCE
SOUTHOLD, N. Y,
CERTIFICATI~ OF OCCUPANCY
No. Z~02~ ............ Date ....................... ~..1~I~'1~,..3 ................. , 19.61.
THIS CERTIFIES that the building located at I4aI;elm...F.,dg.e .Wa~. ..................... Street
iviap .~'o..;~,Vol ............. Block No ...... X;X .............. Lot No...~.~......,~.[~.~l~hD!ft.~...k~,.~.,. .....................
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ................ l~av.~mber_.~ ........ 19.~.0.. pursuant to which Building Permit No. ~..~ .......
dated ........... :......_N.c.v. emhe~....l~ 19...~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 ....... l~.l~'~e..cme..$~ttty., d~el~lng.,: ........................................................................ .
This certificate is issued to ._Y~mas~...&...The~a..Be3~.i ...................... 0wm}~.~ ...............
(owner, lessee or tenant)
of the aforesaid building.
Building Inspector
FORM NO. 2
TOWN OF $OUTHOLD
BUILDING DEPART/v'~£HT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDIHG PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 1256 Z
Date .............. ~o-~-emb e-~,.---.X.~- ............... 19.60-
Permission is hereby granted to:
Lido Cons~.~.u~t.i.oa.,Co~-t~o.,. ,~.C..~nost,.:~...T. hora Beli'i .... .Rase.~.ale...Aye ..............................................
.......... ~toz'~t~o~J[om~ ..............................................
to .....Bu~.l(l..new... one.. ~.a~i.J~y.. ~t,~1~..in~ .................................................................................
at premises located at .......Lo.t..#...~.~...ge~..7...t~a~er~...(.ma.p..2.9OZ.) .........................................
.......................................... ~ql~.....W~,~..¥d~e-.~a¥ ......................................................................
.................................................. 8.olztaho. ld.,.....~.:~, ...........................................................................
pursuant to application dated .......................... l$ov~al~e,:p...~,,~..7...19.~0.., and approved by the
Building Inspector
Fee $...2[0,, 00 .........
'-~';' ~uilding [nspecto~:'~
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT ·
TOWN CLERK'S OFFICE
SOUTHOLD', N. Y.~
(Building Inspector)
Application No. / ~' ~)- G
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS .~
c~ , This' application must be completely filled in by typewriter or in ink,.and sut~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 diagrom which is port of this location.
c. The work coYered by this application may not be commenced before issuonce of Building Permit.
d. Upon approval of this application, the Building Inspec¥6v,,,.~ill issue a Building Permit to the applicant. Such
perm t sho I be kept on the premises avad.a, ble for, mspectlon ,throughout the.progress of the wor .
untd a:Cerhficate of
e. No building shall be occupied or used in whole or in part for any'pt~rpo~e whatever : ~ ' ' Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Deportment for the issbanoe of a Building Permit pursuont 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 a Iterations, or for removal or demolit.ion, as herein described.
The applicant agrees to comply with oil applicable lows, ordinances~l~i~ regulations. ,
/~a~re of~ppli,c~r~t, or name, if a corporation)
(Address of applicant)
.State whether apj~licant is owner, lessee, agent~ architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises~' "--~-~:'~'r ~'~ ,~3~..~......~../.~......~.....~.~...~,..~...~.....~....~...z:../..~...~.-" '~ ...............................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
1. Location of land on which proposed work will be done. Map No: c:~;~/~ Lot No: ~'~
Street and Number .~.~..~.~../.~.~..~`~.~..~..~/..~.~.~...~....~.~.~.`~/`~.~..`f!~.r.~.~(~~~:~~c~(;~p.
Municipality
2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction:
o. Existing use ond occupancy ................~..~:,.;:.,..~.', ....................................................................................................
OCCU anc ~/ ...~../~.~.../..Z.,7
b. Intended use and p y .............................................................................................................................
3. Nature of work (check which applico'ble): New Budding ........... Addmon ..... ~ .......... Alteration
Repair ......"~T.. ............ Removal .....~ ........... DemoHtion........--~... ......... Other Work (Describe) ....................
4. Estimated Cost ............. ../..~/.~...~...~ ............................. 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 .............. ...~...o....,~..(..,?q.. .............................................................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use
7. Dimensions of existing structures, if any: Front........./~;d~...'.~.~.~.; ...... Rear ......... '..-Z. ............... Depth ........~'~. ...................
Height ........ ~ ............... Number of Stories .......... ..-;.2'.; ...........................................................................................
Dimensions of same structure with alterations or additions: Front ......... ~°....~.i...~.~M.i.. Rear
Depth .......... '~ ............. Height ...... ~......'~Z.. ............... Number of Stories .............. % .................
8. Dimensions of entire new construction: Front......~...~.......'~... ....... Rear ........ ..,~......~.....r ........ Depth
/
Height ............................ Number of Stories ............................
9. Size of lot: Front ......./..~.~..i ........ Rear ...... /...~.~...~ ......... Depth ,~-./o '
10. Date of Purchase ........................................................ Nome of Former Owner ........................................................
11. Zone or use district ir~ which premises ore situated .................................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation?
......... ~;;:~;~..£; .........................
13. Name of Owner of premises..¢7..~.~..q..~..z'......~....~...~/...~.../...Address ./.~..~7...c:../.'~..¥:2~r~f¢~..¢~.....Phone NO .....................
Name of Architect...~.~z.~.....~.....,~....~..~...A(..~. ........ ' ...... Address ........ ..,~...~...~../.-4...: ..................... Phone
Name of Contractor...~...('..~..~..~.~.~..~..~....~.. ........ Address .....~.~..°.~..~...q.(¢..(.~...~.(?..E....¢ZPhone NO..f~'.~:..?'.:'..~.../..¢../
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions ~rom
property lines. Give street and block numbers or description according to deed, and show street names and indicate
whether interior or corner lot.
STATE!~C),F NEW YORK, ) S
COU NTYC~F ............................ ) S.,,,t ~,~. ~,
'o~.. ./,~.~.(~..~..~.,~.., . ., . . ~;-I~ei u r d~ sas .~n . "s the applicant
"'~";':'""~"" '~'"~"?~' "~'" ~ :;(Na~e of mdi?~d~al 's~gmng':' ~a~ ...... Icat~on): .......... '??'"' ~ "~g ~' Y~'~ ~"~'~"~ ~ . .~,~. . that he is
above named. He ,s h .............................................................................................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or~ hgv~ ~rformed the said work and to make and file
this application; that all statements containe~ in this applicatibn' aFe 't}~ to the ~est of ~is knowledge and belief;
and that the work will be performed in t~ ~anneEset forth ig the, a~l~atio~ fi~ewith.
Sworn to ~re me th,s ~_ .~'2 / ~/~~ ~
........... ..........
iblJc. State of New Yor~
W ~, .? .................. ~ ..... (~ Express Morel 3 , 19~