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Home My WebLink About1380-zFOEM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...Z..15~I, ........... Dote ................... O~tObe~..23 ............. , 19..62. THIS CERTIFIES that the building located at .~.~.¢[~..,~"Z.f~.t...~..$.~,.:~.~.;~.l~...~...e..,. ...... Street Toilewoo~ 4~at~itu~ Map No ....................... Block No. *** Lot No. 40 & conforms substantially to the Application for Building Permit heretofore filed in this office doted .................... .~.~.~..~...~....~...~. ........................... , 19....6..~.. pursuant to which Building Permit No ........... .~.....[380 doted ......... Ap~'&l...2:t .......................... , 19....65 was issued, and conforms to all of the requirements of the applicable provisions of the law. '['he occupancy for which this certificate is issued is ........ ......... ~..~g..&':l~ ..,ONK.. F,/~ZLY,.. D.t~, .................................................................................... , The certificate is issued to .............................. .,~..1.1..e..~.....o..~...,~.~.....o..w.,.~..e,..r. ........................................ (owner, lessee or tenant) of the aforesaid building. Building Inspector vO~ ~61 ~ 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? 1380 z Date ........................... ~f],.....2~ ......... 19..~-. Permission is hereby granted to: ...Alla~..G....~oz ............................................... ...... ~.~z%pt~a3.~...R~.:d. ..................................... ......... ~a%t:Ltu~k.~...~ ...................................... to ,.. 'B~tit¢}'' ~n'"~d¢}it'~:ot~" o:~....an."e:~i~'~inf~"d~e'-Ei~:ng ...................................................... et premises Ioceted at ...~o~..~O..&..~.J~...~e~o(~ .................................................................... ...................................................... t4e~ ~¥.*~...~t.~inoi.$...~ve .......................................................... .................................................................. ],.¢~.~.ti.~ueJ~...N.,.Y., ........................................................... pursuant to opplicotion dated ........................... ,A~.-~,,-]~, ................. 19~...., and cpproved by the Building Inspector Fee $......~,,O0 .......... Buil, ding Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ' ........ Approved ........................................ 19,.,.j,,,Permit Application No.../...~...~:f). ......... APPLICATION FOR BUILDING PERMIT Date .................. ~ ....... ~..! ......... 19..(~.1 ..... 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 Occuponcy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuanae 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. & (Address of appl cant) i State wheth.er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................... .......................................... Name of owner ofr ~-'~y -~-f~""~'~Z ~',~)-c~.. 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 Nkk: ~ .~...~.~.~.~.:...~.(%~.~..~.i~.i.~.~.~ Lot No: ..~..~..~.~..~./.... Street and Number ?.J .[: .17. .,.~..~.. ~.~.~' ~...1~]~.. Z~.~..I.~...~..I~.~......~?..~. ....................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....................... ']~t-~,...~.~' ........................................................................................... b. Intended use and occupancy......~,~ ........ /~/~.,~.<~2.?~3~.....~.~.1~...~.J~......,~.¢~;.~../..~ ................................................. 3. Nature of work (check which applicable): New Building .................... Addition ...... ; ............. Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimoted Cost ..............~..~...0....O..t. .................. Fee ............ i~'~"~;' poid on filing this opplic~[i~) 5. If dwelling, number of dwelling units ................... ~ ~ ........... Number of dwelling units on each fleor ........ /. ................. If garoge, number of cots ............................................................................................................................................ 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 ........... / .............................................................................................. Dimensions of same structure with alterations or additions: Front ......... ~.. ~ ~ ................... Rear ...... ~.....~. ................... Depth ........ ~.~..~..~...! .... Height ......... /..~. ............... Number of Stories ......................... 8. Dimensions of entire new construction: Front ........... /...~.. .......... Rear ....... ,~. .............. Depth ...... ~...~. .............. Height ......... /..~.../. ........... / ~'7,~2t/CNumber of Stories//~/· ~'g~ .J ~ ~ / 9. Size of lot: Front ........:..=.r...r-.r...- Rear ...... /...~..~., ............ Depth ........................ 10. Date of Purchase~5£.~.~...~..~.../..¢.,~....O.. ....................... Name of Former Owner 11. Zone or use district in which premises ore situated ........... .?..~...J::...gT...~....../~....O..~...~.., ....... ..~.~ .~...~.~./~...T...O..(r(.../5'Xm..~.z.Y.· 12. Does proposed construction violate any zoning law, ordinance or regulatio,n? ............... ~ ............................. 