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Home My WebLink About2212-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEFART/~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. g'"1'8'1'0 ............. Date ........................ M~J,~h'""~ ............ , 19..~. THIS CERTIFIES that the building located at Map No. Dl~,.~.y. ............ Block No.... 'Z:~ ............ Lot No. '~X~ ....... J3"Ot~'l~J~O]:d'i'"'~i'~i' .................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................ 01~tO.~,..,..~) .......... , 1911~... pursuant to which Building Permit No. '"2~2~' dated ................. Oo~l~r .......... 0 .......... , i,~L~ ...... 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 ........ "'l:~"~V~t e "ene'..£ami. ty' "dwe].'ting .............................................................................................. the c~rt~f~cat:e ~s ~ssued to .~e=:tn...~t.~...t~e~.~t¢..&..%%Tn~.~,..i~.~.~.~;...f~.,~.~ ....................... of the aforesaid building. H.D.Approval Feb, ~1, 196~ by R.Villa TOWN OF $OUTHOLD BUILDING DEPA~RTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT -. I~E~LACF~ (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2212' Z Permission is hereby granted to: ..... ~.~l.¢.~k ..................................................... to ~ 1~ .. ne.~... One...£~i&~....d~ ~tn~ ...................................................................................... at premises located at .~/.~Flt~..~.T.*,..R,~,W.,....Of~...~/~..~..~o~...~lrle ..................... ..: .......................................... t~.cc~.~h.old., .......... ~,,~:,.~......~,.~, .............................................. i ........... pursuant to application dated ............................ O.O,t;~O~......~ ............ !9.~.~.., and approved by the Building Inspector Fee $...1.O,,...ptt..~ recelpt #~288 ........ ................... Building Inspector t SCHD SUFFOLK COUNTY DERikTI%NT OF HEALTH Date__ February 21.196h Building Permit No. 2212E TO ~OM IT M~Y CONCERN: The sewage disposal facilities for a structure located at East side Town Harbor Road~ Southold ~ (G~V~' deed location) have been inspected by this Oepartment and £o~nd to be satisfactory. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam,ned ........ ~..~.~i .......... ,~9.. ~ ...... A~,k, .... d ................. 7-'-~ ....... ~" ...... ' ~ ............................... Disapproved a/c .~~ ...... .......... ........................... ~i;~;~;;~) ................................. Application No. ~ '~ I Z-~ APPLICATION FOR BUILDING PERMIT Date ................ .......... ? ............ ...... 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 pa rt for any purpose whatever until a Certificate of Occupancy shall have been gr.anted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department far 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 regu!ations. .... ~..,.~.g/.~.y....v..~. ~.~'..z......2T.~ .................................... (Signature of applicant, or name, if a corporation) ...................... ( ' 'A~'~" '-'p p I ic-'-'~)uu,~,u,u u,,, .............. ' ...... "~'r/' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................... ~.~.:~.~.c~..:~ .................................................................................................................................................... Name of owner of premises ../~...~'../,/../...'~.... ~,-'~'~ ?1~ If applicant is a corporate, signature of duly authorized officer. .............. .......... ....................... (Name and t~le of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number .~,~ .T...~...~(...~..~..~..~.~.....T.g.."//..~-..../~...~..-~..~.~'~..,....~..-.~..../~,.~ ............... ' ........................................ 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 ................................................................................................................................. whether interior or corner lot. 3. Nature of work (check which applicable): New Building / Addition Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost .........~...0.,...9..~ ...................................... 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 ......../~...0 ............................................................................................................................ 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 ................................. ~>. ......... .. ............. .~T.T .......................................... Dimensions of some structure with alterations or additions: Front ................................ Rear ............................ Depth ............................ Height ................................ Number of Stories ........................................ 8. Dimensions of entire new construction: Front ................... [~ ........... Rear..~.~..~..~. ............ Depth ........................ ~/:~ Height .......... ~.~..ff: ........ Number of Stories ...... 9. Size of lot: Front ....... J...~...o....' .............. Rear .../..~.~ ................. Depth ..... ~.~.'.'.~. .......................... 10. Date of Purchase ..~..~..~..:...~..~, ................................... Name of Former Owner ............................... 7-~/,~/~r ./~..,~t,~ ................ 1 1. Zode or use district in which premises are situated.......~...: ................................................................................. 12. Doe~ proposed construction violate any zoning law, ordinance or regulation~ ..... · 73Xo~X. F~:~ .;~/,~ .................... 13. Name of Owner of prem ses~l//4C../~..~;.~xe~.Z/F. ........ Address/N~..~:Z~...'t;..~.~/.~.~...x:KZ-.~...~/.,~.~. Phone NoT-~.,.~..-~?.?..: Name of Architect/J:,~.~-./.Ck.Y.:f..~.~ .~X:~....Z..7.7.'~~4')Z~J.z:.7./.Z:..w..~.~..' ....... ~./.,..... Phone No./~..,~.Z~..~..~...~. Name of Contractor ...~..:...~/.e./z.y...V:.,~.f..~.4,....Z:../~.~l-~kA~jdress .~..'?:..~../'./T~.~../~......~..'.'.~.'. ....... Phone No. ................ Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr~ property li'nes. Give street and block numbers or description according to deed, and show street names and indic~ STATE OF~ NEW .Y(j~._K//~ ,/~) c ~ I COUNTY/'~/ ~' ,-~ z,,~OF ..~~ ~'~' // .................. ~..~~ ............................... being duly sworn, deposes and says that he is the applicdnt (Name of i.divid~,:gg~_~plication).~Z:~ ~ above named. He is the ..~:~, ..................................................................................................................... :... (Contractor, agent, corporate officer, etc.) of said owper or owners, and is duly authorized to perform or have performed the said work and to make and f this application; that ail statements ~Dl~i~d~Nt~is application are true to the best of his knowledge and bell and that the work will be performed i~hlfb~t~¢~e~ ~ forth in the application filed therewith. Sworn to b'efore me this ' :, ,',,,~,~, ~ur~ ~tu~(~ ........ .............. ....... , .............. .................................................... Nofary PuElic, ..~....~~~u~ ' (Signature of applicant)