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Home My WebLink About1785-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..S.../..~......~.=;.~...e...~.~.~.e. ................................... Street Map No ..... ~ ........... Block No ...... ~ ......... Lot No. g ....... J~.q~.~O.~ ................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......................................... ~..~....e. ..... ~.~. ..... , 19.~...~.... pursuant to which Build,ng Permit No..~..1..~..8..~. .... dated Jtzt3_e 23 19..6...~..., was ~ssued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ · .~.r..~.v.,~,e.....°..,n.~...~.,z.~....~.~.Z..,z.$,.n.~ ............................................................................................. The certificate is issued to .... g.e.~.~..g~.~Ls~ ................ ~J~e~ ..................................................... (owner, lessee or tenant) of the aforesaid building. H.D. Approval Oct 9, '62 by P. MaJkowski ..................... .............. FOR¢~ !/O. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 1785 Z Date .................... ~11. _r~_ .... ,~1...]1~ .. 19 6~.. Permission is hereby granted to. · ..4~eueh~l~ .............................................. to -~e~..:Bu~a ~ew..oae...~.~ .~v..~wet.l. in¢ ..................................................................... at premises located at .... ~/l~--~a. ~i'¥e ............................................................................... .............. ', .................................. ~t, hel~..~,,~,, ......................................................................... pursuant to application dated ................................. ~T~5~t.....~_,~ ...... ]9.~..., and approved by the BuHd;ng I'nspector Fee $3.O,,00 ........... Bciild;ng Inspector t ' ' FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... ~..~ ...........=......~..~ 19..~..''''~' ~ Approved ........................................ 19.~....Permit No......~.....~...?......~...~..... Disapproved a/c .............. ~~ ~ ........ .......... ' ..... APPLICATION FOR BUILDING PEI~IT Da~ INSTRUCTIONS~' o. This application must be completely filled in by typewriter or in ink and submitted in dul:>licate 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 drawn on the diagram which is part of this location. 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 t~ 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 Lows, Ordinances or Regulations, for the construction of buildings, additions or a Iterations, or for removal or. demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances/~nd regulations.,,/ .... .............. ~=~"~~,'ii~ .............................. Store whether applicant is owner, I.~ee, agent, architect, engineer, general contractor, el~tri¢ion~ plumier or builder. ............................... ............. · .................................. If applicant is a corporate, sigj~re// of duly ~horized officer. :;~-~l--~r~'~ title o~[~corpprate officer) ~ ,~,,~/~ .///~ j~, ~, 1 Location of land on wh ch _l~roposed work will be done. MaP ~~':..~...~..~ ............... Municipality 2. State existing use and occupancy of ~re~s~ded,~ use a~ :~a~cy· of p=~:, .~:s. lruction: a. Existing use and occupancy...~ ....... b. Intended use and occupancy ....... 3. Nature of work (check which applicable): New Building ........ .. ........... Addition ................ ~...Alteration .................... Repair .................... Removal .................... Demolition ............... ,Other Work (Descr be) 4. Eshmated Cost ..... d~........~ ............................ Fee .......... ../~....~.....~......-. ............... . (to be paid on filing this application) 5. If dwelling, number of dwelling units .........~....Number of dwelling units on each floor ............................ If ga.ra, ge~ 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: t~ront....i ....................... 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.....~....~...[ ........ Rear ..~...4,~... .............. Depth .?'......'). .................... Height ....... /..~5~ ..... Number of Stories ...(;;:~-~,/,~ ......... 9. Size of lot: Front ..... .J...~..ct .......... Rear' .....,/.'4.4~. ............ Depth ..,~....~,_j~ 10. Date of Purchase ~../.~.....,~..~.~...~ .......... Name of Former Owner~. 11. Zone or use dist~ct in which premises are situated....~ ............................................ 12. DOes proposed construct on~/~ ,'//~, ~ - ~"~--'--'~, '~v0 ate' any zon ng law, ordinance or r~_,u at on? ~ 13. Name of Owner of premises~~..Address ~,~.,~: .......... Phone NO ..................... Nome of Architect .......... ~:~.._.-...Address ...~~....Phone NO. Name ...~? _ . . ................... of Contractg~.~c...~.~::~...~..-.55.-.t.'...~..~'.r...~..,~.....Address .,,~".~~......Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate alt 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. 3'7' STATE OF N~/'~°~~ ............... ~.., .being duly s~orn, deposes and says that he is the ~6me of i~ivi~ual ~gning application) ~ : ~ ~ ,~ ' applicant able named. He s the ................................................. (Contractor, agent, co~orate officer~ etc.) o sa,d owner or ownem, and ~s duly authorized to perf6rm or have performed the said work a~ to make and file this application; that all statements contained in this application are tr~e to th~ ~st of ~is~!~ge and belief; and that the work will be performed in the ~nner.set fo~h in the apphcation fll~ t~it~ Sworn to ~re~ this ~ ............... ~:....~~da~ of .............. ~ ...... 19......~ JUmp,. ~e~ Nota~ Public ..~ ~-.~.Co,,~,s2'°~ee3. ~lk ~- ., , .......... ................