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Home My WebLink About1874-zFOP~i~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z 1603 Date ........... Juice .1.7 .6...3. ......................................................................... , 19 ... THIS CERTIFIES that the building located at LO~t....L¢tD. rae..J.~f~l~'~J~f~,~, ..................... Street Map No .........~.~ .......... Block No .......... ~ ......... Lot No .......... .~.~.. ........................................................ conform~ substantially to the Application for Building Permit heretofore filed in this office dated ................................. .~..e.?.~..e...u~...~.~.....'7. ....... , 19....~ pursuant to which Building Permit No. ..... ........... doted ...................... ~...~.2'~t~.e...~.....7......, ]9....6.'.2.., 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 ........ ..... :~,~W.'~ O~ ~Z~ ~:~:~;~ ....................................... The certificate is issued to ...~'.~l.~.~..~..:I;'....~.~..~...:.~.~.~.~I....G.~.Z..L...O..~..~..e..~.I~. ....................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector FORM 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 1874 Z Date ..................... :--.-. ~e.jJ~lJJ~...-.6. 1969... Permission is hereby granted to: ........... /~.~.e.....'.~e~a ............................................... ..................... ]~.ttStu~k ...................................... to .~...$ ~..d... &n....~ .~.~:~.t~ ~.. ~'L ~n ..e~l~t ~n~ ..d.~e~:t.t.n~. .......................................................... at premises located at ...]~..~.......~.~.~...~lM~e ........................................................................................... ........................................................ ..~....t..t...t..t...u.c..~ ..~...~. ..................................................................... pursuant to application dated ............................... .~e~)~L=~]]:%~.:~.....~...196~..., and approved by the Building Inspector Fee ~. ~..0..0.. ............... '~ Bui ding Frlspecfor - / TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE t /)~ ~OUTHOLD, N. Y. Examined ..... .~..,....., 19~,~ Approved ~l[3~:~ff.'.......~.~........, 194~rmit No...~/Z..~,..~...... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No ....... ./..& .~....../...... 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 p remises, 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 thi.~ applica- tion. 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 any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. ApplICATION IS H.£REBY M,~DE 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, alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinan~e~s~.,~ ,z~and regulations. L // (S.gnature of opp';t, or na;~, if a corpo~c~i" .............................. i',il;iii ' ; ;ii .................. ......... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............... .......................................................................................................................................................... Name of owner of premises ~..~..L~..~..~. ..¢~. I"l(a m~LJ~'l~?/ ..~...1~1~2. . 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.: ........................................ Lot No.: ...................... Street and Number Lou'e L.. ct e Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed cor~truction. a. Existing use and occupancy ~'~O ~ ~, ......... b. Intended use and occupancy ........ ,., ................................................................................................... 3. Nature of work (check which applicable): New BuiM'ing .................... Addition ........ .~......... Alteration .................. Repair .............. ~'~7,~x~ ,nx~Rem°va! .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost ..... /..~...M;..~...% ........................................ Fee ........................................................................................ 5. If dwelling, number of dwelling units ~"-~/~'~ ~,~i~H~i,,~mber (to be paid on filing this application} ................................ of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occupancy, specify, nature and extent of egch type of use ........... ~ ............... ;... 7. Dimensions of existing structures, if any: Front .....,~.. ..................... Rear ...wi. .......... ..~_ ........ Depth ...o5.../.......~.. .............. 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 .............................. Depth .............................. Height .............................. Number of Stories ...... ~...R/..~-. ............. 9. Size of lot: Front .............................. Rear .................................. Depth ............................... 12. Does proposed construction violate any zoning ]aw, ordinance or regulation .......................... 'IY-~ ................................. Name of Architect .................................................... Address ................................................ Phone No ................... Name of Contractor /~/OIV~/ ~/,~/?),/~ ...... ./.. ........................................ Address ................................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from praperty 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/YO,O,X,-- ) - - o, ................. · ~..~.~ ................................ being duly sworn, deposes and says that he is the applicant ebove n~med~He is the ........... ~ ............................................................................................................................ (Contractor, egent, co~or~te officer, etc.) of said owner or owners, ~nd is duly ~uthorized to perform or here performed the said work end to meke end file this epplicetion; that ell statements conteined in this ~pplicetion ~re true to the best of his knowl~ge ~d belief; ~nd thet the work will be performed in the menner set forth in the epplicetion filed therewith. ~ Sworn to before me this ~ / % / / _ ~ - ............... o, ......... No. 52-0344963, Suffolk Coun~/~ ~ ~mm,ssion Expires March 30, 1~ ~'