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Home My WebLink About1407-zFOI~M 1~0. 4 TOWN OF gOUTHOLD BUILDING DEPARTMENT 'I'OWN CI~EBK'S OFFICE SOUTHOLD, ~. Y. CERTIFICATE OF OCCUPANCY TH]iS CERTIFIES that the building located at ..O.~tl~a~..I~.o, SJ; ..Read .................. Street ~.~o.V?...~ ........... Bloc~ ~o. ~ ............... ;~ot ~,'o....~, ......... ~..e.~o~,...~.~., .......... . .... conforms substantially to the Application for Building Permit heretofore filed in this office dated .................... NI~.....~.. ............ 19...~J[ pursuant to w.hich Building Permit No..~..~.~..(~.~.... dated ..................... i~Ialg. ....... :1t~ ........ 19.6J,.., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is ..... P~2J..val;~..ol~e...faltl~Ll.,~..tl~.e2_lL~[lag .............................................................................. This certificate is issued to ..Yu~.8~.e~.....~...~)$.~g) .............. 0.'d~. ................................... (owner, lessee or tenant) of the aforesaid building. Building Inspectqr FOI~M NO. ~ TOWN OF $OUTHOLD 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 14o7 z Date ......................... ~ .......~J~ ............. 19~1 .. Permission is hereby granted to: .... ]~ .. :L3~,.... ~.~.c~.~e ................................ to ~t. ld...t~w..e~...t, amit.y..~wel, t.~n~ ...................................................................................... at premises located at ....~O~..~..~.,~Vell...l~)~J; ...................................................................... ................................................. .O.~.r.e~....tt.e~.f,..~,~.a~ ........................................................................ pursuant to application dated .............................. Ma~.....~.~l' ................. 19.6.~..., and approved by the Building Inspector Fee $..;],0.00 ......... Building Inspector · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. APPLICATION FOR BUILDING PERMIT Application No ..... /..~....O....~. ......... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and suUmitted in duplicate to the Building Inspector. b. Plot plan showing location of iai and of buildings on premises, relationship to edioining 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 issuanc.e of a Building Permit pursuant to the Building Zone Ordinance of the Town of $outhold, 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 regulati?ns. ........ (Signature of applicant, or name, if a c, orporation) :- ,,~ ~ ,' . , \ ............... iAddress of applicaht) ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................................................ ..................................................................................................................... Name of owner of premises ........ %es.~e~...~o...2ha. p;L~.e. ................................................................................................... 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 No: ....... ~7..5.~...., ....................... Lot No: ...... ~. ........... Street and Number .......... .~..8.~..zl..e..~...~.e..~..t¢....~..O...a:~.~...~....~.&f¢~...~v~.8,~..,i~Olqk .............................................................. Municipality ,2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................. ¥.~,.q.a....zJ,.tc.....],~..z~.g~ ......................................................................................... b. Intended use and occupancy ............. .o.~?....._P_.e~...~.]r.~...~..w..e...~..~.~..z!..~. ..................................................................... property lines, Give street and block numbers or description according to deed, whether interior or corner lot. 3. Nature of work (check which applicable): New Building...~...~.Z.. .......... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work IDescribe) .................... 4. Estimated ~ost ....................... ~...fZffL ............................. Fee ..../....~ ................................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units .......o...~..e. ................... Number of dwelling units on each floor.....O,~,e. ................. If garage, number of cars ....... ..C.§?..p.O...~..~. .................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.......t!..o. .................... 7. Dimensions of existlnft structures, if any: Front....l?..O..~..e.. ............... Rear ............................ Depth ............................ Height ............................ Number of Stories ............................................................................................................. Dimensions of same structure with alterations or additions: Front ....I'lg~.~ ................... Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front.'.'.....,13..6. ................ Rear ....... ,2.~ ................. Depth .....~-.~. ................... Height .....~ .................. Number of Stories ....... .o...T!:.e. .............. 9. Size of lot: Front .......~.~..~./~.3 .......... Rear ...... ~.~..0..,..8.~. ........ Depth ......]-.'Z.~ ............... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ................................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? .....~,o. ............................................ · NO ..................... 13, Nome of Owner of premises...~,~^,..g.~9,P.~.~g ........ Address ~ ~ Name of Architect ........................................................ Address ............................................ PhOne NO ..................... Name of Contractor...O.q~Al3..~lOlil.e.lll ...................... Address .~X,..~,~.2.~...~..~,.'b.qtl.O.F~.'~Phone NO,~..~....;~.-.~7.~. PLOT DIAGRAM Locate clearly and distbctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from and show street names and indicate STATE OF NEW~YOI~ ) COUNTY OF ..:g..~....~.-J.~.l./.<; ....... SS. ......... .'~.../~.1~.1.~. ....... ...~......~...~..~.5.....c;..L.~..,..x/...~., ......................... being duly sworn, deposes and says that he is the applicant (Name of individuol signing application) above named. He is the .........~..~7..~....~....~/....c.,..~..~ ................................................................................................................... (Contractor, agent, corlborate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and fils · a 'caton' that o statements contained in this application ore true to the best of his knowledge aD~ belief; this pp I ' ..... r, ' and that the work w~ll be performed m the manner set forth m the epphcat~on~f,~ed tl3e~ew~th. Sworn to before me this ~ ,. ~m~ ..., ('"'-~ ~ Z ~,~ ~"'~, / · Z~ da" o~. ~ -,o~0~u~' -'19 ~Z. '(S,gnature-o(apphcant) .......... 7 .......... ' ~t~4~0~?~Z~:~'~:'t~, '% ...... Nota~