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Home My WebLink About1529-zFOl~t~ NO. ~ TOWN OF $OUTHOLD !~UiLDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLDI, N. Y. CERtIFiCATE OF OCCUPANCY No. ........... Z 118~'................. Date ................. ~O~embe~.......~O ........., 196~1... THIS CERTIFIES that the building located at ~/S..M~O~.~..20~..&..~.O~.~...~.e Street Map No. ~, .............. Block No...X~..~ ............. Lot No. ~ ....... ~O~'~'~'"'~'~'~'~ .................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................... /k~.~.~. ....... 2.~ ...... 19.6..~.. pursuant to which Building Permit No..~.~29... dated ........................... ,~.~.~....2~.., 19...6.]., was issued, and conforms to ail of the requirements of the applicable provisions of the I.aw. The occupancy for Which this c~rtificate is issued is .......... .. Busineas...bu:Llfl,i~,...A~t omohi~.. ~e~.~.JL~..~t ~ti~n..&..~a~4~e~t..e,e~t e~ .......... This certificate is issued to ..~..~.~tk...Ab.~..B~,~...~l'~..r....: ...................... 0~ .~.* .................. ~ ................. (owner, lessee or tenant) .', of the o.forcsaid building. Building [nspecto' FO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPA:RTMENT TOWN CLERK'S O'FFiCE SOUTHOLD, N. Y. BUILDING PERMIT · (THIS P, ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°, 1529 Z Date .............................. Attg~s t;..-.. 2,~ .... 19../o"1. Permission is hereby granted to: · .~.~.:...~..r.~.~.~....~?.. .......................................... .............. o.uthold ................................................. to. B~ Id.. art.. ~d dt i.or~..on., an.. ~xi.s ting., huain~ s ~.. build in~ ..................................... at premises located at ...~Id.d!a..Road..&..~Zoang. s..&~'t~ ............................................................... ........................................................ S~th~ld ................................................................................ pursuant to application doted ........................... J[llg.t3.S.'[....,~l.3 ............. 19(~1...., and approved by the Building Inspector Fee ~.~.0.0 ............... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c .................................................... .................... ..._...~ ...... APPLICATION FOR BUILDING PERMIT Application No ........... . .'~...~..~/~ .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in dul~licate 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 o detailed description of layout of property must be drawn on the diagram which is port of this location. c. The work covered by this application may not be commenced before issuance al~ 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 port for any purpose whatever until a Certi{icate 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 laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................ .Ql~/~,f~. .............................................................................................................. ' .......................... ~ .............. Name of owner of premises ........ ~7..8~t~:..,~.b~tmS..~':~ .............................................................. :~ ......................................... 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: ........ ~ .................. ....~ ..... I~ot No: ...:}~ ............ Street and Number Mumcipality . i State existing use and occupancy of pr. emises and intended use and occupancy of proposed construct on: a. Existing use and occupancy....~.~.::J,~.J~*S...]~.~$~C~JjJ ...................................... ...: ............................... i ............. 11 b. Intended use and occupancy .................................. ~ ....... ~$~.~..~.$~ ....... ~'. ......................... ~.....' ............. property lines. Give street and block numbers or description according to deed, whelher interior or corner lot. 3. Nature of work (check which applicable): New Building .................... Addition ....~.-,,T~.....AlteratJon .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... (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 ......... .~....t¢~....1..~..~...~..~... 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 ..................... . ........... Height ............................ Number of Stories ....... ~n~ .............. 9. Size of lot: Front .......... ,~ ................ Rear ............................ Depth ............................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ I 1. Zone or use district in which premises are situated.....~B~...'b'lZ~,;I.l'.J~Sl .................... i ......................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... ~ ......................................... 13 Nome of Owner of premises...~l'~....~lI)Z'~3~,..2'~ ....... Address ........ ~Ot~)1.O3.~1. ................. PI~one NO ..................... Name of Architect ........................................................ Address ............................................ 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 Y~RJ~.,, ... ) S S. COUNTY OF ....... ~...'1~.. ~ .0..1....~.....) ............. ,~,',~t3.~ ~'~ ~T~. ....................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) ~ ~ above named. He is the ............ .(~f~.~. ........................................................................................ ' .......................... ~ ............ (Contractor, agent, corIborate 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 h!s knowledge and belief; and that the work will be performed in the manner set forth in the application flied therewith. Sworn to before me this JUDITII T. 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