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Home My WebLink About1548-zFOl~l NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFI[S thor the building Io¢oted ot ...~.:~...P.~'tt~OI~OO~..~O~ ........... ~ ........... [treet Map No....~e.~ ...... Block No...~X ............ Lot NO.'~,~(~ ......... ~OhO~'UO '..~¥','; .......... conforms substontiolly to the Application for Buildinfl ~rmit heretofore filed in this o~¢fice doted ................................. ~.~g~omB~ ....... .~., 19..6~. pursuant to which Buildin~ ~ormit d~ted ............................ ~p~O~hO~..~l 9.~L, w~s i~ued, ond conforms to oll of the requirements of the opplicoble provisions of th* Iow. The occuponc~"for which this certificote is issued ~s y ........ .......... ~rl~t ~..one..$,mil~. This certificate is issued to ..D~na. ld...C~hl.11.. &.'~,~e ....... ; ........ ~e~s ............ ~ ........... )~ ....... ' ,,t6wner, ~essee or tenant) of the aforesaid building. H.D, approval ~/1~/62 ./.~ r :j:') Building Inspector J J ~ i FOI~i~I NO. ~ 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.o 1548 z Date ........................... So~t,~lJ'J~.....-1~ 19_ 6~ Permission is hereby granted to: Chet. Or.l. owski.....~/C--Dona~d. Caht.~.% .................. to ....~.ld.. n~"~"f~'~-'d~[t[~ .................................................................................. ~t premises I~ofed ~t '"'~e"~d"E~ad' .......... (~e~s"'N~k) .............................................. ...................................................... ~te~ .................................................................................... pursuant to eppiicofion doted ........................... ~t~.....~ ....... ]9~..., ond =pproved by the Building Inspector Fee $'""~'(}&'O0 ....... ......... [....~-,~..,-.~ ........................................... ~ ....... Building Inspector / TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUT.OLD, N. Examined ....... ~....(.~... 19.~..I... Approved ....................... .[..L. ............. 19....!...Permit No ............................... Disapproved a/c Application No..../..Z~'~..~ ....... 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 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 appllcable 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) (Ad,ess of applicant) 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 title of corporate officer) 1. Location of land on which proposed work will be done../~ap No: .. .........:~' ...... Lot No: .................... Street and Number ~Enicipality 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construct[on: a. ..................................................................... ....... ................................... 3. Nature of work (check which applicable): New Building ...... ~ ......... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Ot~ Work (Describe) .................... 4. Estimated Cost ................... /.....~...~ ......................... Fee ................... ../...g.../...~ ................................................... (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 ..,,~..~.. ................ Height ........ .......... Number of Stories ....... ~.L.~.,.~.J.. e 9. Size of lot: Front ....../.....~. .............. Rear ....... ./....r':~A.....! .......... Depth ............................ 10. Date of Purchase..~,,~r,(...~..../...~.i..~./.-- ----- u ...................... Name of Former Owner ~"//~~..,..~.../~¢~......~ ........... 11. Zone or use district in which premises are situated......r~....~....~...~ .......................................... ]2. Does proposed construction violate any zoning law, ordinance or regulation? .................................................... 13. Name of Owner of premises~Y~/..~'~ *-- * ' ...... Address ~.z./.~'...~..:.....Phone NO ..................... ~i NameName of Contractor..~...~-~¥,~...; Address ..~./..~.:/.'...PhoneC/'~ ~L~ -- NO.A.~...~<?...?...~ PLOT DIAGRAM · Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from lines. Give street and block numbers or description according to deed, and show street names and indicate ~ther interior or corner lot. - STATE OF NEW~YO, I;),K/~ ,,// )' S-S COIJNT',FJDF~..)~,..~' ,' ..... .~,~.-[..,~~ .............................. being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ................ ~ .......................................................................................................... (Contractor, agent, corfforate 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 a~plication fJ~he~with. JUDITH Sworn to before me this ' -. ~ ~ ~ f .... 1~ -~2-~4963. S~[ 0rk (S~gn~ture of applicant) ......... ~ ..... day o .: e~. . Nota~ Pubh r RIVE~HEAD BUILDING SUPPLY CO. 30~,OST~A*~DER AVENUE I~LA N S ID.