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Home My WebLink About1121-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOL~ N.Y. CERTIFICATE OF OCCUPANCY Date ~'anuaffy. 2:~ 19 ........ 62 THiS C£RTiFiES that the buiiding located ate/~S..C~a~...i~/'~.r..~O~tih~a,~ ........... Street MCtaOpO~oe. Bay ~t~t*~ , ...................... ~,OCK No. '~*~. ............... Lot No ................ ~.:~...~..?&...~.ltel.~ ...................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... ~r.~lr~.e..7,,?. ...................................... , 1 g~.~. .... pursuant to which Building Permit No. ~..~,.~,~..J,.. dated ¢T~t~...:~? ................................... , 19....6~ was issued, and conforms to all of the requirernent~ of the appiicable provisions of the law. The occupancy for which this certificate is issued is .......... .......... ........................................................... This certificate is issued to ....... (owner, lessee or tenant) \ of the aforesaid building. F01~I~I NO. 2 TOWN OF SOUTHOLD 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? 1121, z Permission is hereby granted to: to bu~l~ &ddltton on ~xLst.~g one ~i~ Building Inspector ' ~e~ $..,?..0....~..? ~ia, l~OlrCM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... ,..f~ ~ ~. f.'~,¢: .~:...~..~... 19..~..9 Approved ....... ..~:~. ~/, ~.......c~. ·..~... 19 ...~..0.). Per m it No ....... r;-~' .~.../.,..:~.../. ..... Disapproved a/c ...................... ]]~....~.~.: ...... ~.......]]],_ Application No ..... . .~.....~]...'~....../fi.. ..... (Bui ding Inspector) .................. iQ' APPLICATION FOR BUILDING PERMIT 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 cov. ered 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 Certificai:e of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Buliding 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) .............................. ............................. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................ ..................................................................................... Name of owner of pram.sas ......... ....... - ........ ~.....,,]~.....~..~...~...~f..,',~..,~ ................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ?/ Street and Number ........ ~,z~.~.......f~..~..~...~r~..~.~....~. ,~.~..~./.. .................................................. / "Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Bxisting use and occupancy ............ ~.~....~..~.~. ~ b. Intended use and occupancy .............................................................................. ~..L~...~~ ........... 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-,,,L:~,.~i].i ...... Alteration .................... Repair .............. ~.Removal .... ; ....... Demolit on .......... Other Wore (Describe) 4. Estimated Cost.......~..C...~ ...... ~ ..................................... Fee ...... -..~... ............................................................................. (to be paid on filing this application) 5. ]f 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 natu, ze and extent of each typ,,e of use .............................. 7. Dimensions of existing structures, if any: Front ........ .~...~..... ...... Rear ............ .~.,...~..,... Depth ..... ~-?...~.... ........ Height Number of Stories / ' ~, Dimensi~'~"~'f"~i~"~i';~'cture with a Iterat ion's" ~"~ ~if[~n'~i"~';~'i'iii'.i i'.'.~.ii iiiiii ii'."~ ~';' i'.'.'.~i ~.'.'.i' ". ....... Depth ....... ...~....~.. ........... Height .............................. Number of Stories ...........,,/, .................. 8. Dimensions of entire new construction: Front ........... /.....cr~ ....... Rear ............. ./...¢~,~... Depth ..../~,,'. ............... Height ............................ Number of Stories ...... Z ................... 9. Size of lot: Front ..... ./..,.~....(~. ........... Rear ........ /.~..~/). ........ Depth' ../....'~...~..~....~. ......... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ............. i~...~.~...~.~.t...!..f.~.~...?.: ........................................... 12. Does proposed construction violate any~ zoninq la.w, orglinance o~ zegulation?X" ...... ..~...~.r. ............... /./~....,~,~Z.~ .... 13. Name of Owner of premise~,~_~/~Z...~~.~..~..~,.,6,~...~..~o~e~(.~,.,~~., ~~' - z4o . ~..