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Home My WebLink About2081-zFOEM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z 1732 Date l~ovember 4 19 63 THIS CERT[FIES that the buildin9 located at .,~./~....~..o...~.~...~,...C~,,..d.,~........~..O,,tl...~..h..O..~...d. ........ Street Map No ....................... BJock No ......... .............. Lot No ..................................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated 3'utte 7 19...6.?.. pursuant to which Building Permit No. Z dated ................... .J...tl...~..~....~. ....................... , 19.......6.,3was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ The certificate is issued to ........~...h.~..°....?..~..?.~..~.?...~...C.,,l~.~?.~...~.....°..~...~..e.~ ........................................... (owner, lessee or tenant) of the aforesaid building. 1~01~ NO. ~. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS I~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2081, Z Date ............................ ~.l~es~.....~ ............. Permission is hereby granted to: Gold s~.i.~..~tdg,,&,.gen~....,A/C.. 8B$1o.,B~p.tfst C~ht~r eh ....... ~o't~h'o'Z~ ..................................................... to .. Bu.l..~d... am.. ~d d.~ ~.i.o~..~n..~.. eh~eh..btti, id. tng .............................................................. at premises located at "~'~"'~cr~I"~o~'"~eR~'~) ................................................................... ................................................................ $~uCho.Z.d ............................................................................. pursuant to application dated ............................... 0'~.~ ...... '~ .............. 19.~.., and approved by the Building Inspector Fee $'"~0~ ........... - ~ulloing l~qs~ectc¢I FOEM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUT.OLD, Exam,ned ..... ........... ..... ............... ........... , .... Disopprovod ................... ......................... Application No....~......~.~.~../. ....... APPLICATION FOR BUILDING PERMIT Date ....~..~.,'¥;~. ......... Z ................. , 19..C~... INSTRUCTIONS a. This appiication must be completely filled in by typewriter or Jn 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 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 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) (Address of' applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... .~..~. z~..~. ~.~.e.7-~ .................................................................................................................................................... Nome of owner of premises ....... ~..~?~...~...~...0.. ........ /~.~..~./..'7-.~;/.~. ...... .~../~/./~-~.'/..~. ................................................................. 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 ...~.~./.7.~....J~.~/.~.....~.. .............. .'~.~.~.~..**.~.~..***.~'~J~'...~.. ....................................... Municipality 2. 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 ....~?~...~....~...C./.:.~.. .................................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition ...... ~.... Alteration Repq? .................. Remova! .................. Demolition .................. Other Work (Describe) .................. 4. Estir~ated Cost ............... .~...'~.~...~.~ ................................ Fee .......... (to be paid on filing this application) 5. If dwelling, number of dweJling units ................................ Number of dwelling units on each floor If ggrage, number of cars ...................................................................................................................................... 6. If b6siness, commercial or mixed occupa,ncy, specify nature and extent of each type of use ...~.~.~....~,.~....~/. 7, D~mens~ons of ex~sting structures, if any: Front .....~.,~, .................. Rear *~ ! Depth ...... ,.,~,,~,,,,~, Height ...... ~:~. ................ Number of Stories ................ Dimbnsions of same structure with alterations or additions: Front ..... ,~.,4....~, ................ Rear ..... Depth ......... ~..~..i ................ Height ............. ~..~. ............ Number of Stories ........../.. ................... 8. Dimensions of entire new construction: Front .............................. Rear .............................. Depth Heig~ht .............................. Number of Stories .............................. 9. Size,of lot: Front .............................. Rear .................................. Depth .............................. 10. Dat~I of Purchase ...~./~H~,/~.~¢ ..................................... No,me of Former Owner 11. Zon~ or use district jn which premises are situated. 12. Doe~, proposed construction viol,ate, any zoning law, ordinance or regulation? ..... 13. Name of Owner of premises~"~.W~/~.'.~...~../ZS~'/..~.~dress ....~.~Z,/:/'~z~.'~,f~.,:..-Z. ................ Phone No. Name of Architect .................................................... Address ................................................ Phone No. Nam~e of Contractor ~;~/,.~ K~. x~?.i. ~.~.~..'~..f~'~i~,/Z Address .~. ~,',',',',~.11~;/~.. ~ ~ .............. Phone PLOT DIAGRAM Loco?e clearly and distinctly a!i buildings, whether existing or proposed, and indicate all set-back dimensions properly lines. Give street and bbck numbers or description ~ccording to deed, and show street names and indic whether interior or corner lot. '~ STATE OF' NEW¥OP*K, / ) ~ ~ ....... ~'~'~'~'~' ....... ~"~'~:2.