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Home My WebLink About1804-zF~i~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the budding located at S/,t~ ..... So'd~d...V. iew..J[we ......................... Street Map No..~ ............. Block No ......~ ......... Lot No~ ....... I~t.~]:iO~...K,I, ...................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................................... .~.1~1~J~......~. ..... , 19~.... pursuant to which Building Permit No ..Z~..~ doted ........................... ~.u..~.2'......~ ......... , 19.~.., was ,ssued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ ........ ..?.~.%..v..~.t .~...~.. ~ ~il~....~lling ...................................................................................... The certificate is issued to .F. dw~rl..J~i.eb~, ..... O~zte= ...................................................................... (owner, lessee or tenant) of the aforesaid building. N.D.approval Nov. 20 1962 by R. Villa ' ' Building Inspector FOIL~ 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? 1804' Z Permission is hereby granted to: ~a~.a.../~..~.,.::~.~ ..... ~...~.~.. ~~ .......... .../Z~...~ ~ ...................... to ............................ ,~ ..... r, ............................. '~ ...... ' ................. ~ ..... ~.....-r; ...... ;.....; ......... {. .... Budding !nspector Building Inspector FOI~M ~0. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ....... L ~,(~ . (:~T_ .~..7_..._F:~........~....., 19..~.....~. Approved ......................... t,/ ~...k.......~.~.., 19...~.'...Permit No. ,7---- LG~-O Y Disapproved a/c ................................ .. ..................... ~'i~;/l~'~t~i ................................. INSTRUCTIONS a. Tills 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 drawn 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 pa rt for ony 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 applicant, 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 and Number C~l.~......~-~...~...~......~ .............. ~...~.. ......................... Municipality 2. State existing use and occupancy of premises and intended us? and occupancy of proposed construction: a. Existing use and occupancy '" '~'"'~"~"~'~'~':/~J,.,././l/-- ............................................................................ b. Intended use and occupancy ...... ~~..'~..T...cl' / T 3. Nature of work (check which applicable): New Building ....... Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ......C~....~...0....O.......~.. .............................. 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 .................... ~ ................................ 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 ............................................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth ............................ Height ................................ Number of Stories ........................................ "~=~ Js~ ~ Depth ~......,~..~....~.....G. ......... 8. Dimensions of entire new construction: Front ........ ~..~ ................... Rear ............................ Height ............................ Number of Stories....Z..~ .............. 9. Size of lot: Front ...... ~ .... Rear ~ ... Depth ..... /:..~...O.. .............. ~ 10. ' ¢ ~' ..... "' Date of Purchase ..................... ./...~. ............................. Name of Former Owner .... CC....(~....~.~ 11. Zone or use district in which premises are situated ....... ~..(.i ........... 12. Does proposed construction violate, any zo.ning law, ordinance or regulation?.....~..,0....._.,.....~...~..--..,...,,.__ ,.................:.~.. : 13. Name of Owner of premises ..~..::../~'.~...~"~ '~" '" ' ...... Address .................... Phone No~''''~ Name of Architect .......... ~ .................................... , ...... Address .......................................... Phone No ..................... Name of Contractor ............ Address ....... '. ......... Phone No. PLOT DIAGRAM Locote cleorly end distinctly oll buildings, whether existing or proposed, end indicote oll set-b~ck 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. 1 STATE OF NEWtOn,/) ~f ) ¢ ¢ (KI.am~' of individuol s~g ~p~ ~bove n~med He s the ~~..~.... ~ ................................................................................... (Contractor, ~gent, corporate officer, etc.) o~ s~id owner or owners, ~nd is duly ~uthorized to per~orm or have performed tke s~id work ~nd to m~ke ~nd file this application; t~t ~11 st~,tements contained in this opplic~tion ~re true to t~e best o~ his knowledge ~nd belie~; and that the work will be performed in the ¢8~E¢ ~E~Rh in the application filed therewith Sworn to before me th's ,~,¢ rublic, State of New York ;o 52 0344963, Suffol County '