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Home My WebLink About2128-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No, ~.,.~,~..,0.~. ............. Date .................. ,0,~.~.q]0,~.~..,..~,. ............. , 19..~.,.~,. THIS CERTIFIES that the building located at .~,/~.,..,~a~oD,.,I)~:i.v.e ................... Street Map No....~/[~0~ ...... Block No .....~ .......... Lot No..,.~CX ..........O~l;e,~O~l~ .......................... conforms substantially to the Application for Building Permit heretofore filed in this office doted .................................................. ~.1~,~',..~6 19..6~,. pursuant to which Building Permit No. dated ............................... ~T~1~,...26.-..., 19~3,.,, wes issued, and conforms to all of the requirements of the applicable provisions of the law, The occupancy for which this certificate is issued is ........ ......... ~.;%.v.~.~e...one..~:~ml,~...dwe. l,Iir~ ....................................................................................... The certificate is issued to .--O~o.~.~e,.~h~ie~e~ ..................... 0~ne~ ......................................... (owner, essee or tenant) of the aforesaid building. Building Inspector FORM 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? 2128, Z Date ........................... ~...:. ~.~) ............ 19..6,~. Permission is hereby granted to: ........ a~o~.l~e..&..~,~t,l~e~$ne..~e~e~e~. .... ..................... P~on..~.~.~re ................................. ................................. ~u~hague .......................... to ...... B*~a~3.4~,. ~ · .~tJL. t.~n.. ~ · .~..e~t,~. · · ~e~.~ .................................................... at premises located at ~/~.....~L-~O~..D~'~.'9~ ...................................................................................... ...................................................... b'~e~og.u~.... IC.X. ..................................................................... pursuant to application dated .................................. ~.~.~.....~ .......... 19i~i,3..., and approved by the Building Inspector Fee $..~i',.()O. ............ Building Inspector (r ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ................................ , 19 ........ ,, Approved ...................................... ~, t 9 ........ Permit No ................................. Disapproved a/c ........... .C. mC' .:~.~ ::'"":'zz, ............. Application No. ~ I '~" ~ APPLICATION FOR BUILDING PERMIT · o,e ....................... ........ ......... 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 an 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 alterat!.o.~, or for rem/c~l o..r demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinpq~s and re.g.~fat/foo~./~ ~ . .............................. t . (Si~tur/e of/applic.~pt, or name, if ct corBorotion) .......... iX;~;;;~';?"~;~'~'l'i'~;;~i .................. ~ ..... State whether~,~)3plicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of ,emises ~ Z~6- '' ~ ' O~G~ -- If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ' Z/J~ - ~/ ' '~ I. Location of land on which pr, DeBased work wifl,~e done. Mop No: ~ ........ ~.~d~...~X~ot No: ....... ~ ........ MunicipaJity State existing use and occupancy of pr~s and intended use and occupancy of proposed construction: ..d .......... .......................................................................... b. Intended use and occupancy ........ ~. ~.~)..~. ............................................................................. JA 3. Nature of work (check which applicable): New Building .................. Addition .................. Iteration .............. Repair .................... P~moval .................... Demolition .................... Other Work (Describe) ........................ 4. Esti~nated Cost ....... .~.. ~.....~...~...~.. ................................... Fee ....~.~ ........................................................................ ' , , (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 ~,~xi~ting structures, if any: Front ........ ..~...~...~. ....... Rear .,...~.../..'. ............ Depth ....~.....~....~. ............ /2 / Height ............................ Number of Stories .................................................... Dim~ensions of same struc~ture with alterations or additions: Front .......... ..?...~.....~... ..... Rear ...... ..'~.....~.........~......J... Depth ......~...~....~'..?/...'.~..~-~ Height ........ ./...~...C..: ............. Numbs' of Stories Z 8. Dimensions of anti,re new construct,ion: Front ......... /~.~]~.....~'...].. Rear ......... Height ....... ./..~.. ............. Nu~m~ber of Stories ......... ~, . , ,/ ............. ~ ....... l'" Size of lot: Front ....... ,~, .~...~..C....~.. ...... Rear; ........ ~.~;...','.'..i'.~.'.'."~pth ....... / .~..' .~......~,..'~..g.~,C ~r~ Date of Purchase ~...~...~..,....~...~ ....... ./.~..~].~.. ........... Nam,~ of Former Owner~....--'~......~...~.....'~....~.........~...~....~.~ Zon~e or use district in which premises are situated ..~..q~-.~//__,)~,/./?..~....~. Doe's proposed cpnsh'uction v~lat,,el ony~-z~;~ing law NonCe of Owne~f ~m/se, ........................................ ~ddres~.A~.-...~....~, ........... , ......... Phone N .~'.'~.'.~. ........... 10. 11. 12, 13. Name of Architect ...................................................... Address ............................................ Phone No ............... Name of Contractor .,0.~..r~... .... .~...~........~.. ........... Addr ,:~.. ..~..~....~..O...6]. Phone N ........... ! PLOT DIAGRA,M Locate clearly and distinctly ail buildings, whether existing or proposed, and indicate oil set-b~ck dimensions fr~tm property lihes. Give street and block numbers or description according to deed, and show street names and indic te whether interior~or corner lot. ~./'~*( ~//~-~ STATE OF NEW ~6R)/-/',,~ ) c c COUNTY OF y~~...) ~'~' ............. ~.....~.. ...... ~"~..~ ............................ being duly sworn, deposes ~nd says that he is the applic~ ~ (N~e ~ individual signing ~pplication) above na~ed, He is the ......... ~ ....................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly author or have performed the said work and to make and this applicbtion; that all statements >lication are true to the best of his knowledge and bell and that the work will be performed Sworn to blefo~,~me this c,~s~,, ~×p~res ~l.~,~ ~o~ ~ .......... ...~.'.~....%a)/~f ..................... ~, 19 . ~'~'~ · ('/ ,~ ,,,/ /~--~', .r)fl .... Notary Public,; .~~*~....:...~~ ication filed rith. of applicant) FOR~I NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No....~....; ....................... Disapproved a/c ......... ~ .............. Application No. APPLICATION FOR BUILDING 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, relatioqship to adioining premises or public streets or areas, and giving a detailed description of layout of property must bedrawn on thediagram 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. The applicant agrees to comply with all applicable laws, ordinances and regul,~. ~ j~ ~ ........................ ............... (SignaJ:ure applicp~ o~name, if a corporation) (Address of applicant) State whet,~jr applic~ant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...............Name of owner of Pr e mises/~'/~L ~/~ / 4'/~'- '~ '''~' ' '4~' ' '/) .~'../.....6~....~....~....~.. ....................................................................~....~..-.O, 8 (~ (Z ~ .......... i'"~'''''-~" ~'''~q~ ...~,~.....~.......C-~:./~7'/c,x/z, -/ ............ i .......... ~) '~'JZ .......... applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~. Location of land on which proposed w~k will, be done~. M,ap No:~'ff~f~_~..x~..~..~ot No: ...... ././L ........ Street and Number~.'.?...~....4~..~.~./...~..~.~.~...~..~.~..~.~..~.~(~.~..~.~..~..c ............. '.......~'-L../..~ ...................................... Municipality 2. State existing use and occupancy oF//~remises and intended use and occupancy of proposed construction' a. Existing use and occupancy ..~..~.../~..~.~..~...~.....~....'~..-.c~....~.~. ............................................................................................ b. Intended use and occupancy ../~-...~.~/" ..~...~.../..~......C~...~. ...................................................................................... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ............. Repair .................... R]moval .................... Demolition .................... .~)~/her Work (Describe) ........................ 4. Estimated Cost ........... ~ .............................................. Fee ......... .~..J. ........................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............~.....~ ...... Number of dwelling units on each floor ......... .~...Z ..... 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 ..... .~...~..J ........... He'~ ............................ Number of Stories .................................................................................................... D,mens,ons of same structure with alterations or additions: Front ............... ...... Rear ....... ..~..,.~.....~... 8. Dimensions of entire new construction: Front .......... ./..~. ................ Rear ............................ Depth ..... .~,..~.. ........... Height ........... ./....~.~f. ...... Number of Stories ................ ~ ............... 12. Doe~ proposed,/zonstr~uc, t on .,~,e~a]~ ,g,D,y,~7~o~ng_ aw, ord nan~c,~ or regular on?~ ....... ~.O.. ............... Name of Architect ..................................................... Address ............. "~'"'"'"' '"'No/~.. PLOT DIAGRAM Locat~ clearly and distinctly all buildings, whether existing or proposed, and indicate alt set-back dimensions fn property lihes. Give street and block numbers or description according to deed, and show street names and indi~ ' ......................... ~....~..,~...~ ......... being duly sworn, deposes and soys that he is the applicc (No, Me of ind~idual signing application) above na~ed. He is the .................~ ............................................................................................................ (Contractor, agent, corporate officer, etc.) of said owher or owners, and is duly authorized to perform oF have performed the said work and to make and this application; that ail statements corit,ci~edr i~s opplicafion are true to the best of his knowledge and bell f and that the work will be perform~t,~ ~'?~to~rt~n the~lication~d therewith. I Sworn to b~fore ~e this '~0~-:344963, Suffolk Oount~l~% / / / /~ I ~/-~ Co~.,s~on ~pir~s March 30, ............of ...................... ...... ......... .... I , ............................. Motory Pu~li