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Home My WebLink About1676-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No.Z..2]-~L1 ............... Date .......................... .~ll~Z..~a3c~4r...2 ..... , 1965... THIS CERTIFIES that the building located at ..... J~;J~..JJJLoa~J ........................................... Street Map No ..........-..'..'...'..'.... Block No ...... .-...'..-..-.. ...... Lot No .......... .'...-..'...'..'..'...'.."7.. ....................................... conforms substantially to the Apphcahon for Building Permit heretofore filed in thru office dated ......................... ll[a~'.<:=~...27 ...................... , 19.62~.. pursuant to which Building Permit No. "" ~ dated ............... IL~..2.7. ..................... , 19..6~, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which th~s certificate is issued is ........ ..................................... l~e~deuce .......... ~md,.~u~ea~..~&~.d&ng .......................................... The certificate is issued to ................................. Jjl~l.:j~Jrt..j)~,..~O~.~.~ ............. : .............................. [owner, lessee or tenant} of the aforesaid building FO~ 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.° 1678. z Dote ................. ,~.~....6.. .................. a 9.6..~... Permission is hereby granted to: ...... l~,~]g~ ..D,. ~r il ~-~ ............................. ......... ~ke~:.. ~,n~ ............................................ ............. ¢~l~t~l~-.~a~.~. ......................... to ..~d.~ ,~Ld.~m~T~al.,~dJ.t:Lon..ozt..~7,. ~J,~t~-~,..b~lne~s..,l~LdJ~ ............ at premise~ located at ~.~..~.t~..___~..~c~t...~..]b~ .~;~O~ .................................................. ................................................. ~e~.t~l~t.~..... ~,.¥~, ......................................................................... J[.~a~'J~nce. ~an~CL..l~r..AffA.Ap~.~l..~.~.!.6a~ ............................................................... pursuant to, opphcotion doted ............................ ~ ..... ~ ............. 1~..., and approved by the Bu,/ding Inspector Fee $..,~.~ ............ Budding inspector . FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No./..~.....7....~.. ............. Approved ........................................ , 19 ........ Permit Noz/~ ''~ (O ......................... ......................................... (Building InSl:lector) APPLICATION FOR BUILDING PERMIT 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 Ioca~ion of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving o detailed description of layout of property must be drawn on the diagram which is part of this application. 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 pa rt 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, as herein described. The applicant agrees to comply with all applicable laws, ordinal~c~ s~s a'~d~r gulations. / ( ress O ap~ant) State whether applicant is~, lessee, agent,~ngineer, general contractor, electrician, plumber or builder. Nome of owner of premises ...................... ..~.. ........................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) t. Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number .~././.~....C~....~..~....~.......~...~..~..//..~....~...~.~.~..~.. ...... ...?...~...u...~..fl....o...~..?/.. .................. Municipality .... 2. State existing use and occupancy of premises and intend_~d use and occupancy of proposed construction: a. Existing use and occupancy .............. Z.../~...?./...~....(~....~.......~.....~.....~.....~.. ........ ~ ; ........... ................ b. Intended use and occupancy ............................. . .~..~...~'.../..~¥..~.. ~V ¢ ~' 3. Nature of work (check which applicable): New Building .................. Addition ...~ ....... Alteration .................. Repair .....~......(j~emot, al .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ......."./...~.4...~...°...°.:.:~ ............................ Fee .......................................................................................... (to be paid on filing this application) 5. if dwelling, number of dwelling units .i...O.../~...~'. ................. Number of dwelling units on each floor ............................ If garage, number of cars .........~.......~..~...~. .................................................................................... ..~..?~.: ....... ~..~; ..... 6. If business, commercial or mixed occupancy, specifynatureand extent of each type of use .~'..Z~/.~?.~,,..~...~i;~....?.?~... 7. Dimensions of existing structures, if any: Front.~.Z.../..q. ....... Rear ~<~...T.../.?. ......... Depth ......~....o....-..?.. ........... Height ...../.~....-T....m.. ......... Number of Stories ...... ..~....,~....~'.. ............................ .~ ........ ,x ............................. ,' ................... Dimensions of s,ame structure with alterations or additions: Front .......~.../.'.'T..../.../~_ ........... Rear .....?./...~...J...?...~. .......... Depth ..... '~..--...'~..~ ........ Height .....~..~.. ................... Number of Stories .....<~....~. ......................... 8. Dimensions of eptire new construction: Front.....~....~..'t....°.. .............. Rear .....~...?...'Z..?.. .......... Depth ~t~TT...~. ............ Height ....... ./...~..~..~...~ ...... Number of Stories ........ ~ ..,~......~.. ............. 9. Size of lot: Front../..~'....~.......~. .............. Rear ..~...~...o......-. .......... Depth ...... '/'"O"'"°'"t:~'~',~'~//''''''~ 10. Date of Purchase .~..~.....~.....~..../.~....~.....~-.. .................. Name of Former~ Owner~g~....'~.....':'~...../..~ 11. Zone or use district in which premises are situated.....~.... ................ i ......../'/¥...J...,_ .............................................. 12. Does proposed construction _yJqlate any zoning law, ordinance or regulation~X"// ',~.:..,:~,.~.. ......................................... 13. Name of Owner of premises~..4kr~.....~.'....~.......g~....~..../4...~..Address ...?.~..~...~.~..,y.~..Q..~...~.....~..."-~/....-~..,.. Phone N .~.~...2..'...~...?..Z/. 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 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. J STATE OF NEW YIgRj(i. ~/ ) S S COUNTY OF ..~.) ' · .....~..~.'.t~..~../~ ~....~..~· ...................................................... ..~'..o.. ~(.LZ/.~(. be~n'g duly sworn, deposes and says that he is the applicant ~ (Name of individual signin~qapplication) 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 application; that all statements contained in this application are true to the best of his, k~nowledge and belief and that the work will be performed in the manner set forth in~l~e~:~l~lication filed t, berew4¢~ Sworn to before me th~s Juon~ 1'. ~0~Erl ., ~.~ ( ~ P~blic, State of New York r-~' ;/~z;'~' da,, of ~, Suffolk Courl~ ~o~.~ ........................ 7w ..... ....../ ~ / ,~ ~ ~'"-'~,/. '/~' / ...:.../~--;/7, .......... ,., ....... z.~..~.....:....~ ................... ~ .............. Notary Public, . ...J...¢.~ ...... n[y,~ / ~;' (Signature of a~pticant) L 30- f ,Z -: ,' / V' 7w-- - -X o ,k 0