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Home My WebLink About1070-zFOI~i~I NO. 4 TOWN OF $OUTHOLD B~UILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z ~249 Date ~'anua~'~, 23 ,~.2. ...... THIS CERTIFIES that the building located DGVs, Map Nc~..~.~..~..~..~...~..e.~... Block No...e..?..~. .............. Lot No ................. ~. ................................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ .~...a.~....5.. ......................................... , 19..6..0.... pursuant to which Building Permit No.~....~...O..7...O.... dated ../~1~..5 ....................................... , 19../~, was issued, and conforms to ail of the requirements of the applicable provisions of' 'the law. The occupancy for which this certificate is issued is .......... This certificate is issued to Jose]Dh & Estelle Berc~lnka, owners (owner, lessee or tenant) of the o.foresaid building. FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° lO7O Z Date .......................... ~L~'......~. ................ 19~0... Permission is hereby granted to: Harold.....T. er~$,ko.....A,/C..... Joseph.... ........ B~¥...B~r.~..~Jo~d ...................................... ..................... .s...o..u..~.o...1..d.,......~.,..~.~ ........................ to ...... Bu4..I~ .. e,~n.. ~1~,,~ %.ion ,. oi.~,.,an.,,exis~tztg, ..d~eil. li~ .................................................... at premises located at ~,0%...;~-.;~ ....... Weet..~re~i~--~)e~'et~.-..~...t2.36 .............................. ......................................... Bay...t~e~r.~.- t~oa4 .~ ....... ~ou.th~td.~. · ...-~.~ ~. ........................................ pursuant to application dated ................................ .,~....~.f.....~960.19 ........, and approve.d by the Building Inspector Fee $ · ~"i'O0 ............. NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLF, RK'S OFFICE SOUTHOLD, N. Y. Examined ......................... /...~......, Application No ..... ./..?.. ?...(.-.). ............. 19 ........ Permit No. Approved " ! o '~ O Disapproved a/c .../. .......... ;>,~,~, ............. ~>.~.m,,~ .......... ~.~ ......... ............................. ............................ APPLICATION FOR BUILDING PERMIT Date .................................. .y......,~ ......... , 19.~..0.. INSTRUCTIONS o. 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 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 o 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, ordjn, ances and regulations. ..... ................. ~,~gnatLh~ of applicant, or name, if o corporation) ............................. : ................. (Address of opphcant) "' 1/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and t~tle of corporate officer) 1. Location of land on which proposed work will be done. M_ap No: ~../..C~.,~....~... ............... Lot~ No:.....:~ ........ Municipolity~ 2. Store existin0 use ond occuponcy of pre~isos ond intended use ~nd occuponcy of proposed construction: a. Existing use and occupancy ( ~..~......,~.~..~.. 3. Nature of work (check which applicable): New Building .................... Addition...~ ...... Alteration .................... Repair ............... ~Removal ....................Dem, olition .................... Other Work (Describe) .................... · OO 0 ..... ,. ,' 4. Eshmoted Cost ...... c~9 ........... .~...~ .............................. Fee .......................................................................................... ~ ' r' ..... : :, (to be paid on filing this application) 5. If dwelling, number of dwelling units.../..'....:..,.:,..M..NQmbe¢'of dwelling units on each floor......~... ......................... If garage, number of cars ............................... ', ,:. ...... ..: :.;L....: ................................................................................ 6. If business, commercial or mixed occupancy, specify~ature and extent of e,ach ty~ of use ................................ ..... ~//~ ~/- ~ ~ ,~ ~ . ~ 7. Dimensions of existing structures, if any: Front...~.~ ...... ~ ....... Rear ....~.../..~.~ ......Depth ..Z..~ ...................... . Height ..~.~ .................. Number of Stories ....~. .............................................. ~. ...... ;~ .................................. / ...... Dimensions of same structure with alterations ~ additions: Front ...~....~ ....... Rear ...... ~.~.~.. Denth ~ ~ Height ...~ ..... Number of Stories ...... ~.....,~ ............ 8. Dimensions of entire new construction: Front .,..~.~...~... Rear ...~.~ .......... Depth ~..Z.~ ........ Height .......... .~ ........... Number of Stories ......~.....~ ............ 9. Size of lot: ,font ..../..~.~.... ~ear ,..~.....:.... De~'th .,~..~.. __ 10 .................... :...~ .~.-... .~ . .// . ~ 11. Zone or use district in which premises are situated ....... ~..~.~..~.~.~..~ ............................................................. 12. , Does proposed construction violate any ~o~ing law, ordinance or reguta~ign?, ...... ~.~ ...................................... 13. Name of Owner of premises..~.~ ..~~dress ............ Phone .................................................... ~dd¢ s ............ ....././...~ ...... , ........ Phone NO. Name of Architect , ,,, ,, .. ,,Nam~ of Contractor ..... ,.~ ~. ..A~,~r~ss ........ Phone NO ..................... PLOT DIAGRAM L.oc~te ,clearly and, distinctly qll b~jJdjngf, whether existi~g,~ proposed, ,and indicate all set-back,,dimensions ,fram property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner flor, ...... ~'~ ' ................ ' ~ ' ' .,l~ ~.~~,,~ ' / %o '" ~ ... STATE OF NEW YORK ) S S [ ( ' COUNTY o, ......... ~ ........... L, ' ~'~ ~ ~'~% O U t ~.... ...... ,...:,,.. ........ .~ ........................................... being duly sworn, deposes and says thor he is th~ opplicont ~ (N~me of individual signing opplic~tion) ' ' o~ov~ n~.d.H. ~, ,~ ............... ~:~ . .~, ~." ....... :"~o~;';~L'~;;.:.'~;'~'~;.'.[~;Fg',.~;'~7i~'~;,";~;.'~'"". .............. : ................... of said owne~ or owners ond is du y:outkor zed to perform or hov,e performed the said work ond to make and file this appiicotion; that all stotemenfs contained in this application ore 'true to the best of his~ knowledge ond belief; ond t~ot 'the wbrk will be performed in tkb manhunt forth in t~e application filed therewith. ............... o, ..... ................ Notory ,ublic,~~~t~J County (Sig~atur2of opplico,t) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPART~V~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ............. ...~....!.¢...~.....-~...., 19..~..0.... Approved t/ 19 ........ Permit No. Disapproved a/c ....~..~,~ ................... ;.~ ........... ........................ ............................. (Building Inspector~ Application ldo ...... ./..?..~...~.. ............ APPLICATION FOR BUILDING PERMIT Dote ....................... ........ , 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 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 hove 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 lows, ordinances and re~ulat~oj~s. .......~z~:~ rz :rt ..... ~ ....... i ~ .............. i*~ ............................. ~,utumu, u~p icont, or name, a corporation) ..... (Addresser applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................. ~..~..~.~..~.....,~'..~....ff...~..~. ......................................................................................... Name of awner of premises ................ ~. ........ :...~./. .... tf 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 ....... ...~...~.,/¢ ........ .~...~.~..C., ...... ...'~......-'~.....~..~..'.~.~.f"/"~"' .'/.~.~-7~ .~.......~'.~.~---- -- Municipality / / 2. State existing use and occupancy of premi,ses,and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ,~./.-~';/..~...~.. ....... ~...~..~. ~...'J~...'~ ~'..~. 3. Nature of work (check which applicable): New Building .................... Addition...~ ........ Alteration .................... Repair ................ .~/-Removal .................... De, molition .................... Other Work (Describe) .................... '~'t4~M'~'~/~q3~~flg,~. '~i,~ be paid on filing this application) 5. Jf dwelling, number of dwelling un ts ....... ~.,,.L~..,,.~..~,.~;~,.~ell ng units on each fJoor.....~ ......................... If garage, number of cars .............................................. L .............................................................................................. 6. If business commerc a ar m xed occupancy specify nature and extent of ~ach type of use .................. ...... t ~ ~ et Heighf ....~.~ ................ Number of Stones ....... ~. ..................................... u.z ...... ~.~ .......................... :_;..~.....~ ~,~,~ ...~.~...=~...;. ...... H,i~, ....... ~..] ............ ~,~..of s,~i,~ ............. ~ ....... ~ .......... _ . Height ...~.~....'. ........ Numb~r'of Stories;w.)Z..;...,::...;.,...., si,, of ~o~: F~o,~ ...... ....... ~ ...~...=~. .......... .............. . 10. Date of Purchase~.~/~,...~C4;~,~,~..~~~~r. ~.....~ ]1. Zone or use district in which premises ore situ~ted_...~~ ................................................................. 12. q~o~ proposed construct on violat0 onv,~o~ino ~ow, 9¢~nonce or r*~ul~ti~n? ..... ~ ...................................... Name of Architect. h I A[~N~S~II Phone NO .......... ..,,,. ....... ........... ,..., .................. ,ho,, ...... : ........ PLOT DIAGRAM , ~., :L.gcete, clearly agd, ~shnctl~,glJ~ ,b~ll~ng~,~.,~h~th~h ~b~g~,~qproposgd~ and t~d,icate .all,.set-ba~k,,~i.me~sions, ~rom prope'ty nes G ve strept and b ack numbers or aes~ription according to deed and show street names and i~dicate wnemer m~enor or come. . ~ ~ ' . STATE OF NEW YORK ) S q <~ ~---- rj , C/ / -- ~' ¢'~ COUNTY OF .......... , ............. '") ~/(~ d~,,~k , ~,/,, ~,,~,)( d)JJF,V ,,,~',~ ," ; .... ~ ~, ' ..~..,v~........................ .................................. be..~ d.,~ ~wo.. d~.o~ ~.d ~y~ ,,, ~ ~ ' (~ame of individual signing a~plication) ........ ,__ above named. He is the ..................... ~..Z .................... ~z ............................................................................................... of said owner ~ owners,' and is 'duly authorized to perform or have performed the'sa d work and'to make and filo this application; that a statements ?ntained in this application are true to the best of hi~ knowledge and belief; a~'}~'6~'th'e"~6rE"~iJ] 5f'perT6'rme~ m t~e ~nne~t~ f~n ~h~ application filed therewith. ~ P~Hic, State el N-'~=, ~ .. ' ~ . ., '. ..................... ........... = ........ ............ ,, ............ ' Nota,y Public, ~.~~ ....... County ~gna~re o pp' )