~ /~,~- ~/~// Name of Architect ddress . ~ ....... './ ...... Phone NO 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 ,,)i"OP~Y-~ ,, / ) S S COUNTY OF .~..~.(..~.C~...) · (Name 6:[/i'ndivid~/~l signing opplication) above named. He is the .......... ~~,'~.. ...................... : .................................................................................. (Contractor, agent, corlborote officer, etc.) of said owner or owners, and is duly authorized to perform or have 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 b~o~ me this ...... ~Z~. day of ..... ;._,....~,.. ]9..~... ~*',w Publi~, st;re o'~"~~e ;¢appJicant) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×omined....,~..~... 19. ,.'.c,-~. ·~. App roved....~....~.....~.., 19....~..q, Permit No ............ ,~-~ ...~...~./ Disapproved a/c ........................... ,~z~..,.~c ........................................... (Building Inspector) ~'~__~ Application No ....... ./....~..~,~L / APPLICATION FOR BUILDING PERMIT 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 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 BuiIdlng 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 oil 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 ............. ,.,. .......................... ,~. ......... ~ ....... ?.. ....... ~...' .................................................................... 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 r.~.~;¢..£~-. '.:¢ .~..: ........... Lot No: .................... Street and Number .............. *..~...¢'../¢~.. .-~'.:¢.y .... .............................................. / Mumcipality 2. State existing use and occupancy of pr.e,..mises and i.ntended use and occupa, ncy of proposed construction: a. Existing use and occupancy ............ ~..~..~.¢...,~...~:.(:.¢..~.~-~....~~c::....: ............ i .......... ~ ....... *' ........... b. Intended us a a p y ............................................................................. ..'..';~/....'..;...;' ......... '.~ ..................... 3. Nature of work (check which applicable): New Building .................... Addition ....~ ....... Alteration .................... Repair ................. .~.Removol .................... Demolition .................... Other Work (Describe) .................... 4. Est,m<:ted Cost.......~.~..~....~...O..~ ..................................... 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 .................. ~.0..4~.~ ................................................................................................... '. ..... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .............................. ~ ' ' eth 7. Dimensions of existing structure~, ~f any. Front ........ ~ .............. Rear ................. D p .............. Height Number of Stories Dimensi:~':"~';"~:~"~:'::':ture~ with olterotion's":;'":;~':::~7~:~.).~.~'.~Z~. ......... '.' Re~r".'.'.'.'~'.'.~.'.'.'.'.'.'.'.'.'.'.'.'.'.'.' Depth ......... ~ .......... Height .............................. m . ............................... 8. Dimensions of entire new construction: Front ........... ~ ....... Rear ............. /.~... Depth ..~ ............... Height ............................ Number of Stories ..... ./ ................... 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use d,str,ct ,n wh,ch prem,ses are s~tuated .............. ~......~.~' ......... -~ ............................................. 12. Does proposed construction violate any zoning law, ordinance or~egulation? ...... ~..~ ..............~ ........ ~ .... ..... .......... ......... ..................... Na~e ~ Architect , Address ~ Phone NO ' ' . ....... Phone NO ..................... PEOT 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 inter/or or corner lat. STATE OF NEW//YO~I~,. ,~/ ) S S COUNTY OF ~ .~m~....(.c~.:.) ' ............................. .~.~.(.~..~.,:~:.~.9..,¢~_¢:?-r~..~;:~.~;:.' .~..........being duly sworn, deposes and says that he is the applicant (Name ~ individCal ~igning application) above named. He is the .........~~.~:'~ ........................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have 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 know[edge and belief; and that the work will be performed ~n the manner set forth ~n the apphcat~on flied ther w~th. ~ Sworn to bef~e me th s ,,/ ~,~/~ ~./~, ..~.~V Nota~ Pubhc, ..~....~.,..~~,, y es ~arch 3~ Y/I Z u2 ~' ?/?£,5 &/v T / /V ~ g~