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Home My WebLink About1812-zNO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...B-,[4.78 ........... Date .................. ~tC~..2~ ............. , 19_62. THIS CERTIFIES that the building located ~ ..~a~.~..~.~..~~ ............ Street Map ~'-. ............................................ Lot No ......... i'"~"'J .................................................. confor~ substantially to the Application for Building ~rmit heretofore filed in this office dated ................... ~..lg ............................. , 19...~ pursuant to which Building Permit No ........... ~...~81~ dated ......... ~[..~.~ ............................ , 19....~, was issued, and conforms to all of the requirements of the applicable provisions of the law The occupancy for which this certificate is issued is ........ r~e cerfificcte ~s ~ss~ed to .............................. .~.~.~..~...~.~...~ ................................. (o~er, lessee or FOI~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.o 1812 Z Permission is hereby granted to' Date .................... ~.~ ....... .~.0 19.62.. ................. ~r ee'n~ur t; ................................. to. ]Eh~;~:~. ~n"~cdd:tt¢'om"c~"~-"e~Z~s~¢'ng' d,~e-Z~t~ ..................................................... at premis, es Iocated at "~:~'"T,~2i" ,~ez'ha~'e~ ............................................................ ......................................... W/S'""Bay' 'V'l:ew"A'e'e'~ ..... '~r,eenpcrrt,. ............................................ pursuant'to appficatlon dated .................................. ~ .... '~0 ........19.~.~., and approved by the Bu~ldmg Inspector Fee $...~.~ (~ ........... FORM NO. I TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...................... 19 ........ Approved ' ' ' 7--- / ~-! ~ ........................................ , 19.....!...permlt No ................................ Application No. [ ~ / ~ Disapproved a/c .................................................................. ~//~(Building Inspector) APPLICATION FOR BUILDING PERMIT 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 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 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 pa rt for any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment 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 oil applicable laws, ordinances and regulations. ............. .... (S'gnature of applicant, or name, if a corPoro~on) ...... ................... ................. ( ress of ap¥icant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. owner of premises ...... ~....~../..~ ................................................................................... i ..... Name of If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ? 1. kocation of land on which p_roposed work will be done. MapNo~~kOtNo. l~l-02 ............. ...r. ...................................... Street and Number 2. State existing use and occupancy of premises and intended use and occul~ancy of proposed co~truction: b. '.te.deduseondoccupo.cy ....... 10. 11. 12. 13. 3. Nature of work (check which applicable): New Buildin .. Addition .... .............. Alteration .................. Repair .................... Red,oval .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost .............................................. 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 ~,~h type of use ...... ..~..~_~,~.j .......... 7. Dimensions of existing structures, if any: Front.....~...~..~.. .............. Rear ....... ~! .................. Depth .....~......~..i ............. Height ....~..~.J..~..r.."-~'- ""- .... Number of Stories ........ ~ ............................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth ............................ Height ........................~.~umbe, of Stories ......./,¢7 .............................. .~..~'~ ! 8. Dimensions of entire new construction: Front ....... /..J~.. ................. Rear ..J..?... ................. Depth ..... .................. J er f ~s Height "'""t' .................. Numb o Stor'e ................. . ................ · ~-~. Size of Jot: ~Front ...... ~ .J'... Rear r~...~. ! Depth ~'~O ,, t_ Zone or use district in which pre~nises are situated ......... ~.~.~ .......................................... Does proposed construction~~v, iol~.te ony zoning. Jaw, ordinance or regulation? ...................................................... Name of Owner of premises ~~;A~ddress ............................................ Phone No ..................... Name of Architect ................................................ Z....Address ............................................ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensians from prc~perty 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~'OJ]tI(/, ,eJ ) ~ ~ COUN~ OF~.....) ~'~' - (No~e of inUividual sig~g application) above named. He is the ....... ~~ .................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owne~, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the bpplication filed therewith. Sworn tol~befo e ~ th s J~DITH T BO ~~8~ . / ~ .~ blic 8~ ' KEN / . ..... . .. ................ ................... Noto~ Public, ~**** ~~~~~~u~ ~ (Signoture o~pplicont) .