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Home My WebLink About1141-zFOR~ NO. 4 TO~YI~ OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOL~, N. Y. CERTIFICATE OF OCCUPANCY No ........ ~../,29~ ...... Date ..................... d'a~uar, y...2~ .......... , 19..6~,. THIS CERTIFIES that the building located at Map No.~W ................ Block No ........ ~e.~ ....... Lot No ................... ~,~ ................................... ........ conforms substantially to the Application for Building Permit heretofore filed in this office doted .............. .J..t4..1. Y....~..6. .................................... 19....6..0.. pursuant to which Building Permit No. dated '"~t~"ly'"~8 ................................ , 19....60 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 .......... ~R~VATR ON~ ~A~L~ DWELLING This certificate is issued to ................................... .W..a..1...t..~...~....~.e..~..~.l...e..r..,....o...~..~..~..~ ............................... (owner, lessee or tenant) of the aforesaid building. FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT $OUTHOLD, N. Y. (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1141' Z Dote ..................... r~..:....J/.~ ...~. Permission is hereby granted to: WaZte~...K~s~le~. ....................................................... ........ ~.ti.t~¢k~...,.~,~. .................................. t o .bz~L3~.. ne~.. one.. ,family.. ~e iIin~ ..................................................................................... at premises located at ...S/~.....j~O4~.I.o..AVO ..... O~.f...E/~..G:~...A~o ........................................ ....................................... Me~ .~.$ ~.~e~ ~......N.~.~Z.~ ................................................................................... pursuant to application dated ............................. ~t]~'""]:~ ............... 19~(~..., and approved by the Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y.~ ~/ I Approved ........................................ 19 ........ Permit No......~... Disapproved a/c ................ .¢~....'-r../l......~.'r.....~.. ................. APPLICATION FOR BUILDING PERMIT Application No. i.~..!...E/ ............ ~; Date #.~1~. 16, ......... 1960 . INSTRUCTIONS a. This application must, be~ com?l~te y fi!led in by typewritef 97 in iqk ond sugr~itted in duplicate to the Building '~nspe~tor. - ' ' 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 o 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. ......... ................ (Signature of applicant, or name, if a corporation) .......... ~a.~i~i.t~.~k.,...I~.e~...~To. rk ....................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................... .O..~ft.~.r ............................................................................................................................................................. Name of.owner of premises ................~.l~l~.~e.~...~.e~l..e.3~. .................................................................................................. 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: ............................................Lot No: .................... Street and Number .~a~`~.e...J~.e~...e~..~..~`~..~.~e~r~..~e.~.~1~e~..~e~.~:b.~..~e~.~ .................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed constructiom: a. Existing use and occupancy ........ ~.~c~n~,:~8~. .................................................................................................. b. Intended use and occupancy property lines. Give street and block numbers or description according to deed, whether interior or corner lot. 3. Nature of work (check which applicable): New Building ...... ~ ........... Addition .................... Alteration .................. '.. Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... : 4~ Estimated Cost......~'l.0.~.tO. Cff).o.f).0. ................................ Fee ....~/.~. ................................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............. '1 ................. 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....~T~l.~ .............. 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~I. ............... Rear ...... ~.. ............... Depth ...~,~.'~.~.1. ............. Height ....'L,~;(; ................ Number of Stories ....... .~....'.' ............... 9. Size of lot: Front ...3.'1,,~.,.(~7~ ........ Rear ...... ~..9.,..~.?.? ......... Depth .....O..~..e...~...~..0..O..I.... 10. Date of Purchase ....... ~TL~J~.~..~.~C~ ......................... N'bme of Former Owner ..T,~.~'I:L~..~I~.~.~;L,~.~ .................... 11. Zone or use district in which premises are situated ...... ~. ....................................................................................... 12. ~Does proposed const~dction ~iolbte any zoning law, ordinance or regulation? ..... ,~.~.~,~-~ ........... i~.,.,:,..~.,..~/.~..~..).. 13. Name of Owner of premises,,.~lil]..~..~l~.~l~..e.~...Address ..~&~i~,~l,~...JJ.*~.*~...,.Phone NO, Name of Architect ........................................................ Address ............................................ Phone NO .................... Name of Contractor ...............1~.l~l]..~ifJ~...~l..~.l~'...Address ..~e,.~.~'k~.~...~.,.~....,.Phone NO. ~&...9.~14.~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from and show street names and indicate STATE OF NEW YORK, ) S S. COUNTY OF ..~J~.~..g,T,,~ ........ ) .~l~J.J~ ,[f~ ............................ being duly sworn, deposes and says that he is the applicant (Name of md~v~d~a s gn n~ app ~cat' on) . above named. He is the ............................. ~ ............................................................................................................. (Contractor, agent, coriborate officer, etc.) ~l~:said owner or owners, and is duly authorized to perform or have per.formed the said work and to make and file this application; that ali statements contained in this application are tru~ to the best of his knowledge and belief; and that the work wig be performed in)the manner set forth !p.,th, e apptic,,ation filed therewith. Sw°rn t° her°re .m,~_is / .... ~.~ .......... d.~y ~of ....... ~T.1.1.[I,~ ./...~...,,..~.../.~.. 19...~0 ..... (Signature of opplicant)~ L~ F F c H't <