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Home My WebLink About1894-zFOP~M NO. 4 TOWN OF SOUTHOLD BUILDING D~:PARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No, '"Z~3'9' ............ Date .................... D.~fJ.~.~.~.~'...~,.C). ......... , 19....0_.2. THIS CERTIFIES that the building located ct ...11~/~J.....i~.~Ln...~gJ~e ........... ,, ........................ Street ....................... LotNo ..... ZZ., ........ ............................... conform~ substantially to the Application for Building Permit heretofore filed in this office dated ................................. J]o~.te~)e~......~JJ4-.., lg.~. pursuant to which Building Permit No ..... ~..~. doted ......................... JB~.~p~ ........ 2.~. ....... , 19...~, was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ ........ l~..~.v.a.l;e..ono..~'~m~.:L.~..ctwe&:t:Lng. ...................................................................................... The certificate is issued to ..... Job. n..&...E.l.~be.th...~u~, r~:[oJa ............ 0~,rn~r.a ........................... (owner, lessee or tenant) of the aforesaid building. Building Inspector 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 1894, z Date ........................... Gepte~ll~el~...~.~. 196;~... Permission is hereby granted to: W~...Wett.~ · ..A/G · · Jeh~ .-B~oA e~.. J.l~ ............. ................ Southold ............................................ to ....))u~.td...ne~..~ne.. £gi. tIF.. d~tt~.ng .................................................................................. at premises located at ..Lot....~it...1.t.....l~ty...Ha~,wn..at...Sou~ho.l~. .............................................. pursuant to application dated ............................ S~l~)~li~(91.....~f.....]9...6~, and approved by the Building Inspector Fee $"~O1~)0 ......... Building Inspector ~ FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... ..~-....., 1~.~ Approved ....... .~.. ~.~ 9..~...'.~ rmit No ....... ~ ./....~......~.'.. ...... Disapproved a/c ........... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submi.tted 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 location. c. The work covered by this application may not be commenced b~fore 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 part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE 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 nome, if a corporation) (Addre~ss of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................................ B~'II~' ......................................................................................................................... Nome of owner of premises ..................................................................................................................................................... ~oh~ &~ ~u~ au~Ro/rized ~t~.cer. d'~e If a~plicant is o corporate, signature o~ ~ ~h ~Oh~ (Name and title of corporate, officer) 1. Location of land on which proposed work will be done. Map No: ............................................Lot No: .................... ~ay ~ven 11 Street and Number ..................................................................................................................................................... / ,~ O D 8rii'l ~Da~e Municipality 2. State existing use and occupancy of premises and intended use and ~cupancy of proposed construction: Existing use and occupancy ................................................................................................................................. Intended use and occupancy ...~..~.~.t;e...~.~el~&~; ....................................................................................... 3. Nature of work (check which applicable): New Building ......... · ........ Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ......~,0~.~.0.O,.(~l~l ................................ Fee .....~(~.e.~.~. ..................................................... (to-be paid on fi[lng this application) 5. If dwe !lng, 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 ~tructures, if any: Front ............................ Rear ............................ Depth ............................ 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 ....~J~. ................... Depth ......... .~..~.. .............. Height .....~,.'k.I. ................ Number of Stories ....... .~ .................. 9. Size of lot: Front ...l~ .................Rear ........ 1D~ ............ Depth ...... ],~1~ ............... 10. Date of Purchase ..... RI~p.T~..~.~.~...~. ................. Name of Former Owner ...W~,~,~,~.~..W.e..~,~..B. ...................... 11. Zone or use district in which premises are situated ....... ,~.e.~..]..~.q..~.~...~..~ ............................................................. 12. Does proposed construct on voate any zonng aw, ordnance or regulaton? ..]~0 ............................. ]3. r~ame or uwner or prem*ses ........................................ ^aaress ....: ............................ :.....~l...l~t~l~' NO ..................... Name of Architect ........................................................ Address ............................................ P~one NO ..................... Name of Contractor...~llle...~'~].~ ........................... Address RO~I.~J:LGI~ ........................ Phone NO..8~.~t.-.~l .... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck 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. /I STATE OF NEW YORK, ) S S. COUN ~T~.: OF ~U-~-~L].Ir ..........) i .................... ~/,1~1 ::Li~l~..~/e~ 1-11 .............................................. being duly sworn, deposes and ~ that ~ is the applicant (Name of individual signing application) above named. He is the ................................. ~[de~ .......................................................................................................... (Contractor, agent, corhorate officer, etc.) of ~id owner or ownem, and is duly authorized to ~orm or h~e pe~orm~ the said work a~ to make and file this application; that all statements c~tained in this a~plication are true t~ th~ ~s~ of hl~ ~l~ge and belief; and that ~e work will be performed in the ~nner ~t tach in ~ppli~h~ fll~ tbe~it~. _ Swam to before me this ..... ~''~ ......... da~of ..~~ ............... 19...~: ~ ~~~ ~ppl,cant) /~ ~ ~ .... ~ I . .. ~ f~k~ ~ ' Nota~ mblic, ~.~~ .............. ~.