The URL can be used to link to this page

Home My WebLink About1170-zFO,R~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..11~.~.. l~lt. dd~...lg0~cl,...li~.ol~t;ho.~ct.... Street -Map No ........ ~ ........Block No.....~......~......L~t No .......... ~._...~.....~ .................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. Atlgtt,St;..~.2 ........ , 19.~.0.. pursuant to which Building Permit No ........ ~..~1,.7.~. %ted .... ~l!t[tl~...],;~ .......... 19..~0., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .................................................. · B~S~N~$"'BU':~L'D~He~ ................................................................................ This certificale is issued to .~.~....l.,_..~,~ll~ll,~,~l~..A~O.q~l;iO.11.~....~ ............................. (owner, lessee or tenant) of the aforesaid building. Building Inspecto~c FOE~I NO, ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS BERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1170' Z Date ........................... A~g~S~;.....'~'2 ....... 1960... Permission is hereby granted to: ........ .~,~..~.e.~..he~d .................................................. ..................... .~,.£7~ .................................................. to .But.lc1...an...ad,4 .it i~>n...o~...a~ · .e~.$.se..z.n~ · -.~us.~ne s ~. -bttl.Z~ ~g ................................... at premises located ot .}$/$..,.,,.~,'~.d,t~.,~o~..~e,.rW/S...~o=cm§.s...Ave ............................................. ............................................ Sa~.thold,,......N,~ ................................................................................ pursuant to application dated ................................ ~L~ct'""~ ........ 1960..., and approved by the Building Inspector Fee $. 5,,, aC) ............. Building Inspector FORM NO. 1 TOWN O~: $OUTHOLD BUILDING DI:PARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exom i n ed.......~.. ::~.~ ....k ..'~.. ......... 19.~?..c?. ~ ,, ;z// Approved ........................................ 9 ........ Permit No .......................... Disapproved a/c ....~.~. .......... ........................................... (Buil~'ng Inspector) Application No. ! ) -~ 0 APPLICATION FOR BUILDING PERMIT Do,e .............. ........ ........ ,9C?...o. ..... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot p[on 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 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 Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulatio.ns, for the construction of buildings, additions or a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable lows, ordinances and regulations. .~..~...c....:~. ....... ~o.:L,..~...!..~ .......................... (Signature of applicant, or name, if a corporation) ......... ...... (Address of applicant) State whether applican.,~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... '.~.~. ?. ....... *. ............................................................ If applicant is a corporate, signature of duly autho~-~ed officer. (Name and title of corporate officer) 1. Location of land on which proposed work wil~ ~be done. Map No: ..... '.~....." .~......./~..;,... ...... .f~ ........ Lot No: ........... Street and Number .....~-.Z.~......~.~..~..~......~...~...~.. .............. ~~...~..:'"~ ......................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy.....~~.t....~"~'.~.~ ............................................................ ,. ' ,, " ~-~ c~ ~z~_ b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition ...... ~ ........ Alteration .................... Repair ................... Removal .................... Demolition ........ ~, ......... Other Work (Describe) .................... 4. Estimated Cost..~..~'....6...~._...~.. ........................................ 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..~~' 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 ........... /..J. ............ Rear ............ J...! ........... Depth ....... /../ ................. Height ............................ Number of Stories 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ...................................... Name of Former Owner .................................... .................. ..~....~..~ ,^... ~ .m ' ~ ' ..... 11. Zone or use d~stnct ~n whtch premises are s~tuated .......................... ~ ............................................ 12. Does proposed construction violate,any zoning law, ordinance or regulation? ....... .~........O. .................................. 13. Name of Owner of premises..~.;..[;.~~ddress..~'~.~..~. .................. Phone NO ..................... Name of Architect..~=..~....~.~..~.'......Address ................... :.! ...................... Phone NO ..................... Contractor...~'~Z.~..[~..-'......cm<....... Address ......... Z~...~... ........... Phone NO. Name of PLOT DIAGRAM Locate cleorly and distinctly ell buildings, whether existing or proposed, and indicate aH 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 NE'~L~Y~KI] ~t ) S S COUNTY OF _~,,k ........ ) ' ............................. //..(~-.~,..~.~....W/ ...................................... 0'~V~ I ~ O 'oeing auly' sworn, depos s ande soys that he is the applicant (Name 6f i~ividuoi signingA~l~, 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 file this applicat on; that all statements contained in this $~plication are true to the best of his kn~ledge and belief; and that'the work will be performed in the manner se~t~the application~d therew~/~ Sworn to before me this ~ ............... Z.~. day of ....... ~~..~ .... 19~.~,~ ~~~~*~pl~c~n~ Nota~ Public~.~.~~....,.; ~,.~ ~.~..,~County