~..ll~--].~/..~.. ............................ being duly sworn, deposes and says that he is the applica (J~ame of individua! signing application) above named. He is the (Contractor, agent, corporate officer, etc.) ' of said owr~er or owners, and is duly authorized to perform or have performed the sa d work and to make and file application that ali statement,s contained in this application are true to the best of his know edge and belief; that the wOrk w be performed in the manner set forth in the application filed therewith. Sworn to bbfore me this ..................~day,///,~,°f ............................... ~ ~', ~,~'~ ' ~....~.....~c~. '~...,19 .. . Notary ~u,blic ~,.~,,~~~f~.~_~l<C~'nt~ ~' '" i~i'~'~'~'~e";~"~;~l~ii~'~,~')' ........ ~' No, Y52-0344963, SuffoJk County, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No. 2 ~ & 1 APPLICATION FOR BUILDING PERMIT Date ..... ~. 4f,~ WV.~: ......... Z ................ , 19..~. INSTRUCTIONS a. This applicotion 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, rela¢ionship to adjoining premises or public streets or areas, and giving o 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 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 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 applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or nome, if a, corporation) (Address of~opplicont) Stace whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pi[umber or builder. ...... ................................................................................................................................................... Nome of owner of premises ......... ,: ......................... ,.~ ~...~Z~ ...... ~.x'~(~,~ ................................................................ If opplicont is a, corporate, signature of duly authorized officer. ........ o" fig'; ................ 1. Locotion of Iond on which proposed work will be done. Mop No.: ........................................ Lot No.: ...................... Street ond Number ..,.X~.Z~,..~ .................... ,~&~[~....~:k~¢:.....~[~ .............. Municipality 2. Stote existing use and occuponcy of prem4ses ond intended use and occuponcy of proposed construction. a. Existing use and occuponcy ....... ¢~?~:,~;~'~ ................................................................................................. b. Intended use and occupancy ....~..~..G.I~ .............................................................................................. 3. Nat'ure of work (check which applicable): New Building .................... Addition .................. Alteration Rep~air .................. Remova! .................. Demolition .................. Other Work (Describe) .................. 4. Esti~nated Cost Fee I (to be paid on filing this application) 5. If d~velling, number of dwelling units ................................ Number of dwelling unffs on each floor If garage, number of cars ........................................... 6. If 5bsiness, commercia~ or mixed occupa,ncy, specifv~6 ~ature and extent e~9ch~._ type of use '"~" -:~-~¢'~'--~7 .... 7. Dimensions.o~ existing structures, if any: Front ............................ Rear ............................ Depth Height ..... '"' ................... Number of Stories ................................. ~c z ........................ ~x DiMensions o(,same structure with alterations or additions: Front ................................ Rear Depth ................................ Height ................................ Number of Stories ................................ 8. Didensions of entire new construction: Front .............................. Rear .............................. Depth Height .............................. Number of Stories .............................. 9. Siz~ of lot: Front .............................. Rear .................................. Depth .............................. 10. Dat~ of Purchase ~o',/r,~-~,'/xt Na.~ of Former Owner ~- 1 1. Zone or use district in which premises are situated ..... 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? ....... 13. Name of Owner of prem se~ff~ ~Zffb/Z~ff~ ddress ~; ' .~ ,L ~ ........... ~ ... ~ ~. ....................... Phone No. Name of Architect .................................................... Address ................................................ Phone No. Name of Contracto~'~c,¢.~.~,~.v.~.~:.~.,~,~Z.~.~$~i Address ~.~..~,~ ................ Phone Noc~,..~: .... ~LOT DIAGRAM koc~.te clearly and distinctly ati buildings, whether existing or proposed, and indicate all set-back dimensions property ines. Give street and block numbers or d~ription .according to deed, and show street names and whether i~terior or corner at. ............... ~..' ,--~ ........ _~_ STATE ON NEW,/Yg~,!~,,Zo, ) COUNTY 'OF~..;~/~.~......) S.S. ........ ~.~.~ ....... ~I~.~.1.~ ............................. being duly sworn, deposes and says that he is the ('Name of individual signing application) above na ed. He is the ...~~ ................................................................................................................. (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 application; that. all statement.s contained in this application are true to the best of his knowledge and belief; that the work will be performed in the manner set forth in the application filed therewith. Sworn to~re me this ............ of ....... ' 'Y j ~'~ '"'; .... fifth ~ Pub c, State of Ne~ ~' ~oumy applicant) ~JO 52-0344963, Suffolk County (~lhu/ssion Exbires March 30, 19~x3'~'