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Home My WebLink About1061-zFO~ ~O. 4 TOWN OF $OUTHOLD BUILDING DEi~ARTMENT TOWN CLERK'S OFFICE SOUTh{OLD, ~. ¥. CERTIFICATE OF'OCCUPANCY No ...... ~,..~.9.~ ...... Date .................. I~ .~..¢.~..m~...e. r.. ?, ................ 19..~0 THIS CERTIFIES that the building located al ..~.t!.~:.? ~ :....~..a.~._.~._~.~. .............. Street Map No ........~.~.. ....... Block No......~........~.....Lot 1N'o ..... .~.......*.......*. ........................................................ confm'ms substantially to the Application for Building Permit heretofore filed in this office dated .............. ,Apt. il...21 ........... 19.6.0.. pursuant to which Building Permit No ........... flated ............... .M..~.~.....2. ................... , 19......6..,0 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for ~vhich this certificate is issued is ~[VATE ONE FAMILY DWELLING This certificate is issued toh.e...°..n..i, da.s.....t't~P~Qn..,......~.,,~.~l..a-r. .................................................. (owner, lessee or tenant) of the aforesaid building. Bufld~hg In~pdctor 'I FO~i NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. BUILDING PERMIT (THIS ~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1061 Z Date .............................. ~t'......~ ............. Permission is hereby granted to: Charles Bur, tbl. e.....A/g... ·. ;/.~o~$~].as... ·. P.a~p zoc, t .......... ......... .Gr.e~n~orJ;.,......1~., ]f~ ................................ to .....Bu~;~il.. a~,n., acl~,.$,J~c~n., on.. a~..e~n~...d.~elli~ ..................................................... at premises Iocoted at .,..~.~.~....~.~.~...~ ....................................................................................... .................................................... ................................................................. pursuant to application dated ............................ ~;t~.....~lL. ............ 19.~0t., and approved by the Building Inspector Fee $.~,~0.....1;~,,.. oheck ouilding inspector \ -' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. exom ne ........ .................................... , -/06 / Approved ~' 19 ........ Permit No ................................. Disapproved a/c ....... (Building Inspector) Application No ..... ~...0.....~.. ~ ............ APPLICATION FOR BUILDING PERMIT Date ./ 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 or punic 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 ava.ilab e 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 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) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................... ..................................................................................... ....................................... . Name of owner of premises ....... ~..~.~-L~ .?. ...... <..~:~?..~ ............................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work will be done. Map No: ............................................Lot No: .................... Street and Number ........... 4 ........ .~...~ ....................... :~.~' . ..... ~z~r:Z.z;×~, ....................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existin~ use ond occuponcy ............... ~ ...; ........................................................................... b. Intended use and occupancy ............................. ...~.~..'-~..~.~...~..~.~./:..~..-'.~ .................................................................... 3. Nature of work (check which applicable): New Building .................... Addition......~.. ........... Alteration .................... Repair ................... Removal ........ Demolition .................... Other Work (Describe) ...... 4. Est mated Cost .r.~.../ 0T/) 0...~ ~. ...... 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 ............... ,4.~ ........................................................................................... Dimensions of same structure with alterations or additions: Front ........... ..~../J. .............. Rear ...... .~...?. ................... Depth ....... ~.2.~.. .................. Height ........... ~.i ................. Number of Stories ............. ! .................. 8. Dimensions of entire new construction: Front ........... /..9. ............ Rear ......... ./..~ ............. Depth .....~: .................... Height ........ ~.. ................ Number of Stories ........... I .................... 9. Size of lot: Front ......:/:^~..~. .......... Rear ........ L.C.L.~.~ ......... Depth ....... l..~..'.~..~. 10. Date of Purchase ......./~:.~......~. ............ I...~..~...~....Narne of Former Owner 11, Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction;, ,~ ,r-,v~late a,n~y zoni,Qg law, ordinance or~ .,~regulati°n? ........................................................ 13. Name of Owner of premise~..J,,/...~ddress ..~(~z,~....~l....~.... Phone NO.'~.~..~.~.~...? Name of Architect};~.~;~;; ,,,~,~,,,,~ ................................................... Address ~~i'~ii.~'~..IIII Phone NO....~ ............... Name of Contractor .~,~..,.~,,...~.~,~,,.,.,.,.~.,.............Address .~.: 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 NEV~L~Y~/r ) S S COUNTY OF: .~L.~/] ~)~ ' ' ~ ....................................................... ~ ....................................... beinO duly sworn, deposes ~nd soys that ho is the opplicont (Name of individual signing application) above named. He is the ....................................... ~.Z.~ .............................................................................. (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. S ...... *~ h~f~re ~e this ~ ~llc. s?te of N~ ~ " ........... ~s~lng in Suffolk County ~da of .......... f~ ........................... ~Cq~Exp ~s ~rrh 30 ........................ Notary PubliG .~......~~¢~ .... County (Signature of applicant)