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Home My WebLink About1533-zFOR~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY ThiS CERTIFIES that the building located at ...l~g~dl~ll.t,~..,l,..~l.d~,:l.~'...Ll~ ........... Street Map No....:~:1~, ............ Block No .......... ~ ..... Lot No...~1~1~1: ....... G~.~r~oF.t ............................. conforms substantially to the Application for Building Permit heretofore filed in this office doted ............................................. · 1;!~1~..~.~ 19f~... pursuant to which Building Permit No..~...~.~'.,~.~ dated ........... : ........................ A1~.....~919.(1~1..., was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is .......... .......... l~.ate..~ne..f~ll~...d~alLt~ .................................................................................... This certificate is issued to ..... ~'Ohlt..ktl~l'..GF .........;"OWI~ ........................................................ {owner, lessee or tenant) of the oforesoid building. l~.D.Approval by P. gn~kowski ;~une 12, 19~R Building Inspector / BUiCDING TOWlq C'ERK'S SOUTHOLD, Iq, Y. BUILDING P£R~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1533, z Dote ..................... ~.~.~.S.~,,.....;2~ ............ 19.6~,.. Permission is hereby gra~ted to: Zoh~,~.. ~Ba~er...f~r. ....................................................... ..... ~[~.In.. ~ ......................................................... ................ ~een~c~.b ........................................... to ...~u.i.~d.. ,ne:~.. ~ne..~.~,Z~,..cl~eZ.Z~ ................................................................................... at premises located at ~:4~e,~se.t...Ave...&..¥.i.~c. ll~z~...i.a. ............................................................. ............................................................... (}~'e~I~'b ............................................................................ pursuant to application doted ............................... .~.'LIS.'~,*....2~. ........ 19..~.~.., and approved by the Building Inspector Fee $'3'0'0'00' .......... NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ,t ?.! ~-/~'3 ~ .................................... , 19 ..... Permit No ................................. Disapproved a/c ............~ .................. ~ / .................. ................................... (Building Insp~[ctor) APPLICATION FOR BUILDING PERMIT 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 be`fore 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 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 comp y with al app Jcab eows, oral nonces and regu arians. ................. ........ .... (Si~n~ure of applicant, or name, iT a corporati6'n) (Addre`ss of applicant) / ~' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signatu(r/e of~duly authorized officer. (Name and title of corporate, officer) 1. Location of land on which proposed work will be done. M/a~p No: ............... : ............................ Lot No: ...... ?.....~. ....... Street and Number ./.~..~F~:~..~./(~..~.. ......... ..~.~,.~.. ............................................................................ Municipality State existing use and occupancy of p~)7~ and in~ed use and occupancy of proposed construction: a Existing use and occupancy .......... .~..~..~..~. ,~ , ........... b Intended use and occupancy ......... ~.:~...i~'~'".~..~i'.~~.i'.'.'.i'.'.'.i'.iiiiii'. .......... 3. Nature of work (check which applicable): New Building ....~..... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition ............. ~/ ...... (~t~er Work (Describe) .................... F ................................................................... 4.Estimated Cost ............. ____~..~., .......................... ee ...... ~- (to be paid on filing this application) 5. tf 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 ............................................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth ................................ Height ............................... Number of Stories ................................ t 8. Dimensions of entire new construction: Front ......... ~/~..~...~..".. Rear ...... .~..(¢...:.u.. .......... Depth .....~..C~.'~..~..;: .......... Height ............. ~..../ ......... Number of Stories ......./. ...................... 9. Size of lot: Front ............................ Rear ............................ Depth>~--~.....~.~~ 10. Date of Purchase ...................~..:~ ....................Name of. Far/re, er-/~ /J~/~...O~er .~...~..~'~..... 12. Nome of Owner oF premises.~....~:.~ress .~../..,~..:.,~[6~/,-~,'~..~..k... Phone NO.'.~...-:..~.~..] .~... Does proposed construction vi~late arw zoning law, ordir~ance or regulation ......... ~ ............................. 13. Name of Architect ....................... .ff. ................ i] ......... Address .......................................... Phone NO ..................... ............................... ~ ................. Address .......................................... Phone NO ..................... Name of Contractor '~ P,LOT DIAGRAM Locate clearly and distinctly ail 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 NEW~ ~// ) S (No~ of individual signing a~icati~) (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 ali 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 ~I~ PuSlic, State ~ New y Motor~ Public~ ...~~~.~~ (Sion~ture of ~pplic~nt) Examined ...... .~ ....... C~.} ........... , Approved .................................... FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE souT.oLo, ,. ',. 9.J./..,Perm t ....... Application No. / 3 APPLICATION FOR BUILDING PERMIT Date .......... ......................... 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 punic streets or areas, and giving a detailed description of layout of property must be drown on the diagram which is part of this location. c. The work covered by this application may not be commenced be.fore 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 ipspe, ction 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 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, Ne~ 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. (~,~ature of app i6a~nt, or name, if a c'~ orporation) (Address of applicant)// /" State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of (Name and title of corporate, officer) 1. Location of land on which proposed work wdl be done. Map No: ............................................ Lot No: .................... Street end Number ........ ~z~Z?~.~,d.~.~..~...~..-. ......... ~..~.~.~ ..................................................................... Municipality State existing use and occupancy of premises o,~d intended use and occupancy of proposed construction: a. Existing use end occupancy ............ ~~:~ ' / ................................. ,. .......................................... Nature of work (check which applicable): New Building ..~Addition .................... Alteration .................... Repair .................... Removal .................... De~molition ...... ~. ............. Other Work (Describe) .................... 4. Estimated Cost ..........~...~...~..d..~.,.... ~ .............. 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 ............................................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .......... ~.~..~ ........ Rear ....... ~.~ ........... Depth ....~.~.~, .............. Heigh¢ ................... ~ .....N~ber of Stories ............... ~...~ .......... ~, 10. Date of Purch,se .................. /Z~ ........................... Name of Fo~er..O~ne~ ..... ~.;..~Z.~..~,~:~ ~. ~o.~ or .~ ~,~,~, ,. ~,~ ~e~,~ ~ ~,,,~,~ ........................ ...... ~....~ .............. ............................. 12. Does proposed construction violate any zoning law. ordinance or regulation? ....... ~ ....................................... ~ ........... Addross .......................................... ?bono ~0 ..................... Name of Architect ~ ~t Name of Contractor .................. R'I .................... ~ ......... Address .......................................... Phone NO ..................... PLOT DIAGRAM Locate cJearly 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. ,,~L ~/%->.. . / ~:~ STATE OF NEW ~O~K ~ ) ~ COUNTY O~ .~~.....) ~' ~' .................... ~~<~.: ...................................... being duly sworn, deposes amd s~ys that he is the applicant (N~me of individual signin~ application) ,, .............. .................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have ~rformed the said work and to make ~nd 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 , , ~U.~ITH T, BO~EN ' ,, tory ~uo~c, St~t~ o~ ~ew York ,