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Home My WebLink About1921-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY June 17 19 63 No. ~ 1622 Dote ......................................................... , 0l~ Main Rd,, wes*: O~eenpor~:_ . THIS CERTIFIES that the building located of ...................................................................... 5tree~ ~e Map No,...,...............-.e* Block No. . ............ ~* ...,..... Lot No ....................................................................... conforms substa_ntiglly to th_e_Application for Building Permit heretofore filed in this office doted oc~:o~e~ ;ZZ 62 2~ 1921 .................................................................. , 19 ........ pursuant to which Building Permit No ................. 0ctobe~ 22 62 a dated ...................................................... , 19 ......... w s issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ T~e certi{icote is }ssued to .................................................................................................................... (~ner, lessee or tenant) of the oforesa.ld building, FORM 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.° 1921, z Date ...................... O~O]~'-'T'"'"2'~' ........ 196~'" Permission is hereby granted to: Ohos ]3u~b'l~." ' ' '/l/e · ' .Pe.}t s...O~r a.g e.. · .:I:nc .................. ........... ~r~e~po~t ............................................... to ' · ' 'thti'}d' ' 'an" 'ecl'die l'cm' ' 'o~ "a." ~¢l'~tln'g ' · ~tt's'~'iff~' ~'.~'"B~TCL't~ ................................ at premises located at ....N/f~..~..~trl..tqO~t~ .......................................................................................... ........................................................ ~....Gr~e~l~.t ........................................................................... pursuant to application doted ................................ O~:~'"P'~ ................. 19~2..., and approved by the Building Inspector Fee $....~ ............... TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .z// / Approved c ~- 19 ........ Permit No .............................. (Building~nspector) APPLICATION FOR B'UILDING PERMIT Dote October 22 62 INSTRUCTIONS a. 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 and of buddings on p remises, 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 thi.~ applica- tion. c, The work covered by this application m~y not be commenced before issuance of Building Permit. d. Upon approval of this application, the Buiiding Inspector will issue o 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 port for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY 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, end 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 oil applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) Green~ort (Address of applicant) State whether applicant is owner, lessee, agent, archilect, engineer, general contractor, electrician, plumber or builder. if applicant is a 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.: ~% ............................ Lot No.: ,...:?~..,~. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy ~.l),]g]].i.0 ~.~,:~.ag.e. .... b. Intended use and occupancy " " with an a~dition 3. Nature of work (check which applicable): New Building .................... Addition .....;Y-,.~... Alteration .................. Repair .................. Remova! .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost ........... .9~0~..]~,/.[vJ. ............................. 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 .................................................................................................................................. 6. If business, commercial or mixed occupancy, ~pecify nature and extent of each type of use ....~.J:..~..e...~.~.. ............ 7. Dimensions of existing structures, if any: Front ....36.=.k .............. Rear ....... 3..6..Z..k. ........... Depth ...... Height ............................ Number of Stories ........... Qbe ............................................ Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........... ~.8. .............. Rear ......... ..~..8. ................ Depth ....... 73 Height .............................. Number of Stories ......... .O.g.e. ............. 9. Size of lot: Front ...... ~0~ ................ Rear ............... ~(~.0 ............ Depth ........ ~.0...0. ............... 10. Date of Purchase Name of Former Owner ~, 1 1. Zone or use district in which premises are situated. ~ ~e..~ 12. Does proposed construction viol.ate any zoning ]aw, ordinance or regulation? ....~C~ .......................................... 13. Name of Owner of premises ...~.~,]..~..,~...~.~4~.~.... Address ............. .~..z.'..e..q~..o.?,.~ ............. Pbone No ................... Name of Architect .......... ZQ@.....~t,~Z~:~SO~. .. Address ............... .vq..o.q.~.~.o.~.~ ............. Phone No ................... Name of Contractor ...... ~.....]3.~t~l~e ....................... Address ............Q.z'...q.e.~..o...~..t. ....... Phone No .................. PLOT DIAGRAM Loca.te clearly and distinctly aU 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. STATF OF NEW YORK, ) COUNTY OF ..... 8.12~.:CO.'.L~:..,,..) S.S. ...................................... Cha.~..gl:L~.b~.~ ............................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ..............D. OD.t;~.~,¢~.~.¢~' .................................................................................................................... (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 the best of his knowledge a,nd belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ................. ~;2,,.. day of(~ ,.'~-~ ~ ..... O.O.g.O.~ ~. ......... , 1,9 ~2 ~~ h /_/ ~ ~t~te° of Ne~