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Home My WebLink About2094-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..~...~,.~...e,,t,..~...O..O...~.....~...~.~.,~...~....,~..O...8:..~. ................. Street Map No...~ ............. Block No....~ ........... Lot No. ~ ....... .~.~.O...h..O~..~..e..k..~..*.~?. .................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................. ~r~.il ......... ~.~ .......... , 19~... pursuant to which Building Permit No.....~.~Q..~..~.. dated ........................... ~.lllle.....~,~. ......... , 19..63.., 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 ........ .......... P.~&~at e...on~.. £~mily...dwelling ...................................................................................... The certificate is issued to ....~.~.~.~..~.~..~ .................... ~.~ .......................................... (owner, lessee or tenant) of the aforesaid building. H.D. Approval October 11~ 1963 FOEI~ NO. 2 TOWN OF ~OUTHOLD BUILDING DEPARTMENT TOW. N CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2094' Z Date .................. Z'~e.-.-t,9. .................... ~9~,3'" Permission is hereby granted to: ~dr er.. ~ulZe~.. Contrac.~ln~ ....... J~.C....~;~hen ~ta~ahan ............... H,l. lt t-e~--~'.laoe ..................................... to · ~Bai3~ .. ~e~...~ae...~. e~mt~'...eh~e ~..~ .................................................................................... at premises located at ....~e.t~t~oOd...I~.~..&..~]~,~..~O~[. ............................................................... .......................................... Fle.et;~..~eek~.....C.~.t~ho~e ............................................................... pursuant to application dated .......................... U.....~,',..~......,~,~ .......... t9.~,~..., and approved by the Building Inspector Fee $~-~0 ~ O0 ............ s-9 SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Building Permit No. TO WHOM IT MAY CONb~RN: The sewage disposal facilities for a structure located at " y ~ ~ .I --- , have been inspected by this Department and found to be satisfactory. DistriQt Emg,i=e~l District Engineer FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19.....l..Permit No.. F Disapproved a/c ............................ APPLICATION FOR BUILDING 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 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 thi.~ applica- tion. c. The work covered by this application raCy 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 po 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 name, if a. corporation) ....................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............... g .~r~ ~. ~.~,... ~.o~q .~.~. ~.o..~.o.~. .................................................................................................................................... Name of owner of premises ...~;.~.e~L~f~,..}~e,~.~b.e~.~...~..O~'t~:ha~e.d..~l.~m.~...~o~db.uz0.~r.,..N..,...~.,. ...................... If applicant is a corporate, signature of duly authorized officer. ................................................................................. ~.~,.... Andrew Nulle~ Oont~act~g Co~p, (Nome and title of corporate officer) 1. Loc~tion of land on which proposed work will be done. Map No.: ........................................ Lot No.: ...................... Street and Number ~..~.~...~...~.~.~..~.e...~..~8~..~..~.~.~D.~...~.~.~ ............. Municipality 2. State existing use and occupancy o~ premises and intended use and occupancy o~ proposed construction. o. ~isting use and occupancy ................ .~.~.~.~..~ ...................................................................................... b. Intended use and occupancy .....0~...~.~.~..~0~. .............................................................................. 3. Nature of work (check which applicable): New Buildlng ..'~ ............... Addition .................. Alteration ............. Repair .................. Remova! .................. Demolition .................. Other Work (Describe) .................. (to be paid on filing this application) 5. If d~'e ing, number of dwelling units ................................ Number of dwelling units on each floor ....................... If g6rage, number of cars ....... ~....~;~.?. .................................................................................................................... 6. If business, 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 ........................................................................................................... Dim~ensions of same structure with alterations or additions: Front ...... ~ ..................... Rear ........................... Dept~h ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ..... .5.5 .................... Rear ...J5.5.l. ................... Depth .....~4~.t. ............. 10. Date of Purchase .......................................................... Name of Former Owner ................................................... 1 1. Zon9 or use district in which premises are situated .............................. ' .................................................................. 12. Does proposed construction violate any zoning ]aw, ordinance or regulation? ...l'za ................................................. Nar~e of Architect .................................................... Address ................................................ Phone No .............. PLOT DIAGRAM Locate clearly and distinctly a]J buildings, whether existing or proposed, ond indicate all set-back dimensions f property lines. Give street and block numbers or description .according to deed, and show street names and indi~ whether i~terior or corner lot. STATE O~ NEW YORK, ) COUNTY jOF$.U~.£~)&k ............. ) 5.5. .............. ~k'~'~,~.~Yt...~[L.~' ........................................... ~ ....... being duly sworn, deposes and sbys that he is the applic( (Name of individual signihg application) above named. He is the ....... g.a~.~,.~c~ ........................... (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 statements 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 t,o/~.,~.~me this ........... ........... .................. y q' f~~~~ 'g pp' . ) j No. 5~-75~7250; Suffolk County Commission Expires March ~0,196~j