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Home My WebLink About1876-zFOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...J~...~,6~29 ........... Date ............................. ~ur~....1.2 .......... , 1963.... THIS CERTIFIES that the building located et a/~..,QO~r~D~. T4~.1r~.~..~QU.~,~[.¢I ....... Street Map No ..... .~ ............. Block No....?.~. .............. Lot No......~..e. .............................................................. conform~ substantially to the Application for Building Permit heretofore filed in this office dated ................................ .~...e.~.e.~.~.L~.....~..O......, 19.......6.~pursuant to which Building Permit No ...... ~....~..~ffG dated ................... .~...e..~.~?,,~...~.0......., 19...~..~..., was issued, and conforms to all of the requirements of the appticable provisions of the law. The occupancy for which this certificate is issued is ........ ....................................... ~,~..~...~;...~ ..~...~..z. ~.~ ......................................................... oB. G, P~-he~stolaeha,.l.9..h.~' cr~laer The certificate is issued t ................................................................................................................. (owner, lessee or tenant) of the aforesaid building. FOltl~ 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? 1875, z Permission is hereby granted to: · *~i~tl~ltl .......................................................... to .. ~d~'Id"an"~r 'dI tioa"on" mt "existl'ng" 'dwe '~! ng ....................................................... at premises located at "8;~B'""Dc~ood"'Zill~ .................................................................................. ......................................................... '~ b~l~'6It~ ................................................................................... pursuant to application dated ............................ ~1t~11~.....10....19.62.., and approved by the Building Inspector F~e $'"~';00 ........... ]L~O~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .............. ~.. ..................... 19 ........ Approved ........................................ , 19 ........ Permit No .............................. ........... ........... ......................... ^pp,icot,on ......... 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 drown on the diagram which is port of this applica- tion. c. The work covered by this application m~y not be commenced before issuance of Building Permit. d. Upon approval of this ~pplicotion, the Building Inspector will issue e Building Permit to the opplio~nt. 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 Occupency shall hove been granted by the Building Inspector. APPLICATION IS HEREBY M~DE to the Building Deportmen[ for the issuance of o Building Permit pursuant to the Building Zone Ordinence of the Town of $outhold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulotions for the construction of buildings, additions, alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable lows, ordinances end regulations. (Signature of applicant, or name, ~a corporation) ............. ......... (Address of'applicant) Sro.re whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... Name of owner of premises ....~...:.,~.v......~~~~... .............................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work wdl be done. Map N ............... ,v ...................... Lot No.: ...................... Street and Number ..... ...*~..Zx~......~~...~..O~...~..;~...~,, ..z~.,~,~.. .............................. / ~/ Municipality Sfate existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy ....~ ................ ; ............................... b. Intended useondoccuponcy .......... ff........~... ...... ¢.r. ..... ~ ............ I.~. ........... .~..~.~ ................... 3. Nature of work (check which applicable): New Building .................... Addition ..... ../-~.......... Alteration .................. Repair .................. ,,~Rezn°val .................. Demolition .................. Qther Work (Describe) .................. 4. Estimated Cost ..... .~.~,.O..O..C).., ................................... 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 nat~/and extent of each?p/e of use .................................... 7. Dimensions of existing structures, if any: Front ......... ~.:/ .......... Rear ....... ~....~?..: ......... Depth ...... ....~...~,~2. ........ Height ............................ Number of Stories ................ ~ ............................................................................................. Dimensions of same structure with alterations or additions: Front ............ ~.~>~ ........ Rear ......~.~.~ .............. Depth ............ ¢::~.~ ..... Height ....................... }../~mber of Stories ..~,~/¢./. ...................... 8. Dimensions of entire new construction: Front ...~.~..,-,~ ......... Rear ....~....'~ ....... Depth ....~.~ ............ Height .............................. Number of Stories ....... ./ .................... 9. Size of lot: Front .............................. Rear ................................. Depth .............................. 10. Date of Purchase .......................................................... Na,me of Forry6r Owner ................................ 12. Does proposed construction viol.ate onv zonina aw ordinance, or reau at on~ ................................................................ .............. 13. Name of Owner of premises ' " ' .-~-~¢¢~¢~ Phone No Name of Architect~~~ ............. Address .................. ~'~ ............. ' .......... iiii Phone No ................... Name of Contracto ...................... Address3~~~.'ff'~. .......... Phone No .................. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, a'nd indicate all 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. STATE OF NEW. y,~P,,K~,. ~/~j) SS ~l¢~tr:~-.~....~.....x~....~../2'~.-. ....... ................ ...:... ............. bein~ duly swom~ deposes ond says lhot ho is the opphc~nt (No~ of individual s~gnm~ apphcatio~) above named. He is the ................. ~~,, .~~ ................................................................. ~ ~ (Contractor agent, corporate officer, etc.) of said owner or owners, and s duly author zed 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 a.nd belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this / //~, ~ ~ /~ ....................... ........................ ~~~_.~;...~ ~y ~, ~ /~gnamreo~applic~nt) ss~on ~xplres March 30,