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Home My WebLink About1386-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .M~L~e~a~..,l~',Z.~...&..O~e~C~..,~Vj~.reet Southold ,~atLgh~Lng Watelcs~, . ~1~ ~ rmap mo ........................ ~iocK No ....................... Lot No ..................................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. ..~.~.~...~....~..?. .................................. 19...~..~... pursuant to which Building Permit No. Z..J,~JI~.~i.. dated .AJ~.~..~....~.~ .................... 19....(~, was issued, end conforms to ali of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .......... I~lVATE ONE I~A~41L¥ DWE.L..~.IhU ................................................................................ This certificate is issued to ..... ;.A%~...l~.~...~.~.t;.~,... ~.~P~r ..................................................................... (owner, lessee or tenont) of the .o~oresaid building. FOI~M 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? 1386, Z Date ...................... &~.;~"t.... 2~, ............. 19~,1... Permission is hereby granted to: OoW. ~m~h & .~ons.....A/.C.. ~..I~. B~.tz ...... : ............................ ...... S~I4~.....~..Z.. ..................................... to Btttld..an..~clclJ, td, on..on..arL.e~ts.tinZ...d~elJ.~ .......................................................... at premises located at ..l~l~ehah~..21vd..&..Ol~eohe..A.ve .......................................................... ............................................. L~u~.h~ni[...wate~.s~.....Sou~ho&d ..................................................... pursuant to application dated .......................... ~p~il....2~ ................. 1~1 ...., and approved by the Building Inspector Fee $....~,,.0~ ........... FOE~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .............................. .~.. ~'..~:/ ~ .~....~... 19~.(... Approved ........................................ 19 ........ Permit No ............................... Disapproved a/c ......... (Building InspeCtor) Application No...l..'~....(~.....~.. ......... APP.C^T O. FOR BU,LD,.G P .MIT Date ..................... ~.Z.~.. ....... '/.. .............. 19.(0../.. .... 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 hove 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signa~,~re of applicant, or name, if a corporation) ......... ........................... (Address bf applier) State v~hether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises ............ ..~.¢....L.....~..,....'~...~"~;)"/2 ........................................................................................ If~applicant is a corporat.e, signature of duly authorized of/r4tCer. ............ (Name and title of co¢[~orate officer) 1. Location of land on which proposed work will be done. Map No: ............................................Lot No: .................... Street and Number ....................................................................................................................................................... Municipality State existing use and occupancy o.~f pr,emises and intended use and occupancy of proposed construction: b. Intended use and occupancy ............... ~/./ .......... ~.... ............................................................................................ 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 .................... Addition ......... ~Alteration .................... Repair .............. .~.~?emoval., .................. Demolition .................... Other Work (Describe) .................... 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 ........ 'i~ ......... 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 'J'-'~ Z2 Depth .......~z......~.. ............. Height .............................. Number of Stories ....... ../. ...................... 8. Dimensions of entire new construction: Front...~.--~-~¢ .,,-,n---. Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ............................ Rear ....... 7 ............... Depth ............................ '10. Date of Purchase ...... ..~....~-..~...~..~..:~...'.l(..~...~,.~..' ......... Name of Former Owner ....::Z~ ..................... .':' ........................ 11. Zone or use district in (,¢~hich premises are situated ....... ~'~4. ........................................................................... 12. Does proposed construction violate any zoning law, ordinance or reg_ulgtion? .~.~..'~¢~. ............................. ~ ........ 13. Name of Owner of premises.......~......~...~:...Address ~.~.~..~... ........... Phone NO..~..~.~..~..~.~...~:~/'j Name of Architect ..................... ~. ............ ,..../ .......... Address ........... ~.,~.~.....Phone NO ..................... Name of Contractor~.¢'~.~..~'Z/~,Z~.~/....~,~ess ....~.¢~,~...~'..~-.~..-~.[ ........ Phone NO~..~...~...~...~...~o PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from and show street names and indicate STATE OF NE'~ YC~,K, ,~_ ) S S CQUNTY OF ~ ....... ) '~' /') ,~ .............. being duly sworn, deposes and says that he is the applicant (Nome of individual signing application) above named. He is the ............................................................................................................................................................. (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 file th s application; that all statements contained in this application are true to the best of his knowled~ and be~ef; and that the work will be performed in the mal~.r ~.~.orth in the frpplication ~led therewithz/'~ Sworn to before me th s · '"~,,~bi;~s,~O,W~£~ { ',~,~), ,-~ ~' ,~, of ~ ~ ~3'~'~/k'c~w ~o~ (Signature of applicant) ...... ~.~ ............. y .................. ~ ............. Nota~ P~blic, ~...l~ ............ Cou'~ ' ,re~ ~0, ~9