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Home My WebLink About1209-z 'TOWN OF SOUTHOLD BUILDING DEPAR'TM'~-NT SOUTHOLD, Iq. Y. CERTIFICATE OF OCCUPANCY No. Z .1023 .......... Date ....................... ~a.~...e. ll.....~ .~. ............. 19.~.~.. THIS CERTIFIES that the building located at ....Loll{i...VI.~Ig..DI~ ......................... Street Terry Waters 'Map No ........................ Block No...XXX .............. Lot No. 6~t ~.O.R~h~.d..~... ~...Y~ ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................... Se.pI;omhe~....9.., 19..6,0. pursuant to which Building Permit No....I~..~.0~. dated ................. g~.pgamb~....~1,~ 19..~, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ~Z~.i~at; ~ ·..O~1 ~... i~.aitl:~ ~3r...Cl~.li.Rg ........................................................................ This certificate is issued to .~aal~.....L~l~ad:[aa .......................... 0-~i'lar .................................. (owner, lessee or tenant) of the aforesaid building. ....... ' Building' Inspector FOi~NI NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Iq. Y. BUILDING P[RMIT (THIS I~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1209 Z Date ..................... 8'e~;e~b~z~ ....... ]:3'" 19.6.O.. Permission is hereby granted to: G.~. ~_ mx t~z..&... ~z~s..... ~f'C...Pa~..LaiCe~d ±e a. .............. ..... E et~thc~!d. ....................................................... to .~ve..~a~..~i~.~g..~b~i~i~...~e.~h~.~..~e.a~.i.~..~a~d~.~eenv~v.~...~.d.we~.ing at premises located at ..~.../~..~.-...~eF.P~...k~e~s. ..................................................................... ...................................... ~eng...V. iew...Ave..&. :~aCer ~--.E~ge.-~,~y- ............................................... ................................................................. Zen¢~e.~d.s...-..N.~.g~ ............................................................ pursuant to application dated ............................. ~t~b~'""~ ...... 19.6.0.., and approved by the Building Inspector Fee $1Q..OCI ........... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN C,ERK'S OMC'= SOUTHOLD, N. Y. No. ..... Disapproved a/c .............................................................................................. ...... .................. (Building Inspector) ~/~ Application No ..... . .4~..-':~.....~..~... ....... APPLICATION FOR BUILDING PERMIT Date ...................................... IN'STRUCTIONS 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 adioining 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 issuance 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. (Signat'6re of applicant, or name, if a corporation) ............ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises...~....~.. ................................................................................................... If applicant is a corporate, signa,~re of duly oHthorized officer. (Name and title o corporate o ricer) 1. Location of land on which proposed~ work will be done. Map No: ...~. ................ ~.... Lot No: .......... ' .......... ' .................................... Street and Number . .. ~ ......... Municipality 2. State existing use and occupancy of pr, emises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................................................................................... b. Intended use and occupancy...~--~~¢~-~ ..................................................................................... 3. Nature of ~work (check which applicable): New Building .................... Addition ................. ,7JZ '~.~.w'/~lt~r~t'i~""'~*'"~g' ...... 4. Estimated Cost ...... .~....~'..~.~...~ ............................... Fee ....... ...../....~.....'"" ................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ................................ Numbe of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occupancy, specie× nature and extent of each type of use .............................. 7. Dimensions of ex~sting structures, ,f any: Front ........ ~'-?....~.. ............ Rear ...... ...'~...~ ............. Depth .....~....~. .................. Height ............................ Number of Stories ...................................... ~v~.,~,..~ ..................................................... 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 ............., .............. ' -- ~"'~ ~se re s~tuated /~ 11. Zone or use district in wh'ch prem' s a ' · .............................................. -,~ .......................................... 12. Does proposed construction//-~"~///,~~°,~/~t,~AddressOrdinance or regulation? .................................................... 13. Name of Owner of premises.~.. ......... .................................. Phone NO ..................... of Architect ....... ~. .......... ~.~....:,~'...>~ ......... Address ~,.~.~ .......... Phone NO ..................... Name Name of Contractor .................................................... ~xaa e s ............................................ e ~ ,. PLOT DIAGRAM ' Locate clearly and distinctly all buildings, whether existing or'proposed, and indicate 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.' STATE OF NEW S S. COUNTY OF ...................................... being ,duly sworn, deposes ond says thor he is the opplicant (Name of individual signing application) above named. He is the ........... ~~:.~.. .................................................................................................................. (Contractor, agent, corlSorote officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this application; 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 manner set forth in the application filed therewith. Sworn to before,me this ~ lUmTH T. [~.. , St~ e o New york ~ ~ ~f ~~]~963 Su loik Co~ntyt I (Signature of applicant) ........ ~"~' ~'~-~'""~'"~ ~ ' ~ Exm~es M~ ch 30, ~ I ~