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Home My WebLink About1484-zTOWN OF ~OUTHOLD BUILDING DEPARTM~'--NT '~'OWN CLERK*S OFFICE SOUTHOLD, N. Y, CERTIFICATE OF OCCUPANCY No.' '~'~tO~ .......... Date ......................... 'A'AgtlS~" ' ..~,6 ......... 19...6t TH]IS CERTIFIES that the building located at W/S...'Deep-.Ho{le. ~r'ive ............. Street Map No. :eX:g: ................ Block No ....... ~ .........Lot No.~,~ ........ ~.i~:~.l;~lek.~.....~.~.~..~ ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated .................. "~t~y'"...'-'i.'0 ........... 19...~,~ pursuant to which Building Permit No...~+~)+ ..... dated ................... ~Tll'}y' ....... 't~ ....... ,. 19.~.~., wa~ issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is ~ssued is ........ P~,.tvai~e...(me-..f.a.m.i-ly ..(lWe~L~rl~..~ii;k..g~.r.a. ge...a..d.d.i.~.i..~..n.,.., ........................... This certificate is issued to -"-g'-ohr~..t~....Sehm~d.t~ ............. O~nel~. ......................................... (owner, lessee or tenant) of the aforesaid building. Building Inspecto 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) N.° 148 Z Date .............................. ~ ....... .~1 .'~ ...... 196~.... Permission is hereby granted to: · Tohn..H,..Sa~.d~ .............................................. ........... D~et~..Hol~..l~i.v.~ ................................ .................... l~at.ti.t, uck ....................................... to ..Bu~ ~d...nov..od4:L~J, on..o~..~.~,i~t~..~t.l.~i~ ..................................................... at premises located at~/.S..~..]]~..Di~..~ ............................................................................... .................................................. l~t f.~l.t~ck ~..;L, .];, ........................................................................... pursuant to application dated ..................................... ~'lL~r ....... .'LO....]9.~,~..., and approved by the Building Inspector Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .................... 19 ........ Approved ..............r,;..',~,.....L ......... 1? ........ Permit Ng ...................... ~) ....... ........................ ~'i'l)'i'~¢~[;g~ ................................. APPLICATION FOR BUILDING PERMIT Date .......................... .~...~./. ~,~......./.~... 19..~../. .... 1 NSTRUCTIONS 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. J~o 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 issuanoe 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. (A~ldress of applicant) State wheth.er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ........ ~....'/:~..:,~::~.....~...~..'......~.-'~:",~'.~:~"~"~"~' .............................................................. 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: ............... :J....: ..................... Lot No: ..~...~,.~.~:~..~ Street and Number ..... ~..~.z~...~/C;~.~./..~:;~....~...r:2 ............ ff~...4~.,?~..../..~...~Q~,:-~. ..................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................ ~......~.....~' ......................................................................................... b. Intended use and occupancy ............... .~.~.~::~..~..~:~..~.;~. .................................................................................... 3. Nature of work (check which applicable): New BuitdJng .................... Addition ..... ...~..........AlteratJon .................... Repair ................ .~emoval ..... .,~ ......... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ...... ......~.(~...~....: ................................ Fee .......................................................................................... (to be paid on filing this application) §.If dwelling, number of dwelling units ........ ~ ................... Number of dwelling units on each floor ........ ~ ............ If garage, number of cars ............... ~..,"~...~,, ............................................................................................................. 6. If business, commercial or m~xed occupancy, specify nature and extent of each ype 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 ........ ~.~.. ............... Depth .....~..~r.7. ................ Height ......... Z'.~. .............. Number of Stories ..... ~....~..~ ............ 8. Dimensions of entire new construction: Front .......... .~.~.. ........... Rear ........ /...~'.../. .......... Depth ....... ~..../. ............. Height ....... ./.~,./. ............. Number of Stories ........ ~....~2'...I~. ..... 9. Size of lot: Front ..... ..~........~... ......... Rear ....../'...~...~,.....'~.. ........ Depth ...~...../.~.. ............ 10. Date of Purchase .~/~.,.¢..?.,....g.~.O...'~. ............. Name of Former Owner ,.~..Z.~.¢.~.~. ~//(;.~, 11. Zone or use district in which premises are situated .................................................... ,~-7' .................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? .... ,,~.,.~.~2 .................................... 13. Nome of Owner of premises..,,~.."~,.~...~..~.~-~?~'~/'/.~.~Address .~.~4~.~..~.~-~-~'¢,~ .......... Phone NO. Name of Architect ........................ ~ ........................ Address .................. -.: ........................ Phone NO ..................... ..................... .~; .................... Phone NO ..................... Name of Contractor ................ ~ ............................ Address · 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 ihterior or corner lot. STATE OF NEV~z. YOP-~K,~ - '-') S S COUNTY j OF ,.~(..~..../;C.~..~../../5~.) ,' , '~/c/~/D" ~.f~ ~..~..~ ..~.~...Y~.. Y .~.....'~... ...... be ng duly sworn, deposes and says that he is the applicant (Nome of individual signing application) above named. He.,~ the.... .............-.......... ..................................................................................... . (Contractor, agent, corporate off car, etc.) ~ owner or ow.~ers, and is duly outh.orized, to .perfor.m. or. hove performed?he, sa. id ,w,or.k ,and t.o~mak~en,an.d ,.file this application; that ail statements contained .n th.s apphcat~on are true to me oes~ or ms ~now~eage a a oeuer; and that fhe work will be p,~rformed in the manner set forth in tl~b~a~i~p~[g~iled therewith. Sworn to before me this {/, /2 . ~10TARYPUBt,[C,~STATE 0FNE~¥ i'0i~,'k f ¢5c~ 19f~., f., , ture of ppi,cant) Nota~ pubhc, ..~.~.~....~.~' .... ~" - ~ ~ / ~