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Home My WebLink About2065-z'TOWN OF $OUTHO~..D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ~.~.~,b,..~...~L.~..~.f}~,C}T~..~t.~.f~.~. ........... Street ............................................ xY~ O~tehogue Map No. X~f.X Block No. ~ Lot No ............................................ .~ ......................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .~.~r...~..~.l~b/f~.e?.O.~l~..~.~.l~..,.~ ......... , lC~.,~ .... pursuant to which Building Permit No..2.01~;~.. dated M.~.~. l~../ a~t~e~.cled J~t].~.. ~ 19~. was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate .is issued is ........ .............................................................. The certificate is issued to ,,,~,,~,,~,,~,~,.,~,~,~,,~.,,~..~,e.,~.,..~,,,,,l~_$,,~,,e, .................... .0..~/...~..e...~.~ ........................... (owner, lessee or tenant) of the aforesaid building. FORM NO. 2 TOWN OF $OUTHOLD 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? 2065' Z Date ..................................... }~......~.~.... 196..~... Permission is hereby granted to: John TIaur~ .. ~C..~..l~n.. ~¢a~.f. ez-~ .................... ........ Cuteho~ue ................................................. to .~.].~.~ .. ~...a~di~.tc~.. ~n...,~..~m~,~ng .. d~re~ .~ ..................................................... at premises located at ................................................. e:~teho~ue ......................................................................................... pursuant to application dated ....: ......................... ~.....~]~ ............ 196,~,,.., and approved by the Building Inspector Fee $ ' '~"~,~0' ............ ]~OP~I[ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. (Building Inspector) Application No...~.....0....~..f~..-~_. .... APPLICATION FOR BUILDING PERMIT Date ...... ....................... , ........ 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 o detailed description of toyout of property must be drawn on the diagram which is part of this application. 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 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 part for any purpose whatever until a Certificate of Occupancy shall hove been granted by the Bullding 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 or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ......... ........... ..... (Address~6f applicant) State whether applicant is owner, lessee, agent, architect, engineer, generoJ contractor, eJectrician, plumber or builder. (/ Name of owner of prem ses ...... ...~..'..~....;..,~..,..,/~.'.~.~.~.,....~..~,.~.~....~,,~.~.,...,.~./.~g~. ......... ,~, ~.......,,~ ................................... 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.~......-~.. ............ Street and Number ....~.....d.-~...~..~.~..~...~...,../~.....,.-Z~.'.~.i,..~..~..~..~...g.~..~./.~..~...~..).~..~-~.~Z .~.~..~....~..~.~....~.~.~ .~...~..?..~.~.~r.~.._~.~.. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: '...z. o Existing use and occupancy .......... ~..~....~. .,?'....~g.. .................................................. b. Intended use and occupancy .................................... .s-. .............. ~...~ ...................................................... 3. Nature of work (check which applicable): New Building .................. Addition ..... ..¢k?¢......,.... Alteration .............. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ...... ....~.,..~..~,..~...'...~.....~.,.......~.. ................. Fee ................ .~....-~.~...O....,~.. ..................................................... : (to be paid on filing this application) 5. If d~velling, number of dwelling units .............................. Number of dwelling units on each floor ......................... 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 Height ............................ Number of Stories ....... ,c.~'.¥.~ .............................................................................. Dimbnsions of same structure with alterations or additions: Front ................................ Rear ............................ Depih ............................ Height ................................ Number of Stories ........................................ 8. Dimensions of entire new construction: Front ................................ Rear ~ 3 r Depth of Stones .................................. Height ............................Number ' ~ ...... 9. Size!of lot: Front ................................ Rear ............................ Depth ........................................ 10. Dote of Purchase ........................................................Nome of Former Owner .................................................... ]2. Doe~ proposed construction volote any zoning law, ordinance or regulation;~ Name of Architect ...... -~ /v/-~'''~ ............................. /. ............ Address ............................................ C~;(¢c~.~ Phone No ................. Name of Contractor ...~/......,.~.f;~ ........................ Address ............................ .p¢~. ......... Phone No ................. PLOT DIAGRA,M L.ocat dearly and distinctly alt buildings, whether existing or proposed, and indicate all set-back dimensions fn property li~qes. Give street and block numbers or description according to deed, and show street names and indic¢ whether in~erior or corner lot. L STATE OF' NE~¢~ YQR~(, COUNTY OF .~...~.......) ................ ~......~ ..................................................... being duly sworn, deposes and says that he is the applic( above named. He is the ............... f_.