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Home My WebLink About2142-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z 1733 Date ~.~ove~be= 4 1963 THIS CERTIFIES that the building located at ..-~t~r*~.,~S...~,..,~O~,2,'~.].t,l. ........... Street Mal~11rl.~..~J~,~:lj~k No ....... ~..*.~ ......... Lot No ..................................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................ .~cJ~1..~....~,,. ............. , 19..6..~.. pursuant to which Building Permit No.~....~?...~.~... dated ....................... ;a~g~l,~.~..~I. ............. , 19~J...., 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 ........ ~RiVA%~ O~E ~/~ILY DWF, I,L.I~G The certificate is issued to ]:~.tl~.~..~v~,ez'a,...O~n~: ................................................. ~ ....................... (owner, lessee or tena,nt) of the aforesaid building. Building I nspecto~r ~"~'~ ............. FOl~t~I NO. 2 TOWN OF SOUTHOLD BUILDIHG 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.° 2142 Z Date .......................... ~u~t~'""9 ......... 19-63_ Permission is hereby granted to: ~,~,/. S~t ¢.h..&..E~o~e.-....~,~-.~,..l~rez, e ................... ............. ~ho~'8 ................................................ to ........ ~. i.~1.: m~.- .ad~,~,io~.- o~ ..~.. e~rl:~g., d~e't~ ................................................. at premises located at '"~'0~"~ ................... ~e~'~r"~l~ ..................................................... ................................................ t~o~¢l~z,~'"~i~/ ....... ~ou~l~ .................................................... pursuant to application dated ............................. ~.~.....~ ......... i...19..~_~.., and approved by the Building tnspeFtor Fee $..~,~00 .............. uddlng Insp~ct~0r . TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Exomined Approved ~ ~ , 19 ........ Perm t No. Disapproved o/c .......... .,,~..~ ............. z:.~ ..................................... ~.,~ ............ ................ ;; ......... ............................. (Building InspeCtor) Application No ..... .~:.]...~ !...~.=: .... 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 drawn 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 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 MA,DE 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 alteratio~ or for removal or demplition, as herein described. The applicant agrees to comply with all applicable laws, ordina.,~c~ and regulations. ,~ ,~ ' ' ~e, if a corporation) .......... ........................ .... State whether applicant is owner, lessee, oger~t, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises., ...................................................... ~,,,~,~ ....................... If applicon~o co~,~gn~ officer: ........... (~ne and titi~ .~. ~~.~. ............. 1. Location of land on which proposed work will be done. Map Street and Number ..~~......~ ................................................................. ~............: ...... ~. ...... Municipality 2. State existing use and occupancy of pries and intended use and occupancy of proposed construction. a. Existing use and occupancy ...~~ ............................................................................... b. Intended use and occupancy ...~~ .............................................................. ;~ ............ ~ ...... 3. Nafl~re of work (check which applicable): New Building ..'. ................. Addition ....~.... ......... Alteration Rep0ir .................. P, emova] '"~1~ ......... Demolition .................. Other Work (Describe) .................. 4. Est mated Cost~'! ~ .~...0.~i ........................................ 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, c~nmerc~ol or m~xed occupancy, specify nature .and extent of each type of use ................ 7. D mens on ~ ex st ng structures, f any' Front ~ '~""" Rear "~' ~ De th "'~ ~ Height ............................ Number of Stories ..... ~ ....................................................... Dimensions of same structure with alterations or additions: Front ~ ....................... Rear Depth ................................ Height ................................ Number of Stories ................................ 8. D mens ohs of ent re new construct on' Front ....~.....~.......-~.. .......... Rear .............................. Depth Height .............................. Number of Stories ~ ' 9. Size~'of lot: Front .......... ~..,,,~.~... ......... Rear ......... ~...~ ........... Depth ..~..~. ................ 10. DatQ of Purchase .......................................................... No,me of Former Owner .. 1 1. Zon~ or use district in which premises are situated ..... ~...~...~.. ........ : ..................................................... 12. Does proposed construction~"%~,vi°l'ate, any zoning law, ordinance or u ation~ 13. Name of Owner of premise~..?_~... Address~ Phone No. Name of Architect ...~ ............ :,~ ........... .~......,~/ ........ Address ......~.......~......., .......... Phone No. Name of ContracJ~..:....~..t.~Z~..~"..~... Address...'~..~ ..................................... Phone No. PLOT DIAGRAM Locai{e clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions fr property lines. Give street and block numbers or description .a,ccording to deed, and show street names and indic whether interio:r, or corner lot. %,, ....... ~,~__,,~r~--t~..~..t ................ being<.~d~uly sworn deposes and says that he is the applica ~ (Na~e o~dividual signing app ication) nambd~ He is the~~ above (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have perfoc~ed the sa d work and to make and file application; that all statements contained, in this application are true t~the best of his know,ecg and belief; that the ~ork will be performed in the manner set forth in the applicc f~d therewith Sworn to before me this ~ ~ ' ................ .~.~a~ of ................ (~¢.~-~ 19..~.~"~ .~ ~ Notary Public ..,',)~,¢,5~;'~,~.~.(~.f'L~ouoty," , (Signa~'~'r [ ~/ Notary Public, State of New York ~, //~, // , [ No 52-0344963, Suffolk County~ ~ , . ~ ~-~'cz- ' Gomm]ss~o~ [xp~res March 30, 1~