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Home My WebLink About2101-zFOi~M NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No..2~..2,.010 ............ Date ............................. O~t;G~e.~......2,~,,, 19..6~. THiS CERTIFIES that the building located at ..~le~t,~qail..i.a...~e~d ................................Street Map No...;X:x;X ............ Block No..:X;Y~ .............. Lot No...y,~ ........ ~.~..:~:~k.,~....~¥., ................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................... ~t~AL~. ...... ~. ......... , ]9~... pursuant to which Building Permit No. 2,10~L..~. doted .............................. ~Tl$5'le. ...... .2~k...., 19.~,~.., was issued, and conforms to ~11 ~ the requirements of the ~pplicable provisions o~FO~ea~law. The occuponcy for which this certificate is issued is ........ ... P.r. iv. at e...or~e...t;amily.., clwel 1.:trig .............................................................................................. The certificate is issued to ..~'~.eC~..&..C~.~!~]b~...~]~.~[9~. ................................................................ [owner, lessee or tenant) of the aforesaid building. Building inspector ~ FOI~I NO. 2 TOWN OF SOUTHOLD 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) N9 21Ol, Z Date .................. ~T~e.*...~, .................... 19.6.~.. Permission is hereby granted to: ..... Ft~e~el, ,I.0 k.. ~..~ e~o.Z.e~...~r..t~. ............. ................... ,~.t. tl.t,~e,~ ....................................... to ....... Bu~.ld.. ~te:,~.. ~e...~.'e.~11~ ..~e3.:Lt~-~g ................................................................................ at premises located at .-~/'~.'...~'~eS~;.~Ph'~*'~'~-'~'"~' ............................................................................... .................................................. ~.~ ~.t,t.~uc]~ t .....~, ~ ~ ........................................................................ pursuant to application doted ............................... e~p.******~)~ .............. ~9,C~**, and approved by the 13uilding Inspector Fee $ ~.0.,~ '00 ........... t~uualng inspecto~ TOWN OF SOUTHOLD I~UILDING DEPARTMENT~..~,_.,~.~ ~L~ .~3 ,¢5\x~ TOWN CLERK'S OFFICE ~, SOUTHOLD, N. ~ [x~minoO ....... ~ ......... ~...&~....., 19..~.~. Applicotlon Mo. ~1 ~..[ .......... Approve~..~u.~. ......................... ~ ....... Porto ~.I...D...~ .......... Disapproved o/c ........... ~;"> ............ ~U~,.~i~~~. - .............. ~..~.....~ .... ........... ............................................... ~' ~s~-~.,C~ ..... YX 5 ,b ~'~ APPLICATION FOR BUILDING P~F~ ,(~ ,~'~% Date ..q~:Z,;..;~....~.~/ ............................ , ]9.~ ......... a. ~his application mu~,-.b~l~n by typewriter or i~ ~d submitt~n duplicate to the Building b. Plot plan showing location of lot and of buildings on p remises, relationship to adjoining premises or public streets or areas, and giving a detailed description o{ layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application m~ not be corn menced before issuance of ~uilding Permit. d. Upon approval of this application, the Building Inspector will permit shall be kept on the premises available for inspection e. No building shall be occupied or used in whole or in pa rt for ar, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department Building Zone Ordinance of the Town of Southold, Suffolk County, Regulations, for the construction of buildings, additions or a The applicant agrees to comply with all applicable laws, the issuance of aluilding Permit other I~pplicable Laws, York, and , or for remova~6~ lition, as herein nd regulations. ' (Addr, Such State whether applicant is owner, lessee, agent, architect, Name of owner of premises ..... ,~.;a,,.,:.,.~.cz..c,~e:i.f/,-..:....,~:~ ,..~.~...,.~.¢~-.... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number ...................................................... ';~"":'7"';:: ....................... ~"'~'~q~'"'~';~"~-¢~',~%'~'" ii~umc~peury State existing use and occupancy oi~ premises and intended use and occ.¢z~D~oposed construction: b. Intended use and occupancy ..... . .~,/~.~-. ,. ,. .,4 .~....,,/t',. ..... ; ..~,..~.,'...~. ~ .~.'.~.;~ ..... ,~ ~./ ~.'~,~--,.x× \ 3. Nature of work (check which applicable): New Building ...... .~..... ..... Addition .................. Alteration .............. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ Estimated 4. Cost ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............/. ................. Number of dwelling units on each floor ..... If garage, number of cars .......................................................................................................................................... 6. If business, commercial or mixed occupancy, specify natureand extent of each type of use ............................. 7. Dimensions of existing structures, if any: Front ........ F.Z..../: ......... Re.ar ...z.~.. ........... Depth ...~ ............ Height ............................ Number of Stories ............~../ ................. ~z.¥~)?'O''-'' .................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ............................. Depth ............................ Height ................................ Number of Stories ........................................ 8. Dimensions of entire new construction: Front .............. .'~..../'/... ........ Rear ........... ..'~....~... ...... Depth ...... ~...~.. ..... 