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Home My WebLink About1024-zFOI~iV~ ~lO. 4 TOWI~ OF SOUTHOLD BUILDING DEPAHTMENT TOWN CLEI~K'S OFF~CE SOUTHOLD, N~ Y. CERTIFICATE OF OCCUPANCY No. Z /152 Date ........................ : .................................. ........................ octo~ P,O , :t~..~.9- THIS CERTIFIES that the building located a*r~ ,/.~...~.o..r~ ...R..qa.~...i.R..~......,.2.5.).~.....o.r.¢~t Map No ....................... Block No ..................... Lot No .............................................................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 6 19 60 pursuant to which Building Permit No. Z 1024 dated ................. ~...~ ............. ~..~., was issued, a~d conforms to ail of the req~irement~ of the applicable provisions of the law. The occupancy for which this certificate is issued is TOURIST COTTJ~': This certificate is issued to william .P~ B;inf~.~,. ~9/lri.~lr .................. (owner, lessee or tenant) of the aforesaid building. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y.- BUILDING PERMIT (THIS P.ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1024 Z Permission is hereby granted to: pursuant to application dbted .............................. l~p~ii3.....~ ............... 191~0~.., and approved ~y the Building Inspector Fee $~). O0' ............ FORM NO. 1 TOWN OF SOOTHOLO BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOOTaOLD, ,. ¥. 9.. . Perm t No ....... Examined ........, .......................... , Approved Disapproved a/c ........................................... ............................. Application No.../.D~..~.~( ............... APPLICATION FOR BUILDING PERMIT Date ................... tj. ................................... , ........ 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 ar public streets or areas, and giving a detailed description of Ibyout of property must be drawn on the diagram which is part of this location. c. The work covered by this applicati.on 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 whotever until a Certificote of Occupancy shall have been granted by the Building Inspgctor. 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 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 name, if a corporation) (Address of applicant) State whether applicant/J~'~vner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .......................................................................... ~ ......................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work wi~'be~done.,~Map,,~l~: ...:...;,.~ ....... ,.,~ ..................... Lo:[ No: Btreet and Number ............................................................................................................ : ....................................... Municipali~ ' 2. State existing use and occupancy of ~ises a~d intended use and occu~ of ~roposed,construction: a. Existing use and occupancy .......................................... ~ .......................... b. Intended use end occupancy ........................................ d: ...................................................................................... 3. Nature of work (check which applicable): New l~ullding ....... ~ ........ Addition .................... Alteration .................... Repair .................... Removal .................... Demolition ................ ...~,Other Work (Describe) .................... 4. Estimated Cost ............................................................ Fee ./..~.~...'...'.../,, ' .......................................................................... ~-~J~ (I'~L '1 '"x (to be paid an filing this application) 5, If dwelling, number of ~ units .......... ~ ....... Number of dwelling units on each floor .................................. tf garage, number of cars ~ "/~, 6. If business, commercial ar 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 ................................ B. Dimensions of entire new construction: Front ~ g'' Rear ~ ~'' Depth L~- o Height ............................ Number of Stories......~ .......... 9. Size of lot: Front / '~ O Rear '/ ~' O Depth ~6r~/ .-~o o 10. Date of P e / X ,<' ~-/ . /~ex r,~, urchas .............................. Nqme,.of Fo~rner Owner ................................ ..4... 11. Zone or use district in which premises are situated ..................... '..~/ .................................................. 12. Does proposed construct on v o ate any zon ng aw, ord nonce or re. au at on~ ....... ' ' ................................... 13. Name o Owner af premtses~'"'"O/.0~.~/,~,~.~, .......... ;: ........ '~ ......... Address .......................................... Phone NO ..................... Name of Architect ..... ~/£~:'...:...~.7..)....~.::;~?.;)..;!..,.'....Address .......................................... Phone NO ..... ** . ...................................... Name of Contractor t~ .......... ' ....... :~'"';'~ ...................... Address ... ~S~'e~-,,*'-'~-~ ~ '~ Phone NO ..................... 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,.-YQ~K, ~ ) S S COUNI'Y OF ...~..~...~v~....arr.......) ' ' ................................... .~/.~..~..%L.....¢/..~¢..~?.,..-~....-~... ................. being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the .................~',:~-~..~.~.,.~:;r:x~...'>w.....L ......................................................................................................... · (Contractor, agent, corporate, officer, etc.) of said owner or owners, and is duly authorized to perform or hav.e 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. J[/DITFI T, (Signature of applicant)