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Home My WebLink About1877-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY June 3,7 631 No.............................Z 1616 Date ................................ ........................ , 19 ........ Sm~th ~d., Indian Neck, Cutcho~ue THIS CERTIFIES that the building located at ..................................................... ................. btreet Znd~an Neck Park Map No ..... *.?. ............. Bbck No ..........*.~ ......... Lot No. 17 conform~ substantially to the Application for Building Permit heretofore filed in this office doted Z 1877 .....................................mA--~----~,~-- ,n?..~...~...~..~.~.~..~......~..~., 196'........~ pursuant to which Building Permit No ................. dated .......................... ~,e.~..t-t.e....~....e..~.,...1..];', 19...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 ........ PRIVATE ONE FAMILY DWEY~LING The certificate is issued to will,am Bla~e, owner (owner, lessee or tenant) of the aforesaid building. Building nspector FOEH NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS I~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 1877 Z Permission is hereby granted to: at premises located at 'ID~,"~ ......... 7 .......... ]~'~.'jj~,j"~e~"l~'~ ................................................... pursuant to application dated ................................ j~.jj~;. ....... 10 .......... 191~.i]..., agd approved by the Building Inspector l~Ol~NI NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN C,,RK'S OMC.: SOUT,O,D, N. Examined ....... ~....L..~ ....... Approved ........................................ 19 ........ Permit No .............................. Disapproved a/e ....... .... ....................... ................................. APPLICATION FOR BUILDING PERMIT Date....~..[.~. Z...~....~.....~....~... .......................... 19 INSTRUCTIONS o. This application must be complet~ely filled in by typewriter or in ink and su~omitted in duplicatb 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 location. 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 I~ept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or ih'part for any p'uFpose whatever until .o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuanoe 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 !a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (SignLfture4Jf applicant, or name, if a corporation) ..... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome o{ owner o{ premises .............................................................................................. If opplleant is e corporate, signature of duly outhorixed officer. (Name and title of corl~ora~aff~er) 1. Location of land on which proposed work will be done. Mop No: ..~...~....~........~..'CLot No: ..... .]..?. ......... Street and Number .~~.--f.~....! ........... ~..~.~.'~ .......................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exlst~ng use end occupancy .............................................................................................................................. b. Intended use end occupancy ............................................................................................ V 3. Nature of work (check which applicable): New Building .................... Addition ....... ,,~.. ....... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4, Estimated Cost ...... .~.~..~...~...~:..~. .............................. Fee .......................................................................................... (to be paid on filing lhJs 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 .......... ~..'..7...~, ........ Rear..~...Z..i ............... Depth ........ .~.,...~..~ .......... Height .......~.....~..~ ............. Number of Stories ...~., ...................................................................................................... Dimensions of same structure with alterations or additions: Front .......... ~..?. ............... Rear Depth ........... 3. ................ Height ........ .~....6. ............... ,,Nu/mber of Stbries ........~ .................. 8. Dimensions of entire new construction: Front .......... (,.~.. ............. Rear ......... ./..¥.~. ........... Depth Height ........ / .................. Number of Stories ............./ .............. 9. Size of lot: Front /~))_ r ./O J- ' ........ [....~.. ............. ............................ Rear ........................... Depth 10, Date of Purchase ........................................................ Name of Former Owner 11. Zone or use district in which premises are situated 't~'b'/..~...~.~..,7///Z- 12, Does proposed construction violate any zoning law, ordinance or regulation? ..... ..~...O. ......................................... 13, Name of Owner of premises~~ .............. Address .~....~..'..~..~,.~..,~./..Phone NO, .~...b?..T..~..~..'.~.. Name of Architect ........................................................ Address ............................................ Phone NO ..................... .... ....... Name of Controctor~...-~.,~..,;,~..~ ........... Address ~:~...~.,~':t~') ....... ~ .~,~..~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil 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 NE.W,/YO~JK,~ ,~ ~ ,)/ S S COUNTY, OF.~.~.¢~...)~ ~~..-~..'~.:~,,~ ........ being duly sworn, deposes ,and', says that he is the applicant (Name of i~i~g application) above named. He is the ............................................................. ~ ............................................................................................ (Centracto~agent, corporate officer, etc.) of said owner or owners, and is duiy authorized to perf~m or .h~e performed the said work and to make and file this application; that all statements contained in this applicatibn ~ true to the best of his knowledge and belief; and that the work will be performed Jn the manner set forth in ~be~plication filed therewith. Sworn to b re me this ~ ~ i~[?~u r. ~o,f~ . . ......... )~.. ~ of .,,~ .19~'~:~?~~~TM of appl,cont)