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Home My WebLink About1925-zNO. 4, TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ......... 'd~'~i~ti~' ........................... Street Map No. ~Z~m,L]~.t:,Block No..~k~& ............. Lot No ..... .2...0.?..¢....~...q.8...,...~.O...9. .................................. conforrr~ substantially to the Application 'for Building Permit heretofore filed in this office dated ................................. CL¢..'.'~.~'~..~.~...2.'..5. ......... , 19 ...... ..~pursuan, to which Building Permit No.................:~ ]-925 d?ed ...................... .g.~..~,~..~...~.....2..~, ........ , 19.....~.~, 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 ........ The certificate is issued to i~a;~'~. ~',o [~.~,~-")Z~'~ (owner, lessee or tenant) of the aforesaid building. FORM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P__REMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1925, Z Date ................... .0..~..~..~....'0~...Z'........~.6. ............ 19...~...~.. Permission is hereby granted to: ]~rte s.t.. Jenes...A/¢.....Ga~.r.~.ck....3lalle~.¥.. ...... Ma~ti.tuck .................................................... to ....Bu/ld.. an.. &ddi.tion..nn..~n..exi~ting..~welllng ...................................................... at premises located at .~r.~t~..~20~.-a-O~ ...... ~asza~....$.o~n~; ..................................................... .......................................... ~ ....... Bridge.. ;~me.,... g. ut. cl~.g.ue ................................................... pursuant to opplication dated ....................... 0~)~;~, ....... ~ ............ ]9.~,,., and approved by the Building Inspector Fee $"~00 ............ TOWN OF SOUTHOLD BUILDING I~PARTMENT TOWN CLERK'S OFFICE .Z~~~ 19....~..~ SOUTHOLD, N. ¥.~ Examined Approved ........... Disapproved a/c .......................... j (Building Inspector) ~//~ APPLICATION FOR BUILDING PERMIT Date ...~i.~.~../. ............................. , 19...~....'~. INSTRUCTIONS a. This application must be completely filled Jn 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 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 HEREBY/v~DE to the Building Department for the issuance of o 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, ordinances and regulations. (S*gnature of opp~ant, %r name, if a co?ration) ............ ....... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, p~.umber or~. // ~ Name of owner of prem'ses ....~'~..~....~.......~.........~..~....~..~.~.~ 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.: ~.-~.~...~:..~.~....~..G.~.~.~.~.,LotNo.: ..~...o.~.~.?..~..~.~e~ - Street and Numar ~ ~ ~.) ~ ~ S. ~ ~.~ ~.~ ~.~ ~ ~ ~ ~. ~.~.~ ~ ..... MunicipalJ~ State existing use and ~cupancy of premises and intended use and ~cupancy of proposed co~truction. a. ~isting use and ~cupancy ....~.~ ........................................................................... b. Intended use and ~cupancy {~ ............... ~/ ~ 3. Nature of Work (check which applicable): New BUilding .................... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost 800 .~./..~. ............................................................. 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 .......... ;.:.::Z;.7.~L]L~.~,~L ......................................................................................................... 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 .,..~...-....~l ................ Rear ..... .~t.-....8 ............... Depth ......... 3..?. ................ Height .............................. Number of Stories ..... D~3e .................. 9. Size of lot: Front .............................. Rear .................................. Depth .............................. 10. Date of Purchase .......................................................... Name of Former Owner 1 I. Zone or use district in which premises are situated ..... A.....I:[~.S.~ ............................. n ti .......................................... 12. Does proposed construction violate any zoning ]aw, ordinance or regulation? ................... I'XQ ................. 13. Name of Owner of premises ,,,C~,1,g~..}~LS.3.~.ez'3rAddress ................................................ Phone No ................... Name of Architect .................................................... Address ................................................ Phone No ................... Name of Contractor ~Z'nesl; Jones Address ........... ~R.l;.~;.~.t;.l~f~k ............... Phone No .................. PLOT DIAGRAM Locate clearly and distinctly all buildings, .whether existing or proposed, ar~l indicate all set-back dimensions from property lines. Give street and block numbers or description acco,~ ~pg to deed, and show street names and indicate .... ~.__ -- -~ 0~ whether interior or corner lot. OUNTY OF ............................ Yms ..]~. ,ne . ...................................... ~.~...~.g. rlff.~ ...................................... bmng duly sworn, deposes and says that he is the eppllcont (Name of individual signing application) above named. He is the ................... ~,~.~.~.I;...~...¢.Q~'~C~bD~.. ..................... .. . (Contractor, agent, corporate 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 ell 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 ........................ dg~of ................ . .0, g. ,t;..o..17. ,e. ~ ...... 19 Note Pub ~~ ....... J) ..... ' ....... ' ry c ..~-.~',~;~[e~m~.T~..~...~Countv /~ ·" ...................................... ~ livery Public, State of New York ~ I~J 52-~344963, Suffolk County ~ ~/- // ~?