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Home My WebLink About1410-zTOWN OF SOUTHOLD BUILDING DtEPARTNtENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...2h..1.,~O;2 ........... Dote ................... THIS CERTIFIES that the building located at ~tt~e,t,..~O~:~4~..,i~LJ~A~t~ ........ Street Map No.... ............ me* ....... Block No. ...............**w ,...... Lot No ....................................................................... conform~ substantially to the Application for Building Permit heretofore filed in this office dated ................... .~.~.~..~.....2..0. ................................ , 19....~...~. pursuant to which Building Permit No ........... ~....].4]L0 dated ......... ~a~..~9 .............................. , 19....6~, was issued, and conforms to all of the requirements of the applicabJe provisions of the Iaw. The occupancy for which this certificate is issued is ........ ................... ~ ~.~,...O~t~... :~;C~.~.. D~:~.~. ~ ............................................................................ The certificate is issued to ~:L:t,~LD~et] ~1', DG~'ie~, O~e~ (owner, lessee or tenant) of the aforesaid building, FOI~M ~qO. 2 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.° 1410, z Permission is hereby granted to: pursuant to application dated ....................... J~JJ~'.'"'~O ........................ 1~....., and approved by the Building Inspector Fee $~O~00 ............ FORI~I NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ....................... ('~'~'i'l'~'i'~g I "'""" '"nspoctor)(. ............................... Application No. t ~'~ t 0 APPLICATION FOR BUILDING PERMIT Date ......................... ....~.........~.......~ ...... ,9..~..f. ...... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and su0mitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationsbip to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on tbe 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 tbis application, the Building Inspector will issue a Building Permit to the opplicant. Such permit shall be kept on tbe premises available for inspection throughout t~e 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 sN~ll ~ve been gmnted by the Building Inspector. APPLICATION IS HEREBY MADE to t~e Building Dep~rfment for the issuance of ~ Building Permit pursuant to the Buildin9 Zone Ordinance o~ t~e Town of Sout~old, Suffolk County, New York, and other applicable Laws, Or~h~ces or Regulations, for the construction of buildings, additions or a I~ons, or for removal or d~olition, as her~ described. The applicant agrees to comply with all applicable laws, ordinances and regubti~s. ~/ / (Address of applicant) State whether ap~'~'//.-~', is owne~gent, architect, engineer, general contractol, electrician, plumber or builder. ...................... .............................................................. .; ............................................................................. Name of owner of premises ...... .~..~...-Q. ......... ~ ...................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which/l~oposed work wilJ~e done. Map N~. .............. , ................. Lot No: .................... Street and Numbe~/r...f:.~~c'~-Z.....~.....~-':...'??'..'~'''~'':~'''''''-~'':~ .......................................... Municipality 2. State existing use and occupancy of premises and intended ,use and occupancy of proposedI construction: a. Ex,sting use and occupancy .......... ~../..~..~.~...~.; .................. :.: ....................................... /. ............................. b. Intended use and occupancy ....... ../....~..,.~Z..~.. ........................................................... ii .................................... 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair ........... M,....RemovaI .................... Demolition .................... Other Work (Describe) Cost.../-~.,~...~ ................................................. Fee .......................................................................................... 4. Estimated ' ~ ~' (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, Jf any: Front ............................ Rear ............................ Depth ............................ Height ............................ Number of Stories ............................................................................................................ Dimensions of/same structure with alterations or additions: Front ...~....'_.../c ...... Rear~:..~..'. .................. >,~t~'~.'..'. ................ Height . ~¢=..~.~..../. .......... Number of S?ories ..../.././.~ ................... 8..~'~)imen, sJons of entire new construction: Fron~ ........................... Rear ............................ Depth ............................ Heigh;~ ................. .,~..... ~Nuz',~% ofyes'/ ............................ 9. Size of lot: Front~r:.....~'.r~~Ke~/ ........................... Depth ............... ~ ........ 10. Date of Purcho~..':;....../..~........./. ................. Name of Former Ow~"~.~......~....'~.....¢:('.~.-~.....~.., 11. Zone or use district in which premises ore situated .................................................. ...j....../ ................................. 12. 'Does proposed construction violate any zoning Iow, ordinanc~.~,-..regulatioo? ..... ../...~..:..~'./J/ ............ ._~ ................... 