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Home My WebLink About1449-zFOE1H NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..~/.~.:.~,,...rd,,,...~.,/.S..,B~,~..,~.;L~W..~Et3treet $ou~old Map No. ~b~.~l~... Block No ........... .~..~..... Lot No ................... ~ ............................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .................... .~...~..n...e.....1.~ ............................. , 19....6...~. pursuant to which Building Permit No.,.,.............~ 1449 dated ......... ~.e....~ ............................ , 19.....6..'];, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ PRIVATE ONE FAM]iLY D WELLI/~G The certificate is issued to ............................... ..~.~.:¢..9..G....~'B.~.~,......o~....~.~. ..................................... (owner, lessee or tenant) of the aforesaid building. ,/ FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 1449 Z Permission is hereby granted to: A~f~.~d..A~nf, e ................................................... ..... l~-t..t~oad.,...~.~.....Bay...~e~...~oa~ ....... .................. South~l~ ............................................ to .. ~)1~..ld...an.. ~d&.t.i~..a~d...ma~e.. ~.~®~t$on~..on.. ~n.. $~ s.t~n~..dYe~]z~n~ .... at premises located at pursuant to application dated ............................. ~'1~1~ ....... ~?- ............. 19.6~,.., and approved by the Building Inspector Fee $-...~.OO ........... A~FRED AA, t AA/T ~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... II'~" ............... ,t, 9. ......... 19..!~"I' Approved ......... v .............................. 19 ........ Permit No......':'n~.....'..'";..'":..~ ..... Disapproved a/c ...... .~::: :: ........................................................................... (Building InspectOr) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application mu'st be completely filled in by typewriter or in ink and sut~mitted 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 thi.~'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 ~remises 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 ti~e 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. ................................. ............................. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .O?~r~O~ ............. Name of awner of premises......~l~.l~.~.¢l..~'ll~.'be ................................................................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corparate officer) 1. Location of land on ~vhich proposed work will be done. Mop No: ...... .~...e..b..Z'...O. fl.~ ................... Eot No: ~ ............. Street and Number ~,.~./.~.....~.~.{~:i:..Q...~.°.~'~.~ ....... ~ ./.~.....~.~,~....~.~O~...~t~.~.....~hc~],d ........................... ,, Municipality State existing use 6nd occupancy of premises and intended use and eecupane¥ of proposed construction: a. Existing use or~d occupancy ...... .~¥~.~.~L~..rtg. ......................................................................... , .................................. b. Intended use and~occupancy '~r~ha~ add~t~o.]g, 3. Nature of work (check which applicable): New Building .................... Addition .......... ~..Alteration .................... Repair .....~;, .............. Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ........ ~..60,~)0~/.J~ ............................. Fee ....,~...~(~) ....................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........~e ................. 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 ....... :2,Jt,..//...6~lllRear ...~.~...~.l. 6.ll. ..... Depth ....... .3~1...~.],l) ..... Height ............................ Number of Stories ........ ~tl .............................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front ........... 8 ............... Rear .......... ~ ......... ~ ..... Depth ........]'O ............... Height ............................ Number of Stories ...~ ................. 9. Size of lot: Front ..... 280 ............... Rear ............ ~1,0~.. Depth ............ ].~l~.., ..... 10. Date of Purchase ........................................................ Name of Former Owner ...... ~'.. ............................................... 11. Zone or use district in which premises are situated .................. ~.l.~.~...¢~.ll.t, ........................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ... ........... ~.~. ................................. 13. Name of Owner of premises..A,,..,i~l,A.t,e ................ Address ......... ~e~l.~J~O.l.~J ................ Phone NO. Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor .................................................... Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate ali 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, ) S S. COUNTY OF ...~,~.~'~_l~ ........ ) ......................................... ~'~..e4~..~l~l,.~ll~ ........................ being duly sworn, deposes and says that he is the applicant (Name of individual signing application) O~e~ above named. He Js the..x ......................................................................................................................................................... (Contractor, agent, corporate 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 b~ performed in the manner set forth in the application filed therewith. Sworn to before me this '__~ ~, JUDITH T. BOKEN l~'~' day of ~ ~ ~,~A~Lig Stste of New York (S gnature of applicant) ............... y'P ..... "" ................ U~:~; ...... .,N~¥~-O3A4~63, Suffolk County / ~ /, ~ ~t ~~' . . ,, .~ ./ . -- ires March 30, 19 u ~ ~