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Home My WebLink About2083-zI~OP~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ....]~X...~.±e~...A~.e ..................................... Street ~.e...~..s.....~...a..~.....g..si~lock No ...... ~ ....... Lot No..123..~%2.tl conforms substantially to the Application for Building Permit heretofore filed in this office dated ......................................... ~.tt~e ....... 6....., 19..~.~. pursuant to which Building Permit No...~2Q~3.. dated .................................. ~T.l~tl~......~......., 19..~.~..., was issued, end conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ...~i.~at,.e...o. ae...fe.~:tl~...d.v..e~li=g .............................................................................................. The certificate is issued to ....~O.~)D~.~...[~L~.d~t3~ ..................................... ~.e.~. ................................. (owner, lessee or tenant) of the aforesaid building. H.D~ approval Sept. 27t 1963 by' R. Villa ............. F '' ..... ............... FOI~M NO. ~ 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) No. 2083, Z Date ............................ ;T~ ....... .~?~...t.9639 ........ Permission is hereby granted to: Chet...0~.1~ ~k.l.....A/C. Robe.~.t ...H~.de~. ............. ......... C.u.~chog=e ................................................. to....~ui.ld...n~...o~e .. ~.~tl.~ .. d.~ e.1 ~ ~ng. ................................................................................. at premises located at ....,T~'~....]~.3...&...~. LV..~.~t.~L~.,.~..~/¢..~,~ .............................................. ................................................. .~as~...~. i~z~.....~.. X. .................................................................... pursuant to application dated ................................. ,~1't~T~e.....~ .............. 19.6.~.., and approved by the Building Inspector Fee $.. lO~,.C).O. ......... · v- Building Inspector ~ .......... FOI~VI NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE: OF OCCUPANCY THIS CERTIFIES that the building located at ....]]a¥...~.le~...Jkv. e ..................... Street ~/~.~...~.~....~.~¥....~?~lock No ...... ~ ....... Lot No..~3..~14~.~ .......... conforms substantially to the Applicotion for Building Permit heretofore filed in this office dated ......................................... ~.U~ ....... ~....., 19..~.3. pursuant to which Building Permit No...~2~3.. dated .................................. .,T..~rl~......~......, 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 ........ ...~i.~at.e .. one...£a',~i.lY....d .~.e 11 ;tng ............................................................................................... The certificate is issued to ...~[nbe~...t..,~J~.~.~:~ ..................................... 0...'t~. 9.~. ................................. (owner, lessee or tenant) of the aforesaid building. H.D. approval ~qept. 27, 1963 by R. Villa .............. /..z~z..z~:.z ............... i. ........ :.4 ................ ~ Building Inspector ~ 1~1~[ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... ~--')~' ' ~' ~....-";~....~....., 7...., 19.~.-<.?. Approved ............................. ...... , No. ....................... ii ;ii ii;; ..................... APPLICATION FOR BUILDING PERMIT Date .......................................... , 19-.~.~ 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 mczy not be commenced before issuance of Building Permit. d. Upon a.pproval 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 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 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, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or name, if cz corporation) .................... ....................... (Addr~s_,~ of applicant) Name of owner of premises ........ ~..~.../~...~.~..~..~... ..................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ... No' 1. Location of land on which proposed work will be done. Map No.: ..~..... Lot ../.' ............... y.. Street and Number ................ ...... ..~.~.. ......... ~..~ ................................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. b. Intended use and occupancy ~ ~...~?..~.....~,..~.~t~, 3. Nature of work (check which applicable): New Building ...... Z ......... Addition .................. Alteration ................ R~,pa~r .................. Removal .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost .......~...~../..~ ................................... Fee ........ /.. ........................................................................... (to be paid on filing this application) 5, If dwe?ing, number of dwelling units ........... ~ ................... Number of dwelling units on each floor ........................... If garc~ge, number of cars ........................................................................................................................................... 6. If bus,ness, commercial er mixed occupancy, specify nature and extent of each type ef use 7. Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth ............................. Helghtl ............................ Number of Stories ............................................................................................................... DimenSions of same structure with alterations or additions: Front ................................ Rear ............................... Depth i ............................... Height ................................ Number of Stories ................................ 8. DimenSions of entire new construction: Front ....... ...~.~,¢ ............ Rear ..... ~......~r~... .............. Depth ...~........'~'.. ............... / Height' . .......... /..~. .......... Number of Stories .......... ~ ........... 9. S ze of at Front ..~..~. ,.. Rear .~..~..~ .~..3 Depth /~., .~...~...~..../...~¢...,~:~..... 10. Date o~F Purchase ..................................... .--.. .................. Na,me of Former Owner ...-. .................................................. 11. Zone cjr use district in which premises are situated ...... ~-~.~ . 12. 'I ' ' ~ , r..t~eg .... ~.. .................................................. Does proposed construction violate any zomna Jaw etd nonce or u at on~ -- 13. Name bf Owner of prem'ses ~..~ J.~.~ Address ~, /"' ~ ..... , ,-, ,~ ...._. .............. .~ .............. /~...,. · .~..~-._~__.: ........ ,~ .......... mane tx~o ................ Name ]of Architect ...... .f,,~....~..L~..~?. ............ Address ...~...~../~.~...~:.~..:.. Phone No ................. Name "of Contractor ..~...~.'. ..... Address ..~....~..'./~.. Phone PLOT DIAGRAM Locate .clearly and distinctly el/ buildings, whether existing or proposed, and indicate all set-back dimensions fret property lin~s. Give street and block numbers or description ~:ccording to deed, and show street names and indicat whether int?ior or corner lot. STATE OF ~EW h~ORl,,(,/ ,~,~ ) SS ............... ~...~ ......................... being duly sworn, deposes and says that he is the opplicam (Name of individua! signing application) above named He sthe ..~_o~ ~,, (Contractor, agent, corporate officer, etc.) .................. of said owne~ Or owners, and s du y authorized to perform or have performed the said work and to make and file this]l application; 'that all statements contained in this application are true to the best of h s knowledge a:nd belief; andll that the war, will be performed in the manner set forth in the application filed therew th. Sworn ta me this Notary Publi~: York (Signature of applica,nt)