13. Name of Owner of premis .~..'.....~.'./~...~...~....~.. ............. Addres .~.~..~..~....~.: ............. Phone N~. '..~..'..-...?...?~'.~/ Name of Architect ........................................... . .......... Address ¢~ .~,~ ,. ..... Phone Contracto '4 . /~/~. /'~.'.~..~./~../..r/~..~./~.~ .~;... .......... Address ZT)~;,~" 'Z~;"~ .... NO. ~..;,.~. ~;~.:~./..~:~.. ............ Phone N O~_~; ?~.~.~,. Name of PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate .all set-back dimensions from description oc~_(zrdlng-to-deed;-'ard'~'h-o~-street"m, ames-~m~, iD_CJZc~te property lines. Give street and block numbers or ~ . ~_ whether interior or corner lot. - ~/'~%'~ ~/-~-~7~ STATE OF NEW,,-YO~P~K,]/£ ) S S ............................ ~.~..?..-~...~...~..'.....~[~' ............ being duly sworn, deposes and says that he is the applicant (Name of individual signin.gr~pplicotion) above named. He is the ..................... E'~~] ..................................................................................................... (Contractor, agent, corlborate ~ficer, etc.) of sa d owner or owners and is duly authorized to perform or have performe~e said work and to mgke and file th s application; that all statements contained in this application are true f~e ,best of his knowled~ and belief;[ and that the work will be performed in the manner set forth in the appli~iled therewlth~ ~ / Sworn to before me this ~/~; ~ da,, of r~ ~ ...... J¢~r~l~ Sta)e o New~ork~ (Signature o~lic~nt) ........................ / 't ................ N0 , , Suffolk County ........... . ................ . TOWN OF SOUTHOLD BUII~DING DF. PAI~'I'MENT TOWN CLERK'S OFFICE SOUTHOLD, N. Yo Examined " ' Approved ........................................ 19 ........ Perm t No ............................... D~sopprovodoZc ......... / ........... ~'~::'"~X ............ J'~ .......... ~" - --~ (Building Inspecto~ Application No. I c..[ ~ 0 APPLICATION FOI~ IILIILDII~IG I~I:I~Ig, IT Dote ............. ~.~?.'...~.?....d.'~). ....... 1~.~ ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and su6mitted 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 prqperty 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 grbnted 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 of buildings, additions or a Iteration, or for removal or demolition, as he. rein detcribed. Regulations, for the construct Jan The applicant agrees to comply with oil applicable lows, ord./and regu?tion~~:~ ~.~' ~~¢~Z / Stat- ..,hether a.',-,lica'~'l~"~wner lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... ............. ..z.. .................................................................................................................................... Nome of ow,e ......... ................................................................. If applicant is a corporate, signature of duly authorized ~fficer. (Name and title of corporate officer) 1. Location of land on which d work will Map No: ................ ~.~ ........ Lot No: ....... 2. State existing use and 'occupancy of pr, emises and intended~.J e and occupa cy of pr posed, construc 'on: 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ..................... Repair ........... .~--...Removal .................... Demolition .................... Other Work (Describe)',.-L-~.~.~..~.~.7-~'~*~,/ 4. Estimated Cost....,~',~,~.~. ............................................. 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 '~ '-'~ ,~ '~) ~r/' ...... ~../. ...... Number of Stories ...~.....~'~"/~ ................ De,,94~h ..... .~'..; ......... ~ ......Height B./'"~"Dimensions of ent re new construction: Front ............................ Rear ............................ Depth ............................ Height ................ ..../.. ..... Number of Stories ............................ 9. S ze of lot: Front . . . Rear ..... .. ...................... Depth ............. ......... __ //' 10. Date of Purchase ~¢~.~...'~..../~. ...... ./.~....~....~. ....... Name of Former C~ r~_~..~'~,~.,~._..~. 11. Zone or use district in which premises are situated ................................................................................................ 12. Does proposed construction violate any zoning law, ordinance o~,~egulation? ~C ......................................... 13. Name of Owner of premis~..4.~..~..~.~..ff.~.~ ........ Addre~'~....~..~.~. ...... Phone N~.'.~...'~.../.~..~ Name of Architect ....................................................... Address ............................................. Phone Nq(~, ..................... O Name of Contracto~../.~...~..'cZ~-2~(~.~( ........... Address .,~;r~/X-~./~_,7.....~..~.,Phone N PLOT DIAGRAM Locate clearly and distinctly oll 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. ~-- COUNTY OF ..~f.~ ....... ) , '~ ~_ above named. He is tho ............................................................................................................................................................. ~~ (Contractor, agent~ c~orate officer, etc.) ' of sa d owner or owners, and is duly authorized to perform or havep~rmed the said work an~ to make and file/ this'app cation; that all statements contained in this application a~,~rue to the best of his ~wledge and belief/ and that the work will be performed in the manner set forth in t~pplication filed th~ewith./// Sworn to before me this /~ - ~ //