The URL can be used to link to this page

Home My WebLink About1150-zFOE.~ NfO. 4 TOWN OF SOUTHOLD EUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y. C£H~TIFICA'I~E OF OCCUPANCY Date .......................... A%lgU~;-..1.9 .......... , ~9..60 THIS CERTIFIES that the l~uilding located at C:I,~'.!&..Roac~ ............................................... Street Map No.:~X~.. .......... Block NeK~F~ ....... Lot No. --.-~l~.....~Otl%l%O]zd.~....1/[.~"~ ............................ conforms substantially to the Application for Building Pemnit heretofore filed in this office dated ............ ,I.%t1~......22 .............. 19.6.0~. pursuant to which Building Permit No..Zll..~0 ......... -tared .................. 3'111.~......~2 .......... , 19..607 w.as issued, and conforms to ali of the requirements of the appiieable provisions of the la~v.:The oeeupancy for which this certificate is issued is ................ P..r;~.V.~e...~ne...£am~l¥...d~llxn{~ ................................................. ;. ..................................... This certificate is issued to ...I:,lr'~ .....ll~h..BOal~o ................. (.o:~o~..) ........ i ..................................... (owner, lessee 9r, tenant) of the aforesaid building. · L.. ~i .......... :..:-...:.: ..................... ~ : ' ::' '7 ........... Building InspeCtor 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? 115o Z Date ............................. ~. I,~.'. ...... ,~ .......19,6.Q.. Permission is hereby granted to: the% ~zt.'Lo~.ski.. ~.g_ ...B.~h.. ~o~.~e. ..................... ~. ~ehog.ue~.---..N-,,Y. ~ ......................................... to ..... ~td, l~..an.. ~l.i~:t.~..o~...~...e~,~J,~g...~t .v.e.t~.~r~ .................................................... at premises located at ..~l~,~...~Oa~ ............ *~.-~0~1.$~ .............................................................. pursuant to application dated .................................. ~:~.....22...i ....... 19..~.~., and approved by the Building Inspector ' Fee $. 51....0.0. ............. Building I nsp:eq'tor ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLI:RK'S OFFICE SOUTHOLD, N. Y. Examined ....... ...~..~.?~ 19 ..¥~..~ ... Approved ........ .~....6~...~... 19 ........ Permit No .......... Disapp roved a/c ..~.....~.~..-.......~.~ .................................. ........ '~'~l'd~'i ~ 's'~ ~ ~ ~'~ ......... Application No .......... ~..../..~..-~. ;).. APPLICATION FOR BUILDING PERMIT Dote...),., ..... .~..~.....~ ........................... 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 a detailed description of layout of property must be drawn on the diagram whlch is part of this location. c. The work cov. ered 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 15 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. TS~gnature of applicant, or name, if a corporation) (Address ~f applicant) / State whether applicant is owner, lessee, agent, architect, engineer, generaJ contractor, electrician, plumber or builder. ~ome of owner of premises ....... .~. ..... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~..,~.. I ~, L~,~Z .......... 1. Location of land on ~b, ich proposed work will be done. Map No: .~....~,~ ..... Street and Number~?~.~'.....~.~...'. ....... ~x~'/'" '~"~'"~'"~'"'~2'"'F'"~'Municipality .............................. 2. State existing use and occupancy of pr, cruises and intended ~se and occupancy of proposed construction: a. Existing use and occupancy.........~....~.....,...~.......~ ................................................................. b. Intended use and occupancy.......~...~r,~.c~.,.,..~.~.,-~'..,,,,~,,%,-~J,~.,.m~..'~ ~ e ................................................ 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration......."\ ............. Repair .................... Rem~al .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ............... i...~...~..~..~. ............................ 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 rnixed 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 of Stories ................ ~ ............... 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ...,.....~.~...O ............ React ........ ~..O. ............ Depth ....~......O..~...~, 10. Date of Purchase .~~ ............... NamefD ' ~ ~t~- ~°f Former Owner ...... 11. Zone or use district ~ whichk.plremises c~e situated ....... ~.[.~,~~ .................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... ~..m ................................. 13.' Name of Owner of premises.~'~,$.:/,~.,~.J~.,~-~,Address-- ----" .~.....~..~..~..x...Phone NO Name of Architect .................................................... Address .......................................... Phone NO ..................... Name of Contractor ......... Address ..... '. .:.Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and indicale 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. .Lc STATE OF NEW~2~) S S COU/~TY~OF ....~.~.~.:~..) ' , ~ (Name of individual signing.-c~pplication) __ (Contractor, agent, corlborate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and ta make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; Swornand thatto beforethe workmeWdlthis' be performed in the manner set forth~ injt~FTT~the apj~lication~0~<~l~/~._~, files;l.4,he r,c'~vith.~ ~ J/~.~..~Jr