13. Name of Owner of prem,ses,.,,~ ....... ~....~ ................. Address )~,~..,~..~.~../¢.../d/,J~.~.:......Phone NO./I'~..'.~.:~.I..~..~' Name of Architect ........................................................ Address ............................................ Phone NO ..................... it I,t ,-,. Nome of Contractor .................................................... Address ............................................ ~none 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. .t STATE OF NEW y,,6RI(,,,,,~,~ ,,~) S S .................................. ~~ ....... :......~'. ............... being duly sworn, deposes and says that he is the applicant (Name of individual signing app[ic, a.tion) above named He .s the' .~/7'~'~/'~ ........ ~.,... ~. ............................................................. ............................ (Contractor_agent corporate officer, etc.) of said owner or owners, and is duly authorized to p*ertorm oW~F~ave performed the said work and to make and f le this application that all statements contained in this application are true to the best of his knowledge and belief; and that the work wi I be performed in the manner set forth in the application filed therewith. Sworn to befo~e me this // ~ day ~. ............ :.~,.~ ........ 19,~ff. ...... FORi~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19.....'...Permit No ............. ~ ................. Disapproved a/c ........ ~ ~"~. "~ ........ ................. (Building Inspector) Application No ............................. APPLICATION FOR BUILDING PERMIT Dote ....................... ~. .................................. ] 9 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and su6mitted 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 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 Lows, 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';;~;~;ii~'~"n'fj';; ;;~;~;'~j'Ff'b ;~'r~;;~;i;~i ......... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................................... ..................................................................................................................................... Name of owner of premises . ../~.'~ ,~ .,~ .~,.r ~..?. E ~ ..)[ . ' ...... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Location of land on which proposed work will be done. ~ap ~ .~.~ ..... ../..~ .............. E../.. t No'..¢,/'~....~..~'./. .... Street and Number .......... : .......w..~ ....... ./.~..~L.~. .............................................................. Municipality 2. State existing use and occupancy of pr. emises and intended use and occupancy of proposed construction: o. Existing use and occupancy ................ ,/.'~..~..,~.~. ...................................................................................................... b. Intended use and occupancy .~. .~.£/2 I?eoJ~l~ /~.~.. j~../tT.h¢ . 3. Nature of work (check which applicable): New Building .................... Addition ..... ~ ........Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4, Estimated Cost ....... ..~...,~.~,~0...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 ............................................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .............................. ! 7. Dimensions of existinfl structures, if any: Front .......... *~..¢~ .......... Rear.....~.....~....! ............ Depth ~ ? / Height ......... /....~. ............ Number of Stories ................. Dimensions of same structure with alterations or additions: Front ............ ,-~.~.~. ............ Rear ~(~" / / Depth ......,~...~...Z...5' l Height .......... ./...~. .............. Number of Stories ................................ 8, Dimensions of entire new construction: Front ........... ,/...~...~ ......... Rear ......... ./...~.,../. .......... Depth .....~....~.. ................ / / Height .......... /....~.. ........... Number of Stories ............... , ............ Ai~ 70 9, Size of lot: Front ..... /.,0..~.'.....~. ........ Rear ...,/..~...~.: ............. Depth ..../...~....,?...,'.../..~...../. 5' ~ o ...................... 10. Date of Purchase .... .~/..../~'...~...¢., ...... ,)..~...~. ................. Name of Former Owner ..~?~.&~.,...'../~.~.]~..~..~.,, 11. Zone or use district in which premises ore situated ....... ..7~..~../r...Z..,,~....t~.P...°...~..,~. ..................... ..C,....~. ~....!~.,Y..:... 12. Does proposed construction violate any zoning law, ordinance or regulation? .............. Z~..0.: ............................. 13. Name of Owner of premises....~.~.L.~..N..ff;,..~..~.....Address .hC~.5..T'..~...~.)..}..&.,]."~.~..D.! ....... Phone NO. Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor .................................................... Add e s ............................................ 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. of said owner or owners, and is duly authorized to pe~ave 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 before me this . , Notary ........................ Public, .. ~ ...~,~..~¢..~.. Z. ;./.. ................... ~....~~z ~....County ¢ ,01l~1~,1,$1o~ ~xpir,s M'fch '0' ''B'''~'JIiedN°' ~,2.7 1 ,'OOOl,