The URL can be used to link to this page

Home My WebLink About1955-zFO'E~ ~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, iN. Y. CERTIFICATE OF OCCUPANCY No.., .'.~.:....~.'~. ............. Date ..................................................... THIS CERTIFIES that the building located at ..~,....~.~ .................................. Street Map No. ............................................ Lot .................................. ,~ ............................ conforms substantioll~ to the Application for Building Permit heretofore filed in this office d~ted ..................................... ~.~.~......~.., 19.~... pursuant to which ~uilding Permit No..~.~.~,.. dated ............................... ~.~$~..$ 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 ........ ............... e1it ................................................................................ The certificate is issued to ~.,..,~.~ ..................... ~r. ............................................................. (owner, lessee or tenant) of the aforesa,id building. Building ]nspectoy 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.o 1955, z Permission is hereby granted to: FA'ed Dote ....................... De~embe,~......8.,...~$110.(~2.. .......... 8,~eenpo~,.~ ................................................ to .. ~ove...and.,r.e~odeL..and...build..add$.tion.. ~n..Am..exiating...dw. elllng ........... at premises located at ........................................................................ ............................................. · R~s~...P,~ ion-t...N, ¥, .......................................................................... pursuant to opplicotion d~ted .......................... .~)1~,~1~....,.~ ........... 19..~., ond opproYed by the Building Inspector Fee $. ~'...0~1 ............. Building Inspector TOWN OF SOUTHOLD BUILDING DEPART/~,tENT TOWN CLERK'S OFFICE soo'r.o .D, N. ¥. Examined Approved ........................................ , 19 ........ Permit No .............................. (Building I~spector) Application No. ~.?..~..~i ................ APP/.ICATION FOR BUILDING PERMIT Date~ ........ ~. .............................. , 19..~....~..- 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 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 this 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 applic.a,nt. 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 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 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. (Signature of applicant, or name, if a corporation) ......................... i~,~ ~J r e ~ ~' ~'~'~'~'~' " .......... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ......~.....~...:......L...:.' .................. ~ ................................................................................................. if applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work will be done. Map No.: ................................~ ..... Lot No.: .~ ....... Street and Number ~ ~.-~....-~... Municipality State existing use end occupancy of premises and jntended use and occupancy of proposed construction. a. Existing use and occupancy b. Intended use and occupancy ....... ~.~..~(~,. ................................................................................................. 3. Nature of work (check which applicable): New Building .................... Addition .....~.. .......... Alteration ..~ .......... Repair ............. .~ Removal ..................Demolition .................. Other Work (Describe) .................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... ! ...................... Number of dwelling units on each floor ...... J ..................... 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 .............................. Dimensions of some structure with alterations or additions: Front ................................ Rear ................................ Depth ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .............................. Rear .............................. Depth .............................. Height .............................. Number of Stories ...... ~ ...... I 10. Date of Purchase .......................................................... Name of Forr0,cJ~ Owner ........................................................ 11. Zone or use district in which premises are situated .............. '.,~....'.:...~~.._:.:~, ............................................ 12. Does proposed construction violf~t.~,any zoning Iaw, ordinance or regulation? ...... ~... .............................................. 13. Name of Owner of prem ses .~,...~..f~:~O~. Address Pho .......................................................................... ne INO ................... Nome of Architect .................................................... Address .............................................. Phone No ................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from properly lines. Give street and block numbers or description ~:ccording to deed, and show street names and indicate whether interior or corner lot. A STATE OF NEW ~¢¢OR~,/. ,¢/Z ) ~ o COUNTY OF ~) .......... ~i'~i~' . . . . . . ............ ....being duly sworn, deposes and says that he is the applicar'* above named. He is the ........... ~~ ........................................................ , (Contractor, agent, corporate ~f~"e'~:'~ ............................ of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file 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 befor6 me this ~ _ _ .............. ~.~ay of ...... ~~ ...... 19~, _, ' n ~ ~i ~ , Notory Public ~ '~ "~' ~¢~ J ...~~.~m..~.....~.. ...... ~~f~¢,~uqty, ~ (Signature of opplica,nt) .... ¢ '~ ~2P~44963 S~mff01k County B^~H ~l WILLIAM C. BLASER ARCHITECT, A.I.A. 7 WOODCLEFT AVENUE, PORT WASHINGTON, NEW YOR,K r ',WILLIAM C. BLASER A~CHITECT, A.I.~ 7 WOODCLEFT AVENUE, PORT WASHINGTON, NEW YORK, F~. F~ rz d WILLIAM C. gLASER ARCHITECT, A.I.A. 7 ~OII~I~CLEFT AVENUE, PORT WASHINGTON, NEW YORK