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Home My WebLink About1692-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE: OF OCCUPANCY THIS CERTIFIES that the building located at .... .~../..~. .... .~..~p,~..a...~..~....~.e.. .................... Street Map No ...~ .......... Block No .... ~ ....... Lot No ~ ......... ..~..~...~..~....~..O..~..t....~...'..~.~. .......... conforms substanhally to the Application for Building Permit heretofore filed in this office dated ....................... ,~,~. .....,~. .......... , 1S~a ... pursuant to wh,ch Budding Perm,t No ...~.~.~.~...~... dated .................. ..~.-~.~.~..~ ......... ~. ..... , 19~.~...., was ,ssued, and conforms to all of the requ,rements of the apphcable prowsions of the law. The occupancy for which th~s cerhficate is issued is ........ ....... .................................................................................... The certificate ~s ~ssued to .~3,~,.~...m....~.O~Ct, Tii[}~, ............................... .0jy~...e.~. ................................. (owner, lessee or tenant) of the aforesaid building H.D. Approval April 16, 1963 by P. MaJkowski ...................... Building Inspector J FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1692 Z Date ............... Apl~$~_......~ .......... 19.~.. Permission is hereby granted to' ¥~llt~u~....~oiinski .................................... ...... ~..m~'~ n..~t. ........................................... ............. ~l~rt~..~l,~, .......................... to ..... ~%ld..~e~...o;~e...,c.~,l~...4~.~ll&~,~ ............................................................................ at premises located at ..~.~...,_~t**~ 10~r~..~ ......................................................................... ................................................... Aas.t..Nar~ont.. ]I.X. ................................................................. pursuant to apphcahon dated ......................... A]~¢~I.....~ ................. 1~2,..., and approved by the Budding Inspector Fee $.1~.~.....~. cash Building Inspector / FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ................................. D,~sapp roved a/c ..... ~~......~..~ ............................... i~';'~'l'?,i'~' .......................... APPLICATION FOR BUILDING PERMIT! Date ...~.~.¢1../.....'~,.~... .................... , 19..~..,~,, .... 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 location af 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 thediagram 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 1S 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 TR~ngeUla~t~lOir~nftOra~rheeesCC~Stcro~.r~lC~ wOifthbU~[idian~l~icaadbdli~iC~an~vsO, roar~nO~ freOrgt~leat~r~l ar de~n, as herein described. (Signature of applicant, or name, if a ,c;orporation) ........ (Address of applTcah-t) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. / ..~2~ ................................. , ................................... ~...,/. ....... . .............. ,.+. ...................................... ,7, t , ,; . ,lA ~ ./x . ' .................. Name of owner of premises '~..~?,,,~,.~...~...6~..~.'~..i.....~,..~./Z.,<:~.~ ........................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work will be done. /~ap ,N9~ ........................................... Lot No: ......... Street and Number i'~ ........... Munici~flity/ " ' '~' '~'~-(-~' State existing use and occuoancy of premises and intended use ar~i'~o~cupancy of proposed construction: x ' b. Intended use and occupancy ..... ~L..~?..~....~~ ......... ~~... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair ............... .Z.. Removal .................... Demolition ................ .~.~Other Work (Describe) ........................ ~,~ Estimated Cost ..~'~/~..~..¥'~Z~. ........................................ Fee ./.~)-........~. ........................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... ./. .................. Number of dwelling units on each floor ............................ If garage, number of cars ......................... I ................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature end 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 ........................................ (~ Dimensions of entire new construction: Front ....... ~,~?.--~),-.....~ ........ Rear ...~....~...~ ............ Depth ...~.....-~......./. .......... Height ............................ Number of Stories..../. ........................... ~i(~eOf lot: ~;~ ....~.../~.~..; ....... Rear ..... ./...~.....~...~... Depth ...... J~...~...~...:.....;....,.~ ///~ , of Pu h e ..'.~/'~~x.../~.~l.~......~(Xlam~,~f Former~~ Zone or use district in which premises are sityated ...... ~......;.?'..~.. ..... ' .......................................... Does proposed construct on via)late agy zon~!~,~aw, ordinance or regulatiqn? .,~ ...................... ._.:;,~._...~ ............... Name of Owner of premises ~,,?T~ ~7~dd ress~../.~...~..~Z ..... Phone No./~..~...?..~..%Z/.~.. ~ Name of Architect ...................................................... Address ............................................ Phone Nd ...... Name of Contractor ...................... ~. ................. ~!. ........ Address ................. .'.~. ........................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate ail set-back dimensions from property lines. Give street and block numbers or description according to d~ ,"d, and show street names and indicate whether interior or corner lot. STATE OF NEW/YO~,~,/J~ ) c c COUNTY OF~..) ~'°' ........ ~~ ............................... 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 out-' ' horized to perform or have performed the said work and to make and file this application; that all statements contained in this application ~ true to the best of his knowledge and belief; and that the work will be performed in th~a~n~t forth in ~h'e ,~pplication filed therewith. . . ... ~ary Pubic, State of New York Sworn to before me Tins *' 52 034.49 "'/ ~ ..4~. ~Z-O .4963, Suffolk Countv,~ / / . , . / ~ ///. / Nato y ', ~ ...................... ....~,g}~)~ry,/~ ( 'g app 'c )