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Home My WebLink About2042-zFO~I~ NO. 4 TOWN OFSOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..... .~/8......G~ll...~.O~d....~.t?J~f~ ................... Street Fordham Acres Map No ....................... Block No .......~:Y~ ........ Lot No. ~.! ........ G~e.enDor.t...]...Y. .................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................................ ~.])~.-~.....~-~...., 19..~.. pursuant to which Building Permit No..~..0~....~.....~. dated .............................. ~]g~*.z~L....~.3...., 19...~..3., 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 ........ ...... P.~iva~e...one..£amil~....dw. el.l.it~ .......................................................................................... The certificate is issued to }/il~lve~l..&-.LeG~.a.n%..Ch~pm~n ........................................................ (owner, lessee or tenant) of the aforesaid building. H.D.Approval Oat l+, 1963 by R. FOI~M NO. 2 TOWN OF 5OUTHOLD 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? 2042 z Date ................. Al~.l*]* ....... '~3 ................. 19-.~3.. Permission is hereby granted to: }~ildr. ~d .. ~.. Ls~l~ an.t...~ha~ .......................... ............. 6~'.~,~n~.t ............................................. to .B~it~.. ~e~..e~e..-f.a~.lY...d~o !.1.1~.~ ..................................................................................... at premises located at ']:'O¢' ~"~ Fo~qd.ha~ Ae~.a~. ............................................... ............................................................... ~Z'~rtpot* t'~,'" ~ ~' '~,.' ............................................................. pursuant to application dated .............................. A~**,**~ ............. 19~,~***, and approved by the Building Inspector Fee $..lO.O0...pd...ehk FORt~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTN~ElqT TOWlq CLERK'S OFFICE SOUTHOLD, Iq. Y. TEMPOI~.~}f CERTIFICATE OF OCCUPANCY No. Z...I~..~.L[- ............. Date ..................... .OO.t, oTae~, ........ ~. ........ , lf63 .... THIS CERTIFIES thor the building located at ..W. JJ~'.....(~t~.~....~OT-J~...~,~e ...................... Street ~C~.~...,~g~.e..~. ...... Block No ......~ ......... Lot No...~t.....(~..ee~gz~.+,,,~...N.,.~t, ..................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................................... A]~.~;[ .......... 2.,~, t9..~3, pursuant to which Building 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 ........ ...................... ~ ~.'~.~e...o~e.. ~.am~. [~.. Gwet .t.~. ~.~ .......................................................................... The certificate is issued to "~'~'~'t~e~'"&"' 'T~.~.~..G~e.D~tTt .................... 0~e~.S ..................... LOW'her, lessee or reno,hr) of the aforesaid building. H.D. Approval Oct. 1963, FOE~ NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .........~(~...~...~..,...,/-x/ ~ 19~.. Approved .........(~.....~...x.~....., 19...~..?...Permit No .........~..7%~..~.....~...~..... Disapproved a/c ............................................................................................ (Building Inspector~r/~ Application No ..... ~.~.....~...o~.... ..... APPLICATION FOR BUILDING PERMIT 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 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 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 applica,nt. Such permit shall be kept on the premises available for inspection throughout the progress of thb 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 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 appJicabJe 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) (Address of applicant) Sta/-e whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .....~..l.d.~.erl...&....L~.~'atl,.t,..~,,h~/rmn. ............................................................................ 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.: ....~T.O~.f~,~..A¢.7,..~¢~ ..... Lot No.: ....~. ................ Street and Number ....J]ba~..1...~et'l~4..~4)aO,~ ....... 8~,~e~]¢~1"~. ........................................................................... : ..... Municipality State existing use and occupancy of premCses and intended use and occupancy of proposed construction. a. Existing use and occupancy ........ .V.i~l~r~t,.,lo.t, ........................................................................................... i..... b. Intended use and occupancy ........... O~,e..&:cm;~,l~..~,,e.~t~,$~ .................................................................... 3. Nat~Jre of work (check which applicable): New Building ...:Y,.,~r.7,~I~.... Addition .................. Alteration Repair .................. Remova! .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost .... ],O.~.OL~O..~./~.M ................................. Fee ...... (to be paid on filing this application) 5. If dwelling, number of dwelling units ..Ol~e ....................... Number of dwelling units on each floor If g~rage, number of cars ............................................ 6. If bps~ness, 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. Dimens~ions of entire new construction: Front ....... .~'~ ............. ~.... Rear ........... ~,q ............... Depth .... Height ........................... ~.. Number of Stories ..... ~t~. ................. 9. Size!of lot: Front ..... ].f~O .................. Rear ...... '101~ .................... Depth ...... ~00. ................ 10. Data of Purchase ............'1~1~,~ .................................... Na'm~ of Former Owner ....,~.~.~,~.t;.O~l...&..~/~.ll .... 11. Zon~ or use district in which premises are situated....~!~?.......d,:l,~ ............................ 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? ......... 13. Name of Owner of premises .~,~..~..~,~;~ ..... Address ........... ~.~..~.~p~.~*.t~ ............... Phone No. Name o1: Architect ~ Address Phone No. Nar~e of Contractor # Address Phone No. PLOT DIAGRAM Loc.c~,te clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-back dimensions f~om property !ines. Give street and block numbers or description ~according to deed, and show street names and indicate whether ihteFior or corner lot. STATE OF NE)L? ~"~)P,~, ) COUNTY 'OF .~...~..:.z;..o..&~ ........... ) S.S. ............... ! ........... ,,'v~.],fiZ'.e~...Ot~.~.~&,~ ................................ being duly sworn, deposes and says that he is the (Name of individual signing application) above na~ed. He is the ......... ~.",f~f~....-....~.~,~,~.~.~. ................................................................................................. / ..... ~ (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,,'~ile application; that all statements contained, in this application are true to the best of his knowledge and b~l~Jef; that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ............... ~ day of .... ~P.~.~,~, ..... , 19.~3.. ,/ . ~ .,~ , / i , . /1, / ,. r. ................................................ ;.; ....... Notary Pc)bhc ..~fi-.~:g.L.'.,;....~..~v~....~. '~(~(~.,,-/~4..... C6~/nty (Signature of app~iica.nt)