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Home My WebLink About2164-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No..Z..2D. Q0. ........... Dote ................................ 0.¢t,P.~e~...2~., 19...6.~. THIS CERTIFIES that the building located ct ~/~...]~t3D.~f)]~,'J,..~.~l~..~. ............................ Street Norwold Mop No ....................... Block No ....................... Lot No. ~[~J~-~-..-.C~uf~Ghe~1~e.....}~'.,.~ ............. conforms substantially to the Application for Building Permit heretofore filed in this office doted .............................. ~1~13.~.....~ ........... , 19.63.. pursuant to which Building Permit No....P,,~,.~..~...~ dated .............................. .~.~.~L~.~......2..b.'.., 19..~.3.., was issued, and conforms to e1[J ~ the requirements lceal of the applicable provisions of i~j~law. The occupancy for which this certificate is issued is ........ ...... .~. ~.l~a.~ ~....o~...f~i~....dw.e ~, 1~,~ .......................................................................................... The certificate is issued to ..... tle~l;i..tf.e,~,ls,.&:..~t~:e .................... (~me=.s ................................ (owner, lessee or tenant) of the aforesaid building. FOl~rvl 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? 216z/, Z Date ................... A~g:us.~ ....... ~ ............ 1~3 .... Permission is hereby granted to: ..... Cu-t,e~e ..................................................... to Bu:Llcl .. a · ~w.~ one ..£am~i~...d.we.l.t.i.~g. ................................................................................ at premises located at ~t,~...~l.~...~,~.T~.~.~. ............ 'NO'~WO~d ............................................................ ...................................... E/~...~n~t.t..Dri~e¥ ......... (r~ehogt~r ............................................... pursuant to application dated ....... ~. .................. &llg~. ...... ~L~ ............ 1~..~...., and approved by the Building Inspector tee $..Z.9,:.0..0.. ........... Building Inspector [, l~ORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~,/~ SOUTHOLD, N. Y. Examined ................. .~./....~.]~....., 1 ....~...'~ ......................... .................. Application No ....... . ~c~]~../...~......~.... APPLICATION FOR BUILDING PERMIT Date.... ~,1), ~1,1, ~.t¢,... ~. ........................... 19.63.. 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 p remises, relationship to adjoining 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 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; applica.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 ~)f 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 Southoid, 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 all applicable laws, ordinances and regulations. (Signature of applicant, or nome, if e corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................................... ~.e..~...e.~.]:....q .o. ~.t. ~.o...t¢. p~ .............................................................................................................. Name of owner of premises ............ .,~,,e.~,.~..~.~,..~...G.~..~..~. ........................................................................................................... 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.: ........................................ Lot No.:/e.-~,~.~,.~.¢,~ .... Street and Number ......... ~9~..e.,~,~,....~.~..J,.V..~.~ ........... .g.~'t,.~q,~l,l.f~ .......................................................................... Municipality 2. State existing use and occupancy of premises and intended use end occupancy of proposed construction. a. Existing use and occupancy ..... .~.~Q~.~.~..~.~.ti .................................................... b. Intended use and occupancy . ~..~.~.~/.~t,~..e..~i~...~'~.8~Cl, O,t?,f~9 ........................ 3. Nature of work (check which applicable): New Building ..... ~?, ........... Addition .................. Alteration ............ Repair .................. Remova][ ............ , ..... Demolition .................. Other Work (Describe) .................. 4. Estimated Cost ........... ,~i,~..~.~.0.Q.0,~..0...0. .......................... Fee ........... ~,~f).,.Q~). ........................................................ (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 nature .and extent of each type of use ............................... 7. Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth ......................... Height ............................ Number of Stories ........................................................................................................... Dimensions of same structure with alterations or additions: Front ................................ Rear ........................... Dept. h ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ......... 3.6.t. .............. Rear ..... 3.6.~. .................. Depth ....36.! ............... Height ....2...0..t. .................... Number of Stories ..... .~. ...................... 9. Size of lot: Front ....,],~.Q.I. ................ Rear ........ ,~,~.0.~. ................. Depth ........ ],9.0..I ............. 10. Date of Purchase ..... ~.~..]..~. ....... ,],.9..6.3. .......................... Name of Former Owner .~.~.$.G......~/~. ~,~..e.~,~. ................ 11. Zone or use district in which premises are situated ....... ~ ...... .7~t0~.f~ ...................................................................... 12. Does proposed construction viol.ate any zonJna ][aw ordnance or re u at , ~ , g .......... ~.Q ........................................... 13. NaMe of Owner of premisesG..e.,.~..~..~.~...~.~,~. .......... Address .~.~.0.,h,.o.g~. ......................... Phone Name of Architect .................................................... Address ................................................ Phone No .............. Name of Contracto~4,¢,~¢,.~..~..~'.~.~, .............. Address0.~,.~.C~Qi~U.~ ........................... Phone PLOT DIAGRAM Loceie 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 .according to deed, and show street names and indic whether i~terior or corner lot. .................. f~.l,l,,~i~.$~...~L.~.O~, ....................................... being duly sworn, deposes and says that he is the applica~ (Name of individua][ signing application) above named. He is the ..............,...C~Dnt,~.~.0.1~D~. ............... t (Contractor, agent, corporate officer, etc.) nj: said owner or owners, and is duly authorized to perform or have performed the said work and to make and file th application;, that all statements contained in this application are true to the best of his knowledge and belief; an that the wqrk will be performed in the manner set forth in the application filed therewith. Sworn to b~fore,r~e this