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Home My WebLink About1927-zFOR~VI NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..lq'../.$1...~...r..~...rt..d....~:.~..l~..~.~.o..,~..~.~.o..o.~..:~. Street Map No..~'~:~. .......... Block No ........ ,~-~',~.... Lot No. ,7~-,4~ ....... ~,.~.~.:~.~.%1.~;~...~.,.~r, ................... coni~orms substantially to the Application for Building P:ermit heretofore filed in this office dated ............................... .0C.tO~fJ;~.....~ ........ , 196~... pursuant to which Building Permit No...~.~1,9.;~... doted .......................... 0e.~o.be~.....2.9.., 19.62., 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 ........ ...... .~?r.~t .e...~.. ~ £ty....cb;~ ~ ~ r~ ........................................................................................ The certificate is issued to ....~.~...~1~.~1~. ................... ~I~.e~ ........................................... (owner, lessee or tenant) of the aforesa'id building. H,D. Approval ~y 1963 by P. MaJkowski Building Inspector FORM NO. 2 TOWN OF $OUTHOLD 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? 1927, Z Date .................... Oe.to~z,..... ~,9 .......... Permission is hereby granted to: ......... ;~Ob,..'~eet...~,~e .......................................... ............... Pa-t eho~.ue ............................................ to ..B~l.t~..~te~.~.~e...~:am£.l.¥..~t~et.l.~.ng .................................................................................... at premises located at ...... G~..~r~...,~V~.,~..~,qO.]z.].VOOfJ....[L~I~ ........................................................ ........................................................... ~t'c.~tuek ................................................................................ pursuant to application dated ......................... (~;~Be~-....~i~. ............ 19...6~, and approved by the Building Inspector Fee $....1.0.O0. ....... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined 0J~ ~L 1~ " " Z-I° Approved ........................................ , It ........ Permit No. ...../..: .................. ................ ......................... :...: .......... ................ (Building Inspector) Application No..../..~...?T....~ ........... APPLICATION FOP~ ~JILDING PERMIT Date(; " 3 INSTRUCTIONS o. 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 end of buildings on premises, relationship to adjoining premises or public streets or areas, and giving o detailed description of layout of property must be drown on the diagram which is part of this applica- tion. c. The work covered by this application moy not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspeetor 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 H,EREBY MA,DE 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 Lows, Ordinances or Regulations for the construction of buildings additions, alterations, or for removqf~r d~m~lition, os herei~ described The applicant agrees to comply with all applicable lows, ordinance~ and r~"ulatiori, s. ..... >,...b.~:..R:.~, ........ ~.::....~.:~..~:~,:':,::~::~......~.'..~.~ ..... :~ (~'gnature of applicant, or name, if ~,.~qrporation)~ .................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, ~e~.n~era~l~ contr_~_?c,_tor, electrician, plumber or builder. Name of owner of premises .... :: .:....:~. :: ~:~:~. .................................................. If applicant is o, corporate~ sionoture of duly authorized officer. ........... ....... ~ (Name and title of corporate officer) 1. Locotion of Iond on which proposed work will be done. Map., N~o.: ........................................ I-at No.: ...................... Municipality Store existing use ond occupancy of premises ond intended use ~nd occupancy of proposed construction. a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which app!icable): New Building .................... Addition .................. Alteration .................. Repair .................. Removal ....~/ ...... Demolition~ ............... Other Work (Describe) .................. Est mated Cost ..:./.. ~ ~]~)O~ Fee / O (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 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 ............................... '1 Number of Stories ................................ 8. Dimensions of entire new construction: Front .....~......~... ............... Rear ..../..,.~...~...~..~ ......... Depth .............................. Height .......... ~...~...! ........ Number of Stories ......... ..~... ................. 9. Size of lot: Front ......./'.{,~...~.~.!. ......... Rear ..... /.....~....O. ................. Depth .....~....~......~.. ............. 10. Date of Purchase ................ Name of Former Owner ....... 1 1. Zone or use district in which premises are situated ........ '..~........~ .............................................. ¢ :, [z~.%. ~. . ,.~ .,~ / //~-~,~ ~'o'r~:.~' ....... 12. uoes proposed construction viol,ale any zoning law, ordinance or regulation? ........ ,r.,~ ........ ./~-.~j~.~.t/=...~/./.~.../..,~' ...... remises ~, -~6~11~11~.D1-~1~1¢4¢~l~ ~ /V,.~/. , ~- t "l~/ Phone No. ¢. ................ . 13. Name of Owner alp ............................. !.z4. [.. ,,~..~s~ ii~i~ii~i(~ii.~.'~i.~.ii'~'.iiiiiill Phone No...~(....../.:'....~...~1~ Name of Architect ....~..,..~...t~.~..l~...l~...t.~. ................... Address Name of Contractor ...~....~......~.it~,.~J..~,~. ................. Address ..~.....~>...~.~..' ............ ~ ............... Phone PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-bock 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. COUNTY/~z~'~ /f) ('~'~ .'~OFJ'N"~5~"'~'~ ...... ) ' ' ............... ~.,..~.....~~ ............ being duly sworn, deposes and says that he is the applicant ~~ ~di~dual~i~, o~~ above name. He is the ......... ~.~..~ ................................................................................................ (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 all statements contained in this application are true to th~st of his knowledge aC belief; and that the work will be performed in the manner set forth in the applicat~ file&the~itk Sworn to before methis ~ t / ) ~ ~ ~ / ,-/ II / M ) .... ................ Notary Public .~~~~.~. Countv~ [ (Signature of appJica,nt)