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Home My WebLink About1822-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at I~.I~..(;~tc...~[.,...&..~~=~..D~o Street cut. chogve Map No .... .~. ........... Block No ...... ~a~ ........... Lot No ......... e4 ..................................................... conforms substanhally to the Applicahon for Building Permit heretofore filed ~n thfs office dated ............................ ...~...~.~....~..0.. ................ , 19~..~.... pursuant to wh,ch Bu,lding Permit No. ~. ~L~t22. dated ...................... ~t,.~t...~,~. ............ , lC~.~ .... was ~ssued, and conforms to all of the requirements of the apphcable prows~ons of the law. The occupancy for whmh th~s cerhficate is msued is ........ ......................... ~ ~'V~,TE.. ~.. FA[~,~I::~Y.. l~..J~ Z~I~ ................................................................. The certificate ~s issued to ..~:t...~,...~O~.~I~J:I~,...O'~TIJi~ .......................................................... (owner, lessee or tenant) of the aforesaid buildfng 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.° 1522 Z Date ............................... ~l.]r......IL6 .... 19~... Permission is hereby granted to' · Jehu..F,,,...~o.~le~e~ .......................... .... ~0al~...& ~oa~t~a~.~ .................... ............ O~be~,og~te. ................................... to ..2:a~i~. ~t~.. a~.~.%ie, n...em..~_..e~.~-z~&.n-?&welti~g ................................................... at premises Iocated at .~Oa~..&. ]~.o~/~i.t~,..~ ............ ~1~0~+~-~ ................................ pursuant to apphcat,on dated ............................... ~'1~;/' ..... .~O ......... 1~2' ., and approved by the ~3u,ldmg Inspector Fee $ ~.~.00 .............. ding nspect'or ,~ FOIt~ NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE .,-, SOUTHOLD, N. Y. Examined ........~.....Z,.~..., 19...~.....'~ Approved .......~ ...... ~..L. ....... :.:~., 19.....~....Permit N.o.,....~..:..~...~......~...~ Disapproved a/c,~ ................ .....~...........~ Application No ............................. APPLICATION FOR BUILDING PERMIT O- 7~10 19..~ .......... ate ....................................................... , 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 bedrown on thed~ogram 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 po rt for any purpose whatever untila Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY JV~ADE 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. Nome of owner of premises ...... ~..0...~...~.;...?..0..]...1.?..~.?..~. .............................................................................................................. If applicant is o corporate, signature of duly authorized officer. .... ....(Name and title of corporate officer) "' 1. Locationoflandonwhichproposedworkwillbedone. MapNo: ........... ~ ...... .~. ............. LotNo:~ ......... Street and Number Oorne~ lot no~the~l;f ~Ide o~ Oeec D~?e and we~te~l~ ~de B~oadwate~ ~r. 'g~"Sff"g~HSIS; ................................................ ~ ................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Dom~oile b. Intended use and occupancy Dcmioile 3. Nature of work (check which applicable):~New ~.uil'ding .................. Addition ................ **** Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ..... ~{~{50..0 ............................................. Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ....g.i~. .................... Number of dwelling units on each floor .....o...u~.. .................. If garage, number of cars .................. .u..0..u:..e. ................................................................................................................... 6. If business, commercial or mixed occupancy, s~ecify natureend extent of each type of use ................................ . . ' 28,~ Ft. ~8.23 Ft. 24,24 let, 7. Dimensions of existing structures, if any: rranr .......................... Rear .......................... Depth ............................. ,. . One floor with &ttie Height....24 l~t, ..... Number of 3tones ................................................................................ ; Dimensions of same structure with alterations or additions: Front ...4~...:..2..3...1~.t ............. Rear ......4~..:.~.....1~..:. .......... Depth 24,34 Fto Height ........ ?e, ................... Number of Stories ...0...ne.....ff..1..o..o?.....w..L..t..h...a..t.t.~.0 Height ..[..4..?~..t..,. ............... Number of Stories....P.~..e. ........................ 'r - 1§0 Ft .................................................................... 9. Size of lot: v ant ................................ Rear 150 I~1;o Depth 75.02 Fro u llar, 7 1955 10. Date of P rchase ............s ........................................... Name of Former Owner ...~..i..1..1..i...a~.....~.:...&...~..a~....z~.....~.:.~.a.~.e..~... ] 1. Zone or use district in which premises are strua~ .......... : ................................................................................. ~ ..... 12. D~es proposed construction violate any_ zon ng aw, ordnance' or regu at on;) NO .~,.. ~ohn ]~oUOlleben _.. 91 t'idwo0d et, 13. Name~ of C~vner of prem{ses ........................................ ~aaress ............................................ Phone I~C~ ~..~...../.i~A Name of Architect ~lmue ...................................................... Address ............................................ Phone No ..................... Name of Contractor ........ .S...a~..e. ..................................... Address ............................................ Phone No .......: ............. ~ ;': - ' PLOT DIAGRAM Locate clearly and distinctly all buil~ngs, whether existing or proposed, and indicate all set-back dimenSions ~rom property lines. Give street and block numoers or description according to deed, and show street names and indicate whether interior or corner lot. , ' ' , ~ ~ be,n dui sworn de oses and sas that e ............... ;.~;.....~,:.;..;;= .................. ; .......... : ................ ' g y . , p y h is the applicant ,mo~/, f i?yividua, signing app,icotion, above named.~e is the ...... ,..~~ ......................................................................................................................... ~ (C~tractor, agent, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have perform~ the said work and to make and file this ~plication; that all st~ements contained in this application are true to the best of his knowledge and belief; ~n~ t~ t~o~r~i~lisbe perfo~ed i/{ ~ the manner set fo,h Jn th~plication filed therewith. ...................... ..... ', ,. . ..