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Home My WebLink About2057-zFOKM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY ~ovembe:c 4.^ 63 .o ......... .~..,Z.~..°. ..... Dote ........................................................ ,,~ ........ THIS CERTIFIES thor the building tocoted ot ~&~g:~..t,~.,. ~l.~.~h~l.~ .......... Street Map ~..~.~... Block No. ~w Lot No. conforms substantially to the Application for Building Permit heretofo~ filed in this office date~. ................................... ~;..2 ................... , 19 ........ ~rsuant to which Building Permit No..~..~.~.~ doted ~ ~ ~ ........................................................ , 19 ......... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificat~ ~s issued is ........ The certificate is issued to ~ 8~B~P, O~ (owner, lessee or te~anf) of the aforesaid building. Building In~pecto~ ' k FOI~M NO. :~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWH CLERK'S OFFICE $OUTHOLD, N. Y. BUILDI~4G PERAAIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2057 Z Date .................. ~ ....... ~, ...................... 19.63... Permission is hereby granted to: ~oseph Dee~keski......A/~..-- .Wes.ley.....~h~r 1~ ................. ..... rla.~i.~uek ...................................................... to · ~ui..lt.. a.n.. a~l&i.%i.e~ .. en...a~..e.~i~:i~-.d~e.}tt~g ........................................................ at premises located at .~8~a~..~4)i~..~i.H~...l~o~)e~j~y.j....~4~¢...¢ ........................................... ..................................... ~z" ~&ge .. Latte i....aa.s~au..l~o~n~.f .--~t~ie~e~a~. .................................... pursuent to application dated ....................... ~y....~ ........................... 19~3..., and approved by the Building Inspector Fee $..-~',, O0~ ............ l~O~V~ NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOV/N CLERK'S OFFICE SOUTHOLD, bi. Y. Approved "~ 19 ........ Permit No. Disapproved a/c ...... ......... / .................................. (Building I~pector) Application No. ~ O ~ '~ APPLICATION FOR B~JILDING PERMIT 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 tot and of buildings on premises, relationship to adioining premises or public streets or areas, and giving a detailed description of'layout of property must be drown on the diagram which is port 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 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 part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS I~EREBY MADE to the Building Department for the issuance of o 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. Joe Oeer r~ O~kl (Signature of applicant, or name, if ~ corporation) (Address of applicant) State whether appllcont is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................................... .C, oa.t.aae.t, om ............................................................................................................................... Nome of owner of premises ...~.e,.s.'Le,~ ........................ ~.}),~;.r..';q ............................................................................................... If applicant is e, corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map Ixl~ - Nassau P in't ..~ .......................................... Lot No.: ...................... Street and Number ..ZS~.~.g,g¢....1,a~,~......l~a.~.aa.z..Lo.~sa.b.~......C~tc~.og.Ue ........................................................ Municipality 2. State existing use and occupancy of prem¢ses and intended use and occupancy of proposed construction. a. Existing use and occupancy .~,~.{fi~,~,~,._.iNg . " with an add_t3_on b. Intended use and occupe~cy ................................................................................................................................ 3. Nature of work (check which applicable): New Building .................... Add,ifion ..... :X~Y;~;.... Alteration ............ Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................. 4. Estir~oted Cost ~00 13~H Fee (to be paid on filing this application) 5. If dwelling, number of dwelHng units ................................ Number of dwelling units on each floor ...................... If garage, number of cars ...................................................................................................................................... 6. If business, commercial or mixed occupa'ncy, specify nature .and extent of each type of use .............................. 7~ Dimbnsions of existing structures, if any: Front ............................ Rear ............................ Depth ........................ Height ............................ Number of Stories .......................................................................................................... Dimbnsions of same structure with alterations or additions: Front ................................ Rear .......................... Depth ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ c). .................... Rear ........... ~). ................ Depth .......... ~!i'. ......... Height .............................. Number of Stories ....c2~.e. ................... 9. Sizeiof lot: Front .............................. Rear .................................. Depth .............................. 10. Date of Purchase .......................................................... Name of Former Owner 11. Zon~ or use district in which premises are situated ........ ~.....v~,~.,4.~.,x, .................................................... 12. Does proposed construction viol.ate any zoning ]ow, ordinance or regulation? ............... ~20 ..................................... 13. Name of Owner of pram ses ..~e~],m,,y...,.,h,~.z..~ ...... Address ............. Name of Architect .................................................... Address ................................................ Phone No .............. PLOT DIAGRAM koca~e clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions property I'nes. Give street and block numbers or description .according to deed, and show street names and indk whether i~terior or corner lot. STATE OF NE'¢~ Y~Q~,K,~ ) COUNTY OF .~..U.:[..~..O.._.L.!f .......... ) S.S. ................... ~o.se.loh...De..e,r.~;o,s~.i, ...................................... being duly sworn, deposes and says that he is the applic{ (,Name of individual signing application) above named. He is the .......... .C.o~ahr..(~,¢.t. or. .................................................................................................................... i (Contractor, agent, corporate officer, etc.) of said ow0er Or owners, and is duly authorized to perform or have performed the said work and to make and file application; that all statement.s contained in this application are true to the best of his knowledge a.nd belief; that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .................... .~... d~qy of .................... ~..Y.'. ............... , Notary Pu~hc 'P[,1¢ 'fb'rl¢ ...... (Signature of applica,nt) ,I ~ No. ~2-0344963, Suffolk Count~' ~ ..'~'- Conlm ssion Ex[~ifoB M~.(gt~ 30, ~.9(~¢~