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Home My WebLink About2112-zFOEW[ NO. 4 TOWN OF SOUTHOLD BUILDIFIG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ~...1~.~.8 .............. Dote ............... Dene~lbe~.....1,~ ........... , 19.. THIS CERTIFIES that the building located at ...~./.l~...TY. 8,Ctk..~.~.e ................................... Street Map No~.,.Hall~.... Block No ..... XY~. .......... Lot No..%.~-.&...pt...~+.! .......... Cl~tchog. Lte .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................................ ~.I~L~.,...~'. ........ , 19.63_ pursuant to which Building Permit No.~..~,~.. dated ................................... JU:l.y'...~ ...... , 19..0~., 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~.l.v. ate.,,~z.~..~',~m~,~L~F..,~.~l~n~ ..................................................................................... The certificate is issued to ..,J~u~le.$..&..0hrte.ttne.,AL~er. ia. ................... f~:~m.e:c.s. ................... (owner, lessee or tenont) of the aforesaid building. H.D. Approval Dee. 10, 1963 by R~ Villa Building Inspector FOI~M 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) N? 2112, Z Date ............................. ,~tt~'y..... ~ ............ 19.63.. Permission is hereby granted to: Je~,~s...A~.~e~[.~. ,&..W.~.ff' e ...................................... ..... ~o-~..~0~.7. ....................................................... ............. ~u.tehog.ue .............................................. to .bu. it~...~W...o~...f a~..].y. · ~w~t.~.inff ...................................................................................... at premises located at ..... .~,....~..,'~...~¢-..~1, ............ ~.~.~I{~ ...................................................... .................................... ,~/.~.....~ek..A~.e~ .......... :.(~teho~ ...................................................... pursuant to application doted ............................. ~,f~.....~ .................. lC~3...., and approved by the Building Inspector Fee $"~0~)(~ .......... Building Inspector S-9 SUFFOLK COUNTY DEPARTI~ OF HEALTH DEC ! 0 Date Building Permit No., 2112Z TO WHOM IT MAY CONCERN: The sewage dispesal facilities for a structure located at ~rac!c ~yenue~ ~cho~u.e ....... ' ' (GiVe deed location) '' have~oeen inspected by this Department and found to be satisfactory. istrmct Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ....~L...~.. ......... , Disapproved~~ ............... Application No..~....L.J....~... .......... 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 adioining 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 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 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 or alterations, or for removal or demolition, as herein described. Tl~e applicant agrees to comply with all applicable laws, ordinances and regulations. /~/(Sign,ature of ~n~, or name, if o corporation) ........ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................... ..0..~..~.~?. .......................................................................................................................................................... Name of owner of premises . .(,~...~...~..~:.'4 ....... .c~.~.~. .... .~..~.~.~.~.D,..~, ........ .qj...~..~...c% ........................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~,~c~_Q o-(] ~9~z,,c_,u3~r, ~-:~ 8~Z~ 1. Location of land on which proposed work will be done. Mop No:~ ~.,.[~.~ot o:~ .................. Street o~d ~umbe~ ...~.~.~....~5.~.~-.~.~.r~ ....................................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. ...... ........ ........... ........................................... ..... .................. 3. Nature of work (check which applicable): New Building ....... ..V........ Addition .................. Alteration Repair .................... Removal .................... Demolition .................... Other Work !Describe) ........................ 4. Estimated Cost ...~.~..~'....~...~...t'2 ..................................... Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units .............................. Number of dwelling units on each floor ........ If g~rage, number of cars ...~..M~/.~ ....... 6. If business, commercial or mixed occupancy, specify nature,end extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front .......................... Rear .......................... Depth Height Dimensions of same structure with alterations or additiofis: Front ................................ Rear Dep,th ............................ Height ................................ Number of Stories ........................................ 8. Dimensions of entire new construction: ?ront.....~..~....:~ ...... Rear .~,,.~,.,,.~.~,,~ .... Depth Height ............................ Number of Stories .................................. 10. Date of Purchase~.....~..~..~.C~.,~....~. ................. Name of Former Owner :...Co 12. Doe? proposed construction violate any zoning law, ordinance or regulation? .....~..?.. ................................. 13. Name of Owner of premises ..~..~...~).....~..~....~...~.q..~..~..i..~.Address ...Cz...~.~.C.~..~...°...~....~-..,,~.. ............ Phone No. Name of Architect ...................................................... Address ............................................ Phone No. Name of Contractor .................................................... Address ............................................ Phone No. PLOT DIAGRAM L.ocat9 clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimension: property lines. Give street and block numbers or description according to deed, and show street names and whether in~erior~ or corner lot. __~-~/'//"~='/~/~f~ j ~E Pal?eh COUNTY ,OF ............................ ) ' ' ,.. ~p-~:~.. ~ ............................................ being duly swom, deposes and says that he is the opplic¢ f/'P>J' (N,ame ;o,~.~Jividual signing application) above named. He'- is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to oerform or have performed the said work and to make and f this application; that all statements contained in tl~is application are true to the best of his knowledge and bell and that the work will be perforM~f~,,[~,¢~,9 ~'~,,gp, R~r set forth in the application filed therewith. Sworn~t° bbfore me this/Al ~ ///~ '. '~,, ':' ,',~/7~!