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Home My WebLink About1775-zNO. 4, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANC:Y THIS CERTIFIES that the build,ng located at ..~./(~.. [ft. DAq~/..~g.,3,~ .................................. Street Ma~pe~o .~...°..°..~. ............ Block No ...... ~ ..........Lot No ..~p1~,..JZ~c..~[..,~,Z, ........ ~.C~t~g,],C1, ........ conforms substantially to the Application for Building Permit heretofore filed in this office doted ........................... ~...l~..e........~.~ .................. , 19.~...~... pursuant to which Building Permit No .~...]:.~...~..... doted ...................... .~..~..e.....~.¥. .......... , 19. (~, was ~ssued, and conforms to oll of the requirements of the applicable provisions of the law. The occupancy for which th~s certificate ~s issued is ........ ........... ~.t..~..e....g:..rt. ~......¢.~,.z. ~...~.e...z..z.~.:~ ............................................................................. The certificate ~s issued to .... .~t,~.$.~:~...~..][j~l~r~ .Tl~[~.~.~l. ........................ (~/'~.e.~.~. ......................... (owner, lessee or tenant) of the aforesaid budding ~.D. approval August 21, 1963 by R. Villa 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.° 1775 Z Date ............................... ~'~Jtl~ ·....'!.1~ ....... 19.6~.. Permission is hereby granted to: ....... ~03"~th",~ ................................................ ................ 6m'eenl~o~'t, ........................................... to ..... Bu.t.'~.d' ' 'nen~ · 'one · · f'amJ: ~.y · · d~']: t'l'ng ................................................................................ at premises located at '":[;ol;"13~"~'li~I~"'~ennT~o~d"#,~'lSO ...................................................... ..................................................... l~enny'"l~'~d ................................................................................... ............................................................... 8~mt~r]:d. .............................................................................. pursuant to opplicotion doted ......................................... 0'~2.....'~1~....19..6.2., and approved by the Building inspector Fee $' '].0~0 .......... FOI~M NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE $OUTNOLD, N. Y. Examined ......~'""~ ~-'~"'" 19'"~"'"~"'-- '7 / Disapproved o/c ...............,;~...................~.................~,~......~ APPLICATION FOR BUILDING PERMIT Dote ....~..~..~.~....../.~' ................................. , 19..~.....~.. ....... INSTRUCTIONS o. 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 odioining premises or public streets or areas, and giving o detailed description of layout of property must be drown on the diagram which is port 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 o 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 po rt for any purpose whatever until o Certificate of Occupancy shall hove been gro.nted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, 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 oll applicable lows, ordinances and regulations. .............................. (Signature of applicant, or nome, if o corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is o 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: ...~/..~t ............................. Lot Street and Number ~ Y~ ~ ~T~ ' ........................................... ~'nicipali~ ....... State existing use and occupancy of premises and intended use and ~cupancy of proposed construction: a. Existing use and occupancy .......... .~. b. Intended use and occupancy ~.~Z~.~ ...... ~.~ ................................ . 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... oO~ther Work (Describe) ........................ 4. Estimated Cost ./.,.~.,j ~.~ Fee 2~ ~ ................................... (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 natureand 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 ........................................ 8. Dimensions of entire new construction: Front..~..b....-. ...................... Rear ..~'.~..T..~ ............... Depth ..~.~>. ....................... Height ............................ Number of Stories .................................. 9. Size of lot: Front ..../.~..~.../. .................. Rear ....]~ .D.../. .............. Depth ../.~.~. ................................. 10. Date of Purchase .~..~...~......./.~..~...-/.~-...~..-/. Name of Former Owner~.~?.~.~.~.~....~.~C.~'...'~...e..~...~.~..~....~...~..~..../~..;.. 11 Zone or use district in which premises are situated ,/~;/~?~,..rT'/xtZ. 12. Does proposed construction violate any zoning law, ordinance or regulation? .............. ~ ....................................... 13. Nome of Owner of premises ..~.:..~.'...~..~..J'.:...~/..a.~..~.~..~...~..Address .//~.J....~..7'.~.~..~.:~....-...~.:~....~'~ .......... Phone No...~ ......... Name of Architect ,I/I/,,d..~....~..~..~...~...~. .............. Address .~..~..~?.~,¥.~.~....?..A.~..../:..,?..:.. Phone No...&..'.l~.~.~. Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly oil 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 riot or corner lot. COU (Nome of individual signing dl~plication) / 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 tt~is application are true to the best of his knowledge and belief; and that the work will be performed in t~%Gtl~a~re~rs'~t ,,f.,or~rth in the application filed therewith. Sworn to bef e, me this ~ta~ public, State ~ ~,e[0~u~ty /~ ....... .................. .................... ........ ............. Notaw Public,