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Home My WebLink About1912-zFOI~i~I NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTJ~4ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .~/~.....0e~..~t .......................................... Street Map lX~o*....P..~..~..e. ........ Block No....3c3~ ............ Lot No .......................... (l,~ee,la~oz..t.t...l~4Z. ......... conform~ substantially to the Application for Building Permit heretofore filed in this office dated ................................ O(~'~O'De~....~O ....... , 19~.... pursuant to which Building Permit No ..... dated .......... ' ............. O0.1~ot~,'.~...]~) ...... , 19.~2.., was issued, and conforms to all of the requirements of the appIicable provisions of the law. The occupancy for which this certificate is issued is ........ ......... ~ :tv ate" .on~.. f. ara:k iT.' d~¢~]: ..'t~ng ..................................................................................... The certificate is issued to ....1~1~..~..~01~ .......... .O'dlae~. ........................................................... (owner, lessee or tenant) of the aforescid building. FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 1912, Z Date ..................... Oo t.~b~.~.......~0 .......... 19.~.. Permission is hereby granted to: l~en .. l~er~.~,3,1.....A~.C.....l~en...Hor..to~ ................... ............ I~z, e~n.l~O~,.t .............................................. to Bnll~d .. an.. ~dzt l.t ~- c~n.. or~..an .. e~,$t.~ ~ .. c1.~. 15.n~. ......................................................... at premises located ot '"t~t"~"~'t"'~O~"~Z'~'ce"F,'st~t~S ......................................... · .............. ...................................... ~/~.....O~k.. ~ $,t..... ~erl~l,.,c ¥.....tf,.¥.~ ................................................... pursuant to application dated ............................ ~)~tol~.~.....~.~) ......... 1~O~...., and approved by the Building Inspector Fee $~:...0~.. .............. -- Building Inspector FORM ~TO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. xamined .......... C.~'... ~Z .................... 19 ........ Approved ........................................ )9 ........ Permit No ............................... D~sopproved Application No. ~.. /~/2---- APPLICATION FOR BUILDING PERMIT October 29 62 Date ............................................................ 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plat 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 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. Kenneth ~Cerrell (Signature of applicant, or name, if o corporation) First St, Greenport, L.I. (Address of applicant) State whether applicant is owner, lessee, agent, architect~ engineer, general contractor, electrician, plumber or builder. Contractor · Ben Horton Name of owner of prem,ses ..................................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ? c 1. Location of land on which proposed work will be done. Map No: ....................... .~.. .................. Lot No: Street and Number ..~'.e..?.l.....?.?...e...e..~.~..°..~..t..,s.....i!..'..~..: .......................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Dwelling o. Existing use and occupancy ........................................................................... " W/ addition b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition .~.~.~ ........... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ........... ~.0...0.......~./.~! ................................ Fee 5 · O0 (to be paid on filing this application) · one 5. If dwelling, number of dwelling umts ................................ 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 .............. .............. 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.....1.~.~8.~ ............ Rear ..... ~.~.-..~. .............. Depth l0 Height ............................ Number of Stories .o..~.e. ..................... 9. Size of Iot~ Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ "A" aist 11. Zone or use district in which premises are situated ................................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? z~o 13. Name of Owner of premises ...... ..~..~..~....~.o.?..~.o...~. ......... Address oak St, Gpt ............................................ Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of 'Contractor.....~...e..~....~!..e..z'...~.~.~..~. ..................... Address ....?.~.e.~..~.?...°..~..%. ................... Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and 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. I STATE OF NEW YORK, ) S S. COUNTY OF ..... .~...~. ~..o..~...~. ...... ) .................................................................................... ~....t ....... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) Contractor above named. He is the ............................................................................................................................................................ (Contractor, agent, corl~orate officer, etc.) of said owner or owners, and is duly authorized 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 and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this JIJDITH T. Notary Public, State of New Yorl( 2 0 c~obr , ~344963, Su fo k Count'/ · · 9 da of ( gnature of app cor~t) ........................ ~ ........................... ;~'"'"//i;oX~rTLsfort'Ex1~res Marc. 30, 1,(~ Notary Public, ~¢.~,.,,,..~......~~ ~/,, ~/ o o P Co ~t s 'f t~ o o~' i o~