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Home My WebLink About2260-zFOI~M NO, 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..~:/J~......M~L~.n..~O~d .................................. Street Mop No ..... Y,X ............ Block No, ...:XX .............. Lot No...XX.....(~,f~D,~...~.,.~., ............................ conforms substantially to the App_lication for Building Permit heretofore filed in this office dated · Nove~b~ .......................... ~ ............ ~JJ~....23....., t9.63_, pursuant to which Building Permit No. ~22~0~.... dated ........................... ,No.~.em, be~...26.., 19_63.., 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.a.~e ...on~..£.~m~ 1~...d.~eil~ag ........................................................................................... The certificate is issued to ..~..J~],~.d,~.eski ......................~.~e.~ ............................................... (owner, lessee or tenant) of the aforesaid building. H.D.Approval Sept. 2, 196~ FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST~BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 2260 Z Date ........... ..~..o..?,.e.,iA~.e~........~..6.. ................... , 19..6.~... permission is .hereby granted to: ..... ......... ~h~r~e ................................................. to .~%1ild...new.. ~or~e. · ~ ~.y · .~1 ~.~.ng ...................................................................................... at premises located at ..... ~/~.....~m. lD...H,Oa~. ..................................................................................... pursuant to application dated ........................... -~De~....~,.~ ..... 19.~.., and approved by the Building Inspector Fee $. ~.0.~.~. .......... S-9 SC}iD SUFFOLK COUI~TY DEP/;RT}'~t~ OF HEALTH Building Permit No. 2260Z -- TO ~,~14 IT MAY CO~GCERN: The sewage disposal facilities for a strU.cture located at ..... s/s Main Road, Orient (Sledjeski) (Oiv~ ~].o~Fi'on) ........ have been inspected by this'eD .partment and foun~ to be satisfactory. District ~kneer ..... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN C~.ERK'S OFFICE $OUTHOLD, N. Y. Examined/ , . .~., ,~..~...' . .~.. 19...~,..).. Approved ......................................... ] 9....~...Permit No ........ ' ..................... Application No.....~.~..~';...(.?. ...... APPLICATION FOR BUILDING PERMIT Date ................... ~..,,..~... ........................ 19 . 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 drown 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 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, alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances~anjd)regulations. (Si;9~ature of applicant, or name, if a corporation) .......... ~.~:, ,~ ,~¢.' :,'Z7%;; ................................... i: ......................... Sro're whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................ ............................................................................................................... Name of owner of premises ...................................................................................... Jf applicant is a. corporate, signature of duly authorized officer. .................. ................... 1. Location of land on whi:h() ~ ' ~--- ~'~~, ~pr°p°sed war, will,be done. Map No~ ~¢:~%~ ......... Lo; No~~~- Street and Number ...~./~..~..~¢~..~......~-~..~..~..~.~... ~. .......................... / Municipa~ty .... 2. State existing use and occupancy of presses and,~ntended use and occupancy of proposed construction. ~stn use and occu anc ~ ~~~¢~ o. g P Y ..... .//......;..~. ...... ~..r.~ .................. ~ ......................... ~ ................................................ b. Intended use and occupancy ........ ..~... ~~ .~¢~%...~:%~.... ~...~ ......................... 3. Natare of work (check which applicable): New Building .............. Addition .................. Alteration ............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................. .......... ........................... Fee .......... ................................................... 4. Estimated Cost (to be paid on filing this application) 5. If dwelling, number of dwelling units .........../. .................. Number of dwelling units on each floor ........ ./.. ........... If gqrage, number of cars .............,..-rm.. ..................................................................................................................... 6. If bt~siness, commercial or mixed occupa,ncy, specify nature and extent of each type of use ....~ .................... 7. Dimbnsions of existing structures, if any: Front ........ ~ .............. Rear ........... ~ ............. Depth ......................... Height ............................ Number of Stories ........................................................................................................... Dimensions of same structure with alterations or additions: Front ................................ Rear ........................... Depth ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........... (~....~;' ......... Rear ........ 6.....~... ........... Depth ....~..'41 .~... ........ Height ......~...~, ................ Number of Stories ..... ./.....'~,~., ............. Size.of lot: ......./;Z,~_,.._..~ ............. Rear ...... ~...~-..,5Z.~ ........... Depth ......~..;~....~ ........... ,~ _ , Front 10. Date of Purchase ....~¢~./...~.~ .................................. Name of Former Owner ..~...~...-,'~.~.~......l.. 11. Zone or use district in which premises ares tuated ~,~.: ..~: ~ ~ .................. ~ ........... / 12. Doe~ proposed construction violate~,~ n,q ~ ~.,anv zoning law, ordinance or,~regulq~tion? .......... ~ ...................................... 13. N m Own o p mses/~.'~,.~.~..~.... Address .~....~f~....~. .................. --.~... a e of er f '-re ' " '"'~-' J"/ ' /. ........Phone No .............. Name of Architect~~~ ................................................ Address ....~ ......................................... Phone No ............. Name of Contracto~,..~L,J~.¢~;...~ ......... Address ..... ~~ ~..~..~.~...~....-- f Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, a.nd indicate all set-back dimensions f~ property lines. Give street and block numbers or description .according to deed, and show street names and indic whether interior or corner lot. / STATE OF NEW. V~Rl~,/ .' z'~ __ COUNTX ,:OF .~~1i_s's' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or ~ave per~ormed the said work and to make and file applica~ioq; that all statements oontained in this application are true to the best of his knowledge and belief; t~at the work will be performed in the manner set forth in the application filed therewith. Sworn to this of Notary Puplic (Signature of applica,nt)