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Home My WebLink About1558-zFOP~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD', N. Y, CERTIFICATE OF OCCUPANCY No ...... Z..'121~3 ........ Dote ................... ~I~Ui~¥~..23 ............ , 19(~.~... THIS CERTIFIES that the building Iocat~,~t~;~i~.~.~i..~.,;.;...MA.t;~.~.~,~l.i~~ ........ Street Map NcZ~l]~t, Ol~..~f,,~. Block No..~*.'it .............. Lot No ................. ~.** ................................... .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ ~.~.~.1~...~1,~. ........................ , 19.~... pursuant to which Building Permit No~..~l~l~... dated '~:e~"";~0 ...................... , 19..~i~.., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .......... This certificate is issued to ........... .R..~..~.~.~.....O..~..~..~...~..~...~.L...O~..~...tl..~..-~. .................................................... (owner, lessee or tenant) of the a:foresaid building. Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE , ' SOUTHOLD, N. Y. / BUILDING PERMIT · "(THIS PERMIT MUST BE KER~ ON THE PREMISES UNTIL FULL COMPLETION OF THE WQRK AUTHORIZED) 1558 Z Permission is hereby Oronted ~o: pursuant to application dated ................. :¢:~.' ............ 8ep~e~6~ ,r,.ZO19,6~,,, and approved by the Building Inspector ' ~,, 2 - APPLICATION FOR APPRCYVAL OF PLAT To the Planning Baard of the Town of Southold: The undersigned applicant hereby applies for (tentative) (final) approval of a sub- division plat in accordance with Article 16 of the Town Law and the Rules and Regu- lations of your Board, and represents and states as follows: 1. The applicant is the owner of record of the land under application. 2. The name of the subdivision is to be ........................................................................ 3. The entire land under application is described in Schedule "A" hereto annexed. (Copy of deed) The land is held by the applicant under deeds recorded in Suffolk County Clerk's office as follows: Liber ................. ~ ...... Page ........................ on ........................ ; Liber ........................ Page ........................ on ........................ ; kiber .................... Page ........................ on ........................ ; Liber ........................ Page ...................... on ............................ ; Liber ........................ Page ........................ an ........................ ; as devisee under the Last Will and Testament of .................................................... or as dJstributee ......................................................................................................... 5. Tl~e area of the land is .................... acres. 6. All taxes which are liens on the land at the date hereof have been paid except The land is encumbered by .................................................. mortgage (s) as follows: (a) Mortgage recorded in Liber ........................ Page ........................ in original amount of $ .................................... unpaid amount $ ............................................ held by ............................................ address ............................................................ (b) Mortgage recorded in Liber ........................ Page ........................ in original amount of $ ........................................ unpaid amount $ ............................................ held by .............................................. address .......................................................... (c) M~rtgage recorded in Liber ........................ Page ........................ in originial amount of $ ........................................ unpaid amount $ ............................................ held by .............................................. address .......................................................... 8. There are no other encumbrances or liens against the land except ...................... 9. The land lies in the following zoning use Districts ................................................ 10. No part of the land lies under water whether tide water, stream, pond water or otherwise, except .............................. FORM NO. ,1 TOWN OF $OUTHO/D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ,, , Approved ........................................ , 19....!...Permit No ................................. ......................... ........................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date 8ept. em.t~er ].9 19.....6..~ ....... 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 application. 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 ~pplicant. 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 pa rt 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 comply with all applicable laws, ordinances and regulations. John Ha~rus (Signature of applicant, or name, if ~ corporation) MaSh Road, Cu~:chogue (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. o~Br~en R~chard ~W~W~R Name a~ owner of premises ..................................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Lupron Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number ' ~.~. Municipality State existing use and occupancy of premises and intended use and occupancy oF proposed construction: a. Existing use and bccupancy b. Intended use and occupancy ................................................................................................................................. 3. Nature of work (check which applicable): New Building .................. Addition ....... ](~ ...... Alteration .................. Repai[ .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ...{l.~.O...O.:.g..O. .................................... Fee...~.?.O..O. ........................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... 1 ....................... 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 ..... :~]JL]..IJ ........................................................................................... Dimensions of same structure with alterations or additions: Front .....~.~. ....................... Rear ...~J.l~ ........................ Depth ..~.6/(~ ..............Height ................................ Number of Stories ..........'1~ ......................... 8. Dimensions of entire new construction: Front....~,~ ....................... Rear ...~...~. ..................... Depth 1...~. ........................ Height ............................ Number of Stories ........... ..~. .................... 9. Size of lot: Front ................................ Rear ............................ Depth ........................................ 10. Dote of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated .......... .~!A:L.,Jb~JiI~Lc~o~t,~]. ................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ,,,1~,~. 13. Name of Owner of premisesll,~CJ~t.d..O~l~'~ln.....Address ..... 14~l,~'ll.t~Oktl..Jt.d, ..... Phone No ..................... M~tt£t~k Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ........... ll~.g~lJ..~d~.~.l~!{ ............ Address ....~.~.~.~g.g.~.~ ................... 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. STATE OF NEW YORK. ) COUNTY OF .~....U~..[g~ ........... ) S,S. ~ohn Ha~:us ................................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual sign]nfl clpplication) above named. He is the ...... : .................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owper 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 before me this JUDITH T BOKE~ "r' i ~ ' ~