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Home My WebLink About1669-zTOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ............ ..~.,~.~...~.~...e..~.....~...~..~..e. ........................ Street ~a¥ Haven @ ~o~thold ~. Mop Ix~o ....................... oreck ~o ............ ,~'~... Lot No..~. .............. B.~.~t,~.9.1.~ ................................ conforrr~ substantially to the Application for Building Permit heretofore filed in this office dated ...................................... ~ ...... ~!9...., 19..6~,, pursuant to which Building Permit No ..... .~.~....~..~..~ dated ......................... ~r4~,~ ....... ~.0......, 19...6.~., was issued, and conforms to all of the requirements of the apphcable prowsions of the law. The occupancy for which this certificate is issued is ........ ........... :~.t~a~;~..on~..~ea~y...d~e:Llt~g .................................................................................... The certificate is issued to ...~lt,,...W~l~,ll .............. ..b~e:~.,~'0::L~e~. .............................................. (owner, lessee or tenant) of the aforesaid building. H.D,approval August 6, 1962 by R,Villa & Na~kowski .................. ....... ............. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLER~('S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 1669 Z Date ..................... ~.ch ...20. ............. 19...~1~. Permission is hereby granted to: ¥~ i~l~....Wel&~....A/C.....A=.thu=.. J... ~Xlks .... · .~.~CkTL~[ .................................................. to .~u~i~..r~e~.. ol~..~..~Wel~ .................................................................................. at premis,es located at .-.~O.~;..i~.-~ ...... ~¥'..~1..4~t,. So~,t,~;~ ........................................ ;.. .............. i ........................ ~'S.... ~.. ~e~..~au~e ~ ...... ~g~t~o;tA .............................................. pursuant t~o application doted ......................... ~l~t~]~ ........ ~.O ............ 19.6£.., and approved by the Building !nspector Fee $~0,..00 ........... pul amg inspectord FOu.'M NO. ! TOWN OF SOU,THOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .... .~ ~...~....., 19..~....'~.. Approved ............... ~ .................. , 19..~....Permit No. ~-~ Ce C~ c~ Disapproved a/c ........... ~. ............... i" ..... ........................... APPLICATION FOR BUILDING PERMIT~ INSTRUCTIONS a. Tills 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 prOperrty must be drawn on the diagram which is port of this location. c. The work covered by this application may not be commenced be.fore 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 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 alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Sigt~ature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................ ................................................................................................................................................. Name of owner of premises.......A...~..~..~/...t~.....~.J.....W.~.]t...~..~.,~...~....z~.. .............................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Location of land on which proposed work will be done. Map No: ..~e~Zt.....~..~..e..~...~....~..o.~..~.~. L~ No:....~...j. ............ Street and Number ~t.3/' J~zs.¥e~ J, di.l~, JJotl'l;ho'ld, ~-/~h- ~ 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 Building ....... ..Z. .......... Addition .................... Alteration .................... Repair .................... Removal ' Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ....~...~.a~..O..0..n.0...0. ................................ Fee ..... ~]....~.~..0..0. ....................................................................... (to be paid an filing this application) 5. If dwelling, number of dwelling units ........ ..~. ............... Number of dwelling units on each floor .................................. If garage, number of 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 ................................ Depth ................................ Height ................................ Number of Stories ................................ 0~ ........................... 8. Dimensions of entire new construction: Front ..... ~. ..................... Rear . 60 ! Depth ............................ Height ........ .]..,,~.1. ............. Number of Stories ............... ..~. .............. 9. Size of lot: Front ...... .~..~.~.. .............. Rear ..... .1...~.~ ................ Depth .....~...2.~ ................. 10. Date of Purchase ..,~..~.~..~...~....]:..g.~..~. .................... Name of Former Owner ..... .W.~.];...1...~....?.~.]:...~.. ..................... 11. Zone or use district in which premises are situated ........ ~t.6;~ll~t,], .................................................................. 12. Does proposed constru~ction vi~late any zoning law, ordinance or regulation? ..... ]li.O .............................................. ~0 5-~g74 ]3. Name of Owner of premises...-~..~.~....t~....~..~..~..~...~..~...~]L~ddress .~...i~......]~....~..e...~. .................... Phone NO ..................... Name of Architect .................................................... Address .......................................... Phone NO ..................... Name of Contractor ...~]...],~.~.~....~1,;],.1~ .................. Address .....]j~...~'......~...~...e..~.. ................. Phone N~.0......E~...~.~.~..g.... 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. STAT OF COU NTY~ OF ...~...~..!...O.~. William Well8 ................................................................................................. being d~ly s~orn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ............. .~.9~D~..~..~.~e.~ ......................... ~ ................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have ~rformed the said work and to make and file this application; that all statemen~ contained in this application are true to the best of his ~owledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ..................................................... SU~V£~ FOR THOMAS P 8 HELEN D. MC NERNEY AT SOUTHOLO TOtVN O~ SOUTHOLD ~UFFOLK COUNTY, N ~ SCALE~ I"z40' SEPT. Iff, 197.7,