~.~..~ ..................................................................................................... j (Contractor, agent, corporate officer, etc.) of said owper or owners, and is duly authorized to perform or have performed the said work and to make and t this applicgtion; that all statements containeld inCh~plication are true to the best of his knowledge and bell and that the work will be performed iq,the .~e~'fG~¢~ in the application flied therewith. Sworn to bkfore me this ,¢,,,r ...................... ...... : ................... FOP~M[ NO. 1 TOWN OF $OOTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y- Examined ...................................... , 19 ........ Approved ........................................ , 19 ........ Permit No ................................. Disapproved o/c ............................................................................................ Application No ............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT ote ...................... , ..... 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 p remises, relationship to adioining premises or public streets or areas, and giving a de/oiled description of layout of property must be drown on the diagram which is part of this application, c. The work covered by this application may not be commenced before issuance of Buildlng 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 pa rt for any purpose whatever until a Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY 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 or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinonce~and regulations. ......... ..................... Off'Signature of applicant, or name, if a corporation) ................................ ........ ........ : ............ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................. ................................................................................................................................................. ff ~pplic~f is ~ corpomfe, sig~ure o~ ~uly ~ufhori~ed officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Number~,~/:~/~ ~/b //~/u~,?/r~, Z./.~:~ ~ ~.~ ~ ~ Street and ............................................................................ .>. ................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~ 2 b. Intended use and occupancy ~ ~ ~ Z 4 ~ ~ 3. Nature of work (check which applicable): New Building .................. Addition ..... ~ ..... Alteration ............. Repair .................... Removal .................... Demolition ..................... Other Work (Describe) ........................ 4. Esti~nated Cost ...............~..~...~...D.M.~...~. ..................... Fee ........... 5~.,....~.....~. .......................................................... '. (to be paid on filing this application) 5. tf d~elling, number of dwelling units ....... ~. .................. Number of dwelling units on each floor ....... ~ ............. If garage, number of cars .........~ ............................................................................................................................. 6. if business, com~rcial or mixed occupancy, specify natureand extent of each type of use ............................ 7. Dimensions of existinfl structures, if any: Front......~ ................Rear .......................... Depth .......................... t~ ' Heigh ~ .................... Number of Stories ...... :. ................................................................................................. Dimensions of same structure with alterations or additions: Front ...... ~.~.~..~ ............ Rear Depth ..... ~.Z...~ .......... Height .~:.~.Z.~ ........... Number of Stories ........ ~ .............................. 8. Dimensions of entire new construction: Front ~ - ~ Rear ~ ~ ~ ~ ........................................................... Depth Height .~....~.~..~.~. Number of Stories ........ ~ ........................ 9. Size of lot: Front ~ ~ L ~ // Rear ~(~o - O Depth /~ ~ ~ 10. Dar9 of Purchase ........................................................ Name of Former Owner .................................................... ]1. Zone or use district in which premises are situated,...~ ...... ~..~.~ ................... ~.~..~ ....................................... 12. Doe~ proposed construction violate,.... ~,~ ,a:nY zoning law, ordinance~ ,-- _ __°r regulation' ~ ...... ~7~ .......................................... ..... Phone No.~ N,me of Architect ..................................................... '-'r-- ~ -- Address ............................................ Phone ~o. Name of Contractor .~4..~.:.g...~..e~.~ ......... Addres~/~..Z¢.~.¢¢.*.~... Phone Nam ~ PLOT DIAGRAM Locat clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fn property lihes. Give street and block numbers or description according to deed, and show street names and indi~ whether interior or corner lot. STATE OF NEW Y/OR,I~,/ ~j ) cc c~ ~ - 0 ............ ~.....~....~~ ........................ being duly sworn, deposes and says that he is the ~ (Name of individual signi~ application) ~/ (Contractor, agent, corporate officer, etc.) of said owger or owners, and is duly authorized to perform or have performed the said work and to make and ~ this application; that all statements contai~_gd i~t~sraDplication are true to the best of his knowledge and beli and that the work wdl be performed m th%~, ~Je[~f~ m the appl cat~on filed therewith. Sworn to bbfore me this ~ co~,~°~, sU~rol~%~rk ~ _ Notary Public, ..~~ .......... <...~:~o~ty ~ ~ (Signature of applicant)