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Home My WebLink About1487-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .:W~..C~..~/~..&..I~I...Na,[I~..R~, ....... Street Map No ...... ~ ......... Bilk No....~ .......... Lot No ......... ~ ..........~[¢~.~..~[, ......... confor~ substantially to the ~plication for Building ~rmit here~fore filed in this office dated ....................................... ~'"-'~9 ....... , 19.~.. pursuant to which Building Permit No....~. dated ............................... ~.....~O..., 19..~[., was issued, and conforms to all of the requirements of the appficable provisions of the law. The occupancy for which this cedificate is issu~ is ........ · .~...b~$1~i~ ......................................................................................................................... The certificate is issued to ..~tO~..~...Ne~..8~..~i~..~ ............. to~er, ~essee or te~nt) Te~tS, of the aforesoid building. FOEI~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 1487 Z Date ............................ ~'~l;11~t ....... 20 ........ 19.63,.. Permission is hereby granted to: Cor~rln .. ~. ath~o~.. A/¢..¢on~. e~e, tional .. C:hureh 8oelety ..... l/ain..l~ad ..................................................... .......... l:utchog~et.....]loZo ................................ to ..move.. an...e~i sti~.. ~ui.td-in~...to...thl~..loeat~o~ .................................................... at premises located at .$/8.......~il'$..l~gzl,..&..W~f~....Ca~..~l~ ................................................ ............................................... ¢luteho~tte .......................................................................................... pursuant to application dated .......................................... ,Tu~......~.9..19...61, and approved by the Building Inspector Fee $...~ ........... Building InspectS/ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved .......... !../~.. ........ !....!.k ........ 19....~...Pormit No.....~,,~.,~.~.~ ........ (Building/Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and sui~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 coYered 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 k, ept 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 t~ave 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 Southold, 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 oil applicable laws, ordinan~s and regulations. (Signature of applicant, or nome, i a corporation) ~/' (Address of applicoi~t) State wheth,er applicant is owner, lessee, agent~ architect, eng,_.~.ineer, general contractor, electrician, plumber or builder. Name of owner of premises ........x/~ //'~ ~ 'c"~~~:~.~.~.....~....~ ..................................... 'of duly thor~zed officer If applicant is a corporate, signature of du y' au ' ' . . (Name and title of corporate officer) 1. Location of land on whi, qh proposed work wi~ll be~,xdone. Map No: .......... : ............. ~ ................. Lot No: .................... Street and Number ..~.~.~'..~...~.~....~.?.~.~/'. }~'~..~.6~.~--~q~'~.'~r-~/...-~..'~...~..'.~.~....7..~. ..... (,/ Municipality ~ ~' 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy ...................... ~..~ ...................................................................... 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal ..... ~......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 ............................ If ga,rage, number of cars ............................................................................ ..................................... ~.,~.~.~ ......... 6. if business, commercial or mixed occupancy, specify nature and extent of each type of use..~ ......................... Rear ........ .~.c? ............. Depth ..... _~'.~ ................ 7. Dimensions of existing structures, if any: Front ......... Height ....... .,,~....~; ............. Number of Stories ........... ~.. ............................................................................................... Dimensions of same structure with alterations or additions: Front ............... ~...r-.,... Rear ........... ~ ....... Depth ......... ~ ....... Height ........ ..%~....:.¢.z .......... Number of Stories ..... ~ ............... 8. Dimensions of entire new construction: Front ............. ~,, ........... Rear .......... , ................ Depth ......~. .................... Height ................. ~. .......... Number of Stories .............. '.: ............ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ] ]. Zone or use district in which premises are situated ................................................................... 12. Does proposed construction vloj,ate,/~ any ~oning law, ordinance~ .,---/~ -, __°r regulation? ........ ;....~ ............................... 13. Name of Owner of premises..f,~.:.~ .......... Address ..~..~..,,,~....y~.~....Phone NO Name of Architect .......... ,.~ ....... ~ ................................ Address ............................................ Phone NO ..................... 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 interior or corner lot. STATE OF 'NEW YORK, ) S S. COU NTY/~F ............................ ) ,~ ........... ~.~.;."..~-/_-.~.~ .............................. being duly sworn, deposes .and says that he is the applicant (Name of individual signing application) above named. He is the .......................................................... ~ ......................................................................... (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 applicdtion; that all statements contained in this application are true to the best of his knowledge and belief; and that the work w be performed in the manner set ~ort{il~rl~the~el3/llication filed therewith.