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Home My WebLink About2114-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...7,....~,.0.~.0.. ............ Dote ............................... C~.~1~e~...29., 19.6.~.. THIS CERTIFIES that the building located at ....... ~.J~...J~e¢~te,y../~,~e ................................ Street Map NoT.°..~..~..~..°.~... Black No ...... ~X~ ........... Lot NO..J~).'['l~.~. ......... ~l..t.t~..t~.lJ~.T~,...N.e.~', ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................ ~[e~ll. ......... -~,'[, ........ 19~.]... pursuant to which Building Permit No. ~[.~1.~...~. dated ......................... ,TX;[.~.~ ......... ~ .......... 19.~.., 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 ........ ...... Lz,..~:.~r~ ~..e.....o.~?.,....r...~.t...z.~....(.~..~?.~ :~: .t. ~.~ ........................................................................................... The certificate is issued to ..~T.o. 3~.)'~.'g...~,.oz~lf). ........................ (~'tf~'. ............................................... (owner, lessee or tenant) of the aforesaid building. 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.° 2114, Z Permission is hereby granted to: ....... ~-~t~.~ ~...~%i1.~ .......................................... to '"'~Qi~'"~"~'~dt'~i'~fi'"~"~'~"~J~i'~'i~i~'"~9'~'II'~ii~ ..................................................... at premises located ot~L.6;¢...6~...&...6~...,]iSl~.f~i]. ........................................................................ ............................................ ~ay"t~'½'"":~tt'Ituek ................................................................. pursuant to application dated ............................... ;.....~,~L~.(~....~]......19.~..., and approved by the Building Inspector Fee $..~i. 00 ............ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........,r .~::: ~.:i ...... ~......, 19..'~. Approved ..................... !..! ............... , 19..::....Permit No. ~.:.~....I..L..~./ ....... Disapproved a/c ................. ::~, .~.~.~....~ ............. .~.~-~....../. ................... .............. App,cotion !. 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 be drown on the diagram which is part of this opplica- tion. c. The work covered by this application m~y not Re commenced before issuance of Building Permit-. d. Up6n o,pprovol of this application, the Building' Inspector will issue o Building Permit to the opplioo,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 a Building Permit pursuant t6"the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other a'pplicoble Lows, 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. of a~licant, or name, if a corporation)' (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, p]umber or builder. Name of owner of premises ~/' o~ ~'?'~ ,~ ~ '~ "~ ~ If applicant is o corporate, signature of duly authorized officer. (Nome and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ..... ./...~..?. ......................... Lot No.: ...~...~.....~....~....~.~ Street and Number ......... .?~.....C~...~t.):'.. ....... ..x~....~'...~....,~..~ ~ .................. ...,~...~..~..7.?..~...~.Z....T?..~..~.~.....~.~-~....~.~.~..~.~.~. 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 .............................................................. .~. ................. 3. Nat6re of work (check which applicable): New Building .................... Addition ...~ ....... Alteration ............ Repair ................. ;~emova! .................. Demolition .................. ~,ther Work (Describe) .................. 4. Estir~ated Cost ........~-.....~....~..-.'t...~...?. ................................ Fee ....~ ~ ~ (to be paid on filing this application) ~'5, If dwelling, number of dwelling units ........ ?,~.P:~,~.~,__ Number of dwelling units on each floor ....................... If garage, number of cars ..... '..~..g....-;~,..~..~ ........................................................................................................ b~6. If b?siness, commercial or mixed occupancy, specify nature ,and extent of each type of use ...]..~..,.-~..¥~...(:. .......... t,/7. Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth Hei[Tht ............................ Number of Stories ............ /.......c~;.../.-~._ff...~..7. .................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ........................... Depth ................................ Height ................................ Number of Stories ................................ .......... i..:;.:i ............ ' ' L,-"8. Dimensions of entire new construction: Front ].t, Rear ...... ,,~.: .................... Depth ......................... Height //__2 z Number of Stories b-9. S~ze~of lot: Front .............................. Rear .................................. Depth .............................. baa. Date; of Purchase .......................................................... Ne,m~ of Former Owner ................................................... t-11. Zone or use district in which premises are situated ................................................................................................ 12. Does proposed construct on v o ate any zen ng aw, ordnance or regulation~ ~ . , ~, .~ ' .............. ~-u'~-~'~>~Z~"~' ............ 13. Name of Owner of premises ..~.