1 T. o us al'strict in which prem scs ore s tuated ....................................... 12. Does proposed construction violate any zonina law, ~)rdinonce Or reaulation...,~,r~.-~2 .................................... L.ocat~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fromm property lilies. Give street and block numbers or description according to deed, and show street names and indic6t~ whether interior ~r corner lot. STATE OF' NEW YrOR,[(¢¢ ,/2 ) ~ ~ COUNTY ,OF .~..) b'~' (Name of individ(,~l signing application) above nam, ed. He is the .... ~;~..~4..~. ........................................................................................................................... ~ (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 o.pplicbtion; that all statements c~,j~n[d~j~'his application are true to the best of his knowledge and bell and that t~e work will be perfor~ly il~b~lb, est~t~a~tli"~ ~?~ forth in the application filed therewith. Sworn ....................... T day of ......................., 19 ........ ~~ ~ ) ....... ...... .................................... Notary Pubmic,~.~...~~ ...... ~~ (Signot~ of applicant) TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......Q~' ~:...-'a~....%..~..~....., 19.~.~.. Approved .............................~// ~.~ ......... , 19...'.:...Permit No...~......~....!....D...J ........... Disapproved a/c ........ ~~~~.... Application No...L~.'~...!...~?..I'. .......... 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 o detailed description of layout of property must bedrown on thediagrom 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 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 Inspectgr. 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, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ...... ~ ~-('~ .~. ~. ,~ ~ .~r .~.n~ t ........................................ (Signature o appliOht, or name, if a corporation) ...... (Address ot~ applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... ..................................................................................................................................................................... Name of owner of premises ....... ~z,oo.c~.. &,. If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Loc.arian of land on which proposed work will be done. Map No: ............ : ............................... Lot No: .................... Street and Number ....................................................................................................................................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and b. ~ntended 3. Nature of work (check which applicable): New Building ...... ..~...] ...... Addition .................. Alteration .............. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ (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 ......................................................................................................... Dim. ensions of same structure with alterations or additions: Front ................................Rear ............................ Dep'th ............................ Height ................................ Number of Stories ........................................ 8. Dimensions of entire new construction: Front ....... ..W..z.,/. .................. Rear ...... ..zT(..Z ............... Depth .....':~....%~.. ............ Height ............................ Number of Stories ...... c1~ ............ 10. Dot? of Purchase ..................... ~..~.~.....~:.~ ...... Name of Former Owner .....~.%.'..~~ .................... 11. Zon'e or use district in which premises are situated ....... ii~/~.''. ............................................................................. 12. Doeb proposed construction violate any zoning law, ordinance or regulation? ...... ~ ................................... 13. Name of Owner of premises'~ ~'~-- "~--- ,~..~.....C:f....'..~..C...~..:..~.. ........... Address ............................................ Phone No ................ Name of Architect ...................................................... Address ............................................ Phone No ................. Nome of Contractor ...... /.¢.. ~ ..................... Address ........~7...'.~..~f .......................... Phone No ................. -~ ~ ! PLOT DIAGRA,M L(~cot9 clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr~ property Jibes. Give street and block numbers or description according to deed, and shaw street names and indic~ whether interior or corner lot. STATE OF NEW YORK, ) COUNTY OF ............................ ) S,S. ......................................... : ....................................................... being duly sworn, deposes and says that he is the applicc (Name of individual signing application) above named. He is the ..................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owher or owners, and is duly authorized to perform or have performed the said work and to make and t this applicbtion; that all statements contained in this application are true to the best of his knowledge and bell and that t~e work will be performed in ~he manner set forth in the application filed therewith. Sworn to b~efore me this ........................ day of ............................................... 19 ........ . ................. ..~...i.~ ..~..ii .............................................................. Notary Public, . ........................................................... County (Signature of applicant)