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Home My WebLink About1765-zFOR~ ~0. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ~J~.$~L..~..O..~.~x....C...'O...~..?..~..O.~.~..e.. .................... Street Map No ..... .~..'~. ........... Block No ......... .~..~t ........ Lot No .........~.~ ..................................................... conforms substanhally to the Apphcahon for Budding Permit heretofore filed in this office dated ........................ ~..e....It ........................ , 19..6..2. pursuant to wh,ch Budding Perm,t No ....~,....]...~.6..5 dated ............ ..~..~..~.~._.~. ....................... , 19 .... .6,,~as issued, and conforms to all of the requirements of the applicable prowsions of the law The occupancy for which th~s certificate ~s issued ~s ........ 19~TER SHO[~ & FREEZER The certificate is ,s'sued to'.~:.'~.~.~.~.'.~....~...~..~..~..Z..~.~..~.~..~.~.~..,......O~...Dg.Z/. ...................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector FO~M 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°. 1765 Z Permission is hereby granted to: at prem,sbs located at ...~. j~..~:~.i...(X, olm~j....t,a..~¢~=-t ~w~-~e~..it~re..~}.~o.} ..................... ............................................ ~~e~'"'"W'~ Y~' ..................................................................... pursuant to apphcotion dated ................................... ~"'"~L ......... 19~,.., and approved by the Budding inspector Fee $..~.,~00 ............ FO~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE Examined ......... ~..../~ ....... , 19..~...):~ SOUTHOLD, N. Y. Approved ........................................ , 19....g....Permit No. 7--/. ') ~' ~'~ - ........... ................................ APPLIGATION FOR BUILDING PERMIT Dote ...........~.....t~.....(...~.. ............................. ,19....../...~...2.... 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 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 drown 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 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, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ....... ....... ..................................... (Signature of applicont, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..~...~...(~.~..~..~ ................................................................................................. .. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Street end Number ..................................................................... ; ................................................................................. Municipolity 2. Store existing use end occupancy of premises end intended use end occuponcy of proposed construction: a. Existing use and occupancy . ?~..~ .~..L~ ................................ b. Intended use and occupancy ~ 3. Nature of work (check which applicable): New Bu~ d~ng .................. Addition ..:r ............ Alterat~bl~.~.: ............... Repair .................... Removal .................... Demo!ffion,....: ............... Other Work, (De~ribe) 4. Estimated Cost '";~'i~l~l~ .............................. ...... /Fe~".'.. ....................................................................................... (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 ............................................................................................................................................. 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 ............. I ..................................................................................... ' ......... Dimensions of same structure with alterations or additions: Front Rear Depth ............................ Height ................................ Number of Stories ........................................ 8. Dimensions of entire new construction: Front ........ ~.. ................. Rear ...~' ................... Depth ....~&l~...(,t~.~ Height ............................ Number of Stories ......./......: ................... ~. 9. Size of lot: Front ....... ,/~.~ ............ Rear ../.~....~ .......... Depth ,/~......~1~ ....................... 10. Date of Purchase ..~1~,~'~ .............................................. Name of Former Owne ...~...~ll~. ............................... - IV,~. ] ]. ,Zone or use district in which premises are s tuated ....... ~ ................................................. 12. Does proposed corfstruction violate any zoning Iow, ordinance or regulation;~ .. . .~...... 13. Name of Owner of premises "'~lll"~ ............. Address "~"~1~ ........... Phone No~l~I. ~ .... Name of Architect ...................................................... Ad/ess ............................................ Phone No ................ ~ .... Name of Contractor ~r~llllll/¢llll~ .......................... Adrdress ..~ ....................... Phone No~. ..... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr~m 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/XORK, ) ~ ~ COUNTY .(4..~'...~..~.& ./.! ...... ) ~'~' ............... ~~c~'i'~'~':''' being dui? sworn, ~e~oses an~ says that he is the aPPlicant~-'-'- above na~d. He is the ......................................................................................................................................... ' ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to ~erform orxha~ performed the said work and to make and f e this application; that all statements contained in tKis applicat~o~ are true to the best~f his knowledge and be cf; and that the work will be performed in t~r~th i~ ~e application filed th~ewith. Sworn to before me this N~ ~-. ;.,~,;~ ~ ~ / / ~ ~~~ ~~' .......... ~ ........ :~ ~ ...... . .: ...... o , ....