~.~...e...l~..k....!~.~...L~..~'.?..?Address/...~..~.:.t.?.......~.~/.~:?.~..~..c. ........... Phone No, .~.~..~.~...~...~ Name of Architect .................... v~ .............................. Address .......... Phone No. ~- fill '~ ;~ .................................. Name of Contractor ...... ?..~.~ ............................ Address ~:~' ~ , Phone No .............. PLOT DIAGRAM Loaa~e clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-back dimensions f( property lines. Give street and block numbers or description ,according to deed, and show street names and indid whether interior or corner lot. po, ¢t STATE OF NEV~,~OR, K/ ~ ) S ° COUNTY [DJ: .,,~d~/,~..) '~' ........... ... '~~~ ....... ~').~..~..~....'):~...~ ............. being duly sworn deposes and says that he s the appl cc //' (,~ame of ~J~dividua] signing application) , a~bove nka~m~d. He is the ........ .~..~~ .Z~.. ~..~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 ti application; that all statement,s contained in this application are true to the best of his knowledge and belief; a~ that the work will be performed in the manner set forth Jn the application flied therewith. Sworn to b~efore me this ,~, ,~ ................. h '~... ......... , ......................... , 19.....~/. % .................. Notary Pulplic ..,~lr~.-~..~-./,,Z,~........¢'~.o.C~-.~t~'~El~f~,'~r,~ (Signature of applicant) I ,5/ No. 52'0344963 Soffolk Ommtvv _ mmsflion EXl)lres March 30, FO~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Examined ........ ; ...... 19 ~g Approved ..................................... 19,,~J....Permit No. ~..~.:...~..:...., ....... (Building Inspe~or) APPLICATION FOR BUI~.DING PERMIT 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 drown 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 applico:nt. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shah 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 MAiDE 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 atl applicable laws, ordinances and regulations. ..................................... ~' (Signature of applicant, or name, if a. corporation) State whetheh applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....~....o...~...~..~..// ....... ..~..?....v?.....~...~....q ............................................................................................... 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.: / ._s Lot No.: .~..'.~..~...d.,..~.. Street and Number ............... 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 3. Natk~re of work (check which applicable): New Building .................... Addition.... ...... ~........ Alteration Rep{]ir .................. Removal ......~ ........... Demolition .................. Other Work (Describe) .................. 4. Estir~ated Cost ........ ~.....~.:...~..;...~...?. ............................... Fee ~ ~ o (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 ........... t.i!..V...%<..3~.~: .................................................. 6. If b?siness, commercial or mixed occupa'ncy, specify nature .and extent of each type of use 7. Dimensions of existing structures, if any: Front Rear Depth Heiiht ............................ Number of Stories .........../......~...:..~.¢...~../¥. Dirdensions of same structure with alterations or additions: Front ................................ Rear Depth ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .......... ~../¢ ............. Rear ........... '~..~: ............ Depth / c/ Height ............ /.~, .............. Number of Stories ............/. ................. 9. Sizelot lot: Front .............................. Rear .................................. Depth .............................. 10. Data of Purchase .......................................................... Ne,me of Former Owner .......... 1 1. Zon.~ or use district in which premises are situated. 12. Doe~ proposed construction viol.ate any zoning law, ordinance or regulation? ~ o 13. Name of Owner of premises .~..e.~?.?.~......~.~...~f..~...~...~.. Address/.?..f.Z/...3'..f/~/..~..~....~.~.~.e ............... Phone Nam, eof Architect ....................... t , ~ /J~ ........................... Address ................................................ Phone No. NanSe of Contractor ................... ..~,.~. ...................... Address ....... ~.~.~..?.?j.~...~.. ................... Phone No. ' PLOT DIAGRAM Loc.ate clearly and distinctly ali buildings, whether existing or proposed, and 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 Dterior or corner lot,: STATE OF NEV~f"YO~tJ,¢~, ~/ ) c c COUNTY,CgF .',~¥~7....;¢'.'~..¢.:.%~....) ~¢' ........... ~..~-.%; ............... 7~ ......... ; ......... ; ................. ;..being duly sworn, deposes and s~ys th6t he is the ~me ¢~[ndividuol signing opplicotion~ . (Contrmctor, regent, corpormte officer, etc.) of staid owner or owners, rand is duly muthorized to perform or hmve performed the staid worA mhd to mmke mhd fil~ mpplicmtion; tNmt mil stm~ements contmined in this ~pplicmtion rare true ~o the best of his knowledge ~nd belief; thmt ~he work will be performed in the mmnBer set forth in the mpplicmtion flied therewffN. Sworn to b~ore me this ................. .............................. Notary Public .~~~~~ (Signature of applico.nt) I ~ I~o, u2-(~344963, Suffolk 6ounty ~ ' I Commmsmn Expires March