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Home My WebLink About2052-zNO. 4 TOWN OF SOU?HOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. '"'~'],~9~ ............ Date .................... Bapt~.m.~er.....~O....., 1963... THIS CERTIFIES that the building located at ...~..~...~J~.]LZLtte...D~. ................................. Street Map No ...... X.:~Y, .......... Block No .......~ ........ Lot No....~ ..........~t~&~;~,C~t..~,~ ............... conforms substantially to the Application for Building Permit heretofore fired in this office dated ................................. A.~.$~ ....... .~.0 ......... , 19.~.].. pursuant to which Building Permit No..~.O.~.~,... dated ................................. ~:~ ....... ~. ...... , 19..~'.~., was issued, and conforms to oil of the requirements of the applicable provisions of the law, The occupancy for which this certificate is issued is ........ ...... ~.~,ve, te...o~e..~.amf~l.~..c~wel~L.in~ .......................................................................................... The certificate is issued to ..~l~.,.&..~:j~.S,...~],~h...r~l~O~,[3sO~ ...................... 0.~.~ .................... (owner, lessee or tenant) of the aforesaid building. Building Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S O~:FICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS F~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHoRIzED) N? 2052 Z Date ................. ~ ......... ~: ..................... 19..(~3. Permission is hereby granted to: Al, Kene.sk.~..... 3~.~ .. ~/alph ..~,,...Thomp.son ............. ........... ~,.~. ~-t.~¢~. ............................................... to ....Btt~t~:..~m...ad~:.t.~o~,~..en...am..e:~.t.ing...d~e.lt.i. ng ...................................................... ct premises located at ...... ~l~.l.~.~e....L~r-z~ .......................................................................................... ......... '......: ...................................... ~t.t~.-t, uo~,.. ~,.g... ...................................................................... pursuant tc~ application dated .............................. ~]jl~, ......~-1.~,...3Q..1963..., and approved by the Building Inspector Fee $..~00 ............ ~uitding ~nspec~or f i'tll'ttt P OF LAND · ~URV, E.,Y',CO FOF~ RALPH ~. THOMPSON I~11 TTI TI-lC OF' FOI~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. £xomined ....................................... , t9 ....... ,, ,, Approved ........................................ , }9 ........ Permit No .............................. Disapproved a/c ..... ~ .~.. ~ ......... .... i ............ ..................... (Building lnsp~ct7) .... 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 opplica.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 o 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 applicable Laws, Ordinances or Regulations for the construction of buildings, additions, alterations, or for removal or demolition, as herein described. The appUcant agrees to comply with all applicable laws, ordinances and regulations. .......... , ......... ' ( '~,~,~,~ app cant~'o~a~e, it a corporat, on) ....... ...... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pIumber or builder. Nome of owner of premises ...~..Z/~ ................................. 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.: ...................... and Number ........ ' ......................... : ....................... ' · ..................................... 2. State existing use and occupancy of premises and intended use and Occupancy of proposed construction. a. £xist/ng use a.nd occupancy ~~ .~.~ /~ ..~ b. Intended use and occupancy ......... 3, Nature of work (check which applicable): New B~ilding .................... Addition~....... Alteration ............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost~,.......'~...~.....C) ............................. Fee : -'/ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............. / .............. Number of dwelling units on each floor ....................... If gg,,rage, number of cars 6. If b0siness, commercial or mixed occupa,ncy, 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. Dimf.sions of entire new construction: Front ...... ~..~ ..... Rear ....... .~~ Depth ...~..~..~ .... H '~ t .~...~.~ ...... Number of Stories ...... ~ ~ -- S ze of at' Front Rear Depth '~ ' 10. D~te of Purchose .................. ~.~ ........................... ~N~me of Former Owner ..~ ........................... ~ 1. Zone or uso d~str~ct ~ which premises oro situotod ................................................................................................ ]2. Does proposed construction viol.oto Na e of Arch tect ~ . . PkOT DIAGRAM kocate cloorly ond distinctly oli buildin0s property Ilnos. Giro street ~nd bbck numbors or description .occordin~ 1o deed, ond show streot n~mes ~nd indic. whether intorior or cornor lot. , STATE OF!NEW Y,,~)[~I~,,~ ....... ~2~~.:.