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Home My WebLink About1201-zTOWN OF SOUTHOLD BUILDING D~--PARTMENT ~'OWN CIdERK'S OFFICE $OUTHOLD, N. Y, CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ~..,,, ]~{O;~,JSh..S.o,.g..~)It~.V...e. .......... Street Map No. :~XX ................ Block No..~t,~ .............. Lot No..~ ....... .~.'.~..~..~.~..O.~,~ ................................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................... ge.p.~emhe~....6, 19.6.0.. pursuant to which Building Permit No ..... .~....1..2..0.~ dated ................ ~.~ .......... .6 .......... 19..~.0., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is ~ssued is ....l~.~[V.a,~.e...one...£ar~2,y... c~.e,~2,~g ............................................................................... This certificate is issued to ~0~.~..0..g.~,Y....b~.~0.1~ ......... Qwlq..e.~ ......................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector FOEH NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMEHT TOWN CLERK'S OFFIC£ SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1201'. Z Dote ........................ Permission is hereby gronted to: Don F~ ed e~;Lc.i¢.. A/.~ .. D~r.o .~h~...../~a~/aho~ .................. ...... 8o~hol~,..... ~.,.Y-, ...................................... to ....~ai.l~.. ~n...ad4.i.tien.-eh...ar~ · - e:~ .i.e~..in~ - · d.~; e.! .t.f-ng. ..................................................... ot premises located at ....Lo.t..,l~...~i~-iGO..~.~ ........................................................................... .......................................... Nor~..h.. {n. ea.. Drive .i '"' 'Eoutho!~ ........................................................ pursuant to application dated ...................... .~e.p~;e~be~ .......6 .......... ~960.., and approved by the Building Inspector Fee $.,.~.C)1~ ............ FORI~I NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No.....~'......~......[ ........ Approved .......................t ................. 19.....LPermit No .............................. Disapproved a/c ~.~ ............................................ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and su~amitted 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 Building 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 Southotd, 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 regulations. ........... .................... (Signature of applicant, or ~ame, if a corporation) ................. (Address bf app[if~6nt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................................................... ..................................................................................... Name of owner of premises.....~.d,..~d~...~?.~.~....~..Jx~.....~.. ............. ' ............................................................. If applicant is a corporate, signature of duty authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work ~vi[I be do~.e. Map No: ..~.....~'~... LOt No: ..... '.~..-~4... ...... Street and Number/~../,~...~.~..~,...~.,~_.~¢~.....f~~.,.L~..~..~~/.~....~-- /7 / // /'1-- //~7/~ ..................................... / Municipality · 2. State existing use and occupancy of pr, emJses and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ .~..'P/,~."~-~,gr...~.'~.~.-/..,~'~' ....................... v ............................. b. Intended use and ,occupancy ............................ . ............................................ g~....e'S¢~..'.-~.-~(~.C~... .............. / 3. Nature of work (check which applicable): New Building .................... Addition ..... ~ .......... Alteration .................... Repair ................. ..,,Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost.....5...,,:~....~..~....(~...' J ..............Fee...~...~-~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ................. / ............ Number of dwelling units on each floor ............. ../.. ........... If gaFage, 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....i~.~..~ ......... Rear ....... ~..~- .......... Depth ...~....~;.. ............. Height ............................ Number of Stories .......... ./. ................................................................................................. Dimensions of same structure with alterations or additions: Front .......... ~ ............. Rear ........... ~ .~...~ ....... Depth ...~...~./.../..~. .......... Height .............................. Number of Stories ....... ./.. ..................... 8. Dimensions/ofanti're new construction: Front ........ .~...~. ............ Rear ....... .?...~... .............. Depth . ./...~. .................. Height ............................ Number of Stories ........ Z ................. 9. Size of lot: Front ........... ./.....~...: .... Rear ........... ./...~)Z~. ....... Depth ........ ~..~,.~ ' ............................. Name o[, Former g,wner ______ ....... 10. Date of Purchase .~/~.'./(~... ..~... .................. 11. Zone or use distri h s itu ed i2. Does proposed construc 'on vj~at~ y,~ i g w, r~' :~e g ' . .................................................... 13. Name of Owner of premise~Z,.~.~'dd~dres~s~s ....~.~~.,_~, ~...P~none NO ..................... Name of Architect ................. /Z ................. > ................ Address ,-~ ,,~,~"Ph°ne NO ..................... Name of Contractor.~.~,~.22.~, .~...~.'~~..Addres~.~.~'¢~.K~.'~.Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctl all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and bi ck numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW,/'f'O[~I~ ,,?/_ ~/ S S COUNTY O F,~c~...~~. ' - ........................... ~.....~ ....... being duly sworn, deposes and says that he is the applicant (Name of individual si~ning 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 file this application; that a statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth.Ln~the application ~i~d therewith. , Sworn to before me this ~ ~ ~ _ . ~1 ~ ~ . ' J ............. ~ ......... ~ .,~,.~~-..~.. ~otaryl ~1~ m~e ~'~G;w York ~OTO~ ....... ~UO lc,- ~~~~ 57-,,~344963. Suffolk Cou.ty~ ~/