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Home My WebLink About1709-zFO~ 1~0.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No .Z..:L~I.~ ............ Date ........................ ,~l~.itSt.....t..,] ........ , 19..6~. THIS CERTIFIES that the building located at ..]~...~:~..P. GP-J~..~...~B~.~ ..... Street MaROOning wood FS~ . p I'~o ...................... mloc~ No .....I~ ............. Lot No. ~ ......... .Le.1~_'l.,/...~r.,.~.., ....................... conforms substanhaily to the Applicatton for Building Permit heretofore filed in this office dated ................................... ~p~j, ....... .'t.7. ..... 19...(:~ pursuant to which Building Permit No. ~],.~.0.9.... dated .......................... ~lt.:L.],......g~l.., 19~/..., was issued, and conforms to all of the requirements of the apphcoble provisions of the law. The occupancy for which this certificate ~s issued ~s .......... ~r.i~ahe..o~a..f~m~._~y...d~elli~g ............................................................................................ This certificate is issued to ...... B,~a,~so, I:I..A/G .]~o-Tli~i/J~oO~..~S/;a~Bii ............... 01~eV. .... (owner, lessee or tenant) of the aforesaid building H,D, approval August I0, 1962 by P, Ma~kowski Building Inspector FORM i~0. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Iq. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1709 Z Date ................... ~t:r~]....20 ............ 19~2... Permission Is hereby granted to. ~over .Z~p~e~aea~-Ce...~.C-.ReLX-~...F~tates ( .......... a~...~t..Av~a ................................... ................. ~. ~t,~ho~e ....................................... to -.-]~t~..ld-.-ne~. · ~ne · · £~t,T · - d~.!~[~ ............................................................................ at premises located at ..,l~..~.e~r.~ol~e.-.]~y..:~.~-'e~ ..................................................................... .............. i ..................................... pursuant'to application doted ......................... ~,~.~1, ...~.~I ............ 1962..., and approved by the Budding .inspector Fee $ ~0,, ~0 ........... Building Inspector / TOWN OF SOUTHOLD ~ I}UIJ. DING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...... ~~ ....... , 19..~...'~. Approved ~' ~' ...~...{ 7.. .e.~. .............................. , 19 ... Permit No .... .0. .......... Disapproved o/c ....................... ~ (Budding Inspector) APPLICATION FOR BUILDING PERMIT Applicat,on No...'./..2...0.. ~. .......... INSTRUCTIONS a. This apphcat~on must be .completeLy fill.ed ~n by type. writer or mmk and submitted in duphcate to the Builder Inspector. b. Plot plan show~ng location of lot and of buddings on premises, relationship to ad~o~mng premises or public streets areas, and giwng a detaded description of layout of property must be drawn on the diagram which ts part of thts apphcet~o, c. The work covered by this application may not be commenced before issuance of Building Permit d Upon approval of th~s opphcation, the Building Inspector wdl ~ssue a Building Permit to the applicant. Suc permit shall be kept on the premises available for inspection throughout the progress of the work e No building shall be occupied or used m whole or in pa rt for any purpose whatever untda Certificate of Occupan, shall have been granted by the Building Inspector APPLICATION iS HEREBY MADE to the Budding Department for the ~ssuonce of o Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances , Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os hereto describe, The apphcant ag. rees to comply w~th all apphcable laws, ordinances and regulations G~o~er Improvement 0o. Ine. (S~gncture of apphcan~-, or name, ~f a corporation) 8'7 ~. su~mt't X'~. ~ l:>e..tel~o~,ue~ ~.Y. (Address of apphcant) State whether applicant ts owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bu~Jde ..................... .%~!!~.e.r ......................................................................................................................................... Name of owner of prem.ses ..... '..~0. i~../.' .~. ~..V.V..~..0.~) .... ~.~ tm. Cra ........................................................... if apphcant ~s 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 . ~.~Z.~J ................ Lot No ............... Street and Number ...... .?~..~...~1 j~8 .......................................................................... Mumcipality 2 State ex~stmg use and occupancy of premises and ~ntended use and occupancy of proposed construction' a Existing use and occupancy ...~~.. ~ ...................................................... b Intended use and occupancy ...~ .~1~ j~]].~ ............................................................ 3. Nature of work (check which applicable) New Bu,lding .... ,,~ .........Addmon ................ Alteration ......... Repair ................. Removal ................ Demohtlon ........... Other Work (Describe) .................... 4 Estimated Cost ..... ~1.6~>00..00 ......................... Fee .~10, 00 ...................... (to be pal~l on filing th~s application) 5 If dwelling, number of dwelhng umts . .0~..~. ....... Number of dwelling umts on each floor .......... If garage, number of cars .... ~ .................. 6 If business, comrnerc~al or mmxed occupancy, specify natureand extent of each type of use ...................... 7 D~mensions of ex~stmg structures, If any Front ...... Rear . Depth ..................... Height ...................... Number of Stories .................. Dlmensmons of same structure with alterabons or addmons Front. .. Rear ................... Depth ........................... Height ................................ Number of Stones ....................................... 9 10 11 12. 13 D~mensions of entire new construction Front Height . 'J,,~.! ..................Number of Storms Size of lot Front . .].lB_ ............... Rear of Purchase .../.).,~ ¢~L.., ..... Date ]LS~ ..... Depth .... .]..00 ........................ Zone or use d~stnct m which premises are s~tuated ......................................................................... Does proposed construchon wolate any zomng law, ordinance or regulation2 . Name of Owner of premlsesl'/.~U-..L~.~*~ ~.¢f~=¢ .... Address .¢.~l.~,.hJC..~s..f/~L.~.~:./?.//.g~-~ Phone No ~¢.;~.:.3...~.~. Name of Architect C-oze~iota A~_]_ez'~ .Address ,~a~te~ooz'¢, Phone No Name of Contractor C~'.o~e~-...~t~'c~r.e~.et~. go--ss ..~4~;beF~- e...~...~. ..... Phone No PLOT DIAGRAM Locate clearly and d~stmctly oil buddings, whether existing or proposed, and ~nd~cate ail set-bock d~mens~ons fror property hnes Give street and block numbers or description according to deed, and show street names and ind~cot whether interior or corner lot. STATE OF NEW YORI<, ) COUNTY OF .............. ) S S ......................................................................................... being duly sworn, deposes and says that he ~s the apphcan (Name of ,nd~wdual signing apphcat~on) above named He ~s the ......................................................................................................................... (Contractor, agent, corporate officer, etc ) of sa~d owner or owners, and ~s duly authorized to perform or have performed the sa~d work and to make and this application, that all statements contained m th~s applicabon are true to the best of h~s knowledge and belie and that the work will be performed m the man~.r_.set forth ~n the apphcat~on filed therewith Sworn to before me th~s ~I~.- p ..u.~ ~Y u~l~c, Stat~ ~ New ......... day of ..... ~...~....a~, 5~Z, 'o,s,'0 ~. . ~r ~ . m ss,on ~'~2~rc~ ~- ~,~'~" ....... ~.r~z..; ........................ Notary Publ c, ~~ ~~ .. ~y 6~ (S gnature of apphcant) ,,f /7 L¥ 5r~y L -0 ,j H~ ~ £b4/t~ I: P3~' Dr-