~..~..~ .~~[~ .............. being duly sworn, deposes and says that he is the applica above nome . sthe ............. ......... ' ............................................................... (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 opplicotion~ that all statements contained in this application are true to the best of his knowledge and belief; ar hat the wc~rk wdl be performed m the manner set forth n the app cation fileiled,4herewith Sworn to b,bfore me this // ' l~O~ TOWN OF SOUTHOLD BUILDING DI~PARTMIE~IT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ....... ~roved ........................................ , 19...-...Per,it ~o...~ ..................... Disapproved a/c ..... ................. ......................... App icotio,, ..... APPLICATION FOR BUILDING PERMIT ,:::' : , _ Dot ............................. , 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 m~y not be commenced before issuande of Building Permit. d. Upon approval of this appJicetion, the Building Inspector will issue a Building Permit to the opplic~nt. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. t4o building sholJ be occupied or used in whoJe or in part for any purpose whatever untiJ a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS H.EREBY 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 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 app icoble laws, ordinances and regulations. / (Si~o_tu.refif ~pl:~cq~t, o? name, if a corporation) .... ...... (Address of applicant) State whether applicant is owner, lessee, agent~architect, engineer, general contractor, electrician, p~umber or builder. Name of owner of premises~..~....~~ ............................. If applicant is a corporate, signature of duly authorize/officer. Y (Name and title of corporate officer) Location of land on w~hich proposo, d work will_be done. Map No.: ........ ~, .................... ; ....... 'Lot No.: ...................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy ~~..~'~......~..~ .............. (..~. ......... . , ....... b. intended use and occupancy .............. : .............. ~:. ............. ~~ ................. 3. Nott)re of work (check which applicable): New Building .................... Addition .................. Alteration Repair ............... ~:~Remova] .................. Demolition .................. Other Work (Describe) .................. 4, Estimated Cost ..~....%~.~..2 "~.....~ ....... Fee I i (to be paid on filing this application) 5. If d~,e[ling, number of dwelling units ............ /.... .............. Number of dwelling units on each floor ....................... If g?rage, number of cars ............................................ 6. If b~siness, commercial or mixed occupancy, specify nature ~nd extent of each type of use 7. Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth Height ............................Number of Stories ...~ - Dimbnsions of same structure with alterations or additions: Front ................................ Rear Dep{h ................................ Height ................................ Number of Stories ....... ~. ........................ 8. Dimj~nsions of entire new construction: Front ...... ~ ' ",~...~.,~ ..... Rear ....... .Z(...~......'~'.~..~.--~ Depth Hei~lht! .~,~-r~.~ ...... Numb, er of Stories ...... ,'~1~.,.,;;,:;...~ '--.-,~v ,~ ~ 9. Sizelof lot: Front ......~.../....~.....~...~'.... Rear ...X..~......~..~.... Depth ..Z..~.,~..~:~ 10. Dat~ of Purchase .................. .~ ....................................... Name of Former Owner ........ ~. ......................................... t .... 11. Zone or use district in which premises are situated ................................................................................................ It .... 12. Doe~ proposed construction oLate 13. Na~e of Owner of Nar~e of Architect :.. Phone Nar~e of PLOT DIAGRAM LoceCe clearly and distinctly alii buildings, whether existing or proposed, and indicate all set-back dimensions f property lines. Give street and block numbers or description occording to deed, and show street names and indi, whether i? ~nor or corner lot. r IE J E Y (N/~me of i~dividual si,~ng applicatig~ ~ , __ abow, name~. He is the ............. .~ ...................................................................................................................... L.. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sQid work and to make and file application; that all statements contained in this application are true to the best of his knowledge and belief; that the v~ork will be performed in the manner set forth in the application filed therewith. Sworn to J~,~ore me this Notary P~blic applicant)