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Home My WebLink About2182-zFO~I ~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at B ./~...P~C~DZl~.~..]~y...~],.~.t~. ..................... Street Edgmere Park Map No ....................... Block No ....................... Lot No. '1e ....... ~fL~,~.~.*,...N.,.~'., ............................ conforms substantially to the Application for Building Permit heretofore filed in this office dated .......................................... ~.~p.tei~,~e,~.., ~.~)..~,~ pursuant to which Building Permit No ...... dated ......................... .~...e.~.~.......~..O.. ........... , 19...6..~..., 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~.i.v.~te...or~e..Z. amily...dwell.in~ ........................................................................................ The certificate is issued to .....l~..~.e.~-"~.~]~, ......................................... .0~.~3~ ................................... (owner, lessee or tena,nt) of the aforesaid building. Building Inspe7 FOl~t 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? 3183, z Permission is hereby granted to: Date ................ Se~ember-,.,,*lO .......... 19.6.~.. .. *~it~*-. ,~n*- edd. l~.~em .. eh.. ~a...e~.s.~ing...~e t.t~g ....... , .............. : ................................. at premises located at p~'~.t~ ~ ~ ~ ~ / ~ ~ I ~ ~ ........................................... .................. pursuant to application dated ........................ ~e~'""~O ..................... 1~,..., and approved by the" Building Inspector f:ee $ .~"~I(} ............. Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ..................... .t.~ ................ , 19.....'.~..Permit No. ~' - Disapproved a/c .................. ~,.~ ........................................................................... ~-- (Building I nspe~etor) 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, 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 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 part for any purpose whatever until a Certificate of Occupancy shall have been g~anted 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 regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generol contractor, electrician, plumber or builder. ............................................. ..o.L ............................................................................................................... Name of owner of premises ......... !~..$.....G..e:?...o.~.~...~.,...~.e.?):.d.~,~ ......................................................................................... If applicant is a corporate, signature of duly authorized officer~ (Name and title of corporate officer) 1. Locetion of land on wh ch proposed work w bedone Map No ~~..~.~.. ....... Lot No' ~...D Street and Number Peconic Bay. Blvd Laurel ~.. Municipality 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............ ..a..~..e...~..~..;~$~. ................................................................................................... " W/ addition b. Intended use and occupancy ................................................................................................................................. 3. Nature of work (check which applicable): New Building .................. Addition '":~,..,~1(~ ..... Alteration ............... Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ..... $...~,,,QOD...~,~.~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, commercial or mixed occupancy, specify nature.and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ....... 2.~ .............. Rear ............ 2,.LI:. ......... Depth .....~.~. ................ Height ............................ Number of Stories ....OZ~l .............................................................................................. Dimensions of same structure w!th alterations or additions: Front ................................ Rear ............................ ¢ Dep;~h ............................ Height: ................................ Number of Stories ........................................ I~. Dimensions of entire new constrqction: Front......6....,/~.~.l~ ....... Rear ........ 6/......2.1 .-.6. Depth ....... ~.7. ........... Height ............................ Number of Stories ........ O~t~ ................... 9. Size of lot: Front ...... 't0~) .................. Rear ............... ~&O ..... Depth ......... ~.00 ....................... ]0. Date of Purchase ........................................................ Name of Former Owner .................................................... 11. Zone or use distridt in which premises are situated ....... .~.&!!...~,~.¢~ ................................................................... 12. Doeb 'proposed construction violate any zoning law, ordinance or regulation? ..... ~ ........................................ 13. Name of Owner of premises ...6,..~d[~:L~, ............ Address ...~r. ce, l,l.l¢.~]. ........................... Phone No ................. Narhe of Architect .................................................. :...Address ............................................ Ph/~/n~e~lX~A G..fd..i..~ .... .. Name of Contractor ...I~EI.~...~Tt,~,],¢I~'. ........................ Address ....... .1fl.~....~.~.]..~.~. ................. Phone No..~..;~...'-/..t.. PLOT DIAGRA,M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions ir{ property lines. Give street and block numbers or description according to deed, and sho~ street names and indic whether inferior or corner lot. STATE OF NEW YORK, ) COUNTY O F E~.~.~O.~4~ .............) ................................ ~l~....l~..e~. ........................................ being duly sworn, deposes and says that he is the applicc (Nome of individual signing application) above named. Hie is the ....~¢~.~¢.~¢~..~.0~%..¢,8.¢..~.~. ........................................................................................................ (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 this application; that all statements contain¢~, ip ~b ~..application are true to the best of his knowledge and bell and that the work will be performed~,th~b"~."~¢~f~F~h Sworn to ~efore me this ~ No. 52-0344963, Suffolk C0,J,;~¢'. ............. *~ ...... day of .................... e.~ .......... ~:...., 19....~.. ,,, ,, ........ ............................. (Signature of applicant)