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Home My WebLink About2275-zTOWN OF 5OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, H. Y. CERTIFICATE: OF OCCUPANCY No....Z*...i.~8?. .......... Date ....................... O0.gOJ~,Ol~......2]. ...... , 19.~.. THIS CERTIFIES that the building located at ~/J~.....~.~.~e..~OO(l..~O~ ......................... Street Map No. ~ieJ.~e.~ .......... Block No....X..~ ............ Lot No. ~ ...... (l~t~eheg.tte ................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......................................... DeG~,.....'t~....,, 196~1,... pursuant to which Building Permit No...2~..~.., doted .................................... ;Dee.....22L.., 19.~.~..., was issued, and conforms to all of the requirements of the applicable provisions of the law. 'J'he occupancy for which this certificate is issued is ........ .. ,Jg~JL.~.a~.e ..tine..£,$~:L].~'...~l.~e ] .1J,a~ .............................................................................................. The certificate is issued to ......~.he~de~.e..]~ei~$n& ..................... O1~e~' ......................................... (owner, lessee or tenant) of the aforesaid building. FOPS& NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING Pi~RMiY (THIS PERMIT MUST BE KEpT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2275 Z~ Dote .................... ;ae.¢eal~e~.....~l .......... 19-6.3. Permission is hereby granted to: ¢~het,, .~r l~wztc~..A/C...~h~..~ok~na ................... ....... ~.. ~)~t:e~o~e~e ................................................ to ...~.~.:L~,.. ~.e.~ .. ~tl,e.. ,£a~L13r,..~t~e3J~ ~4~ .............................. , ..................................................... at premises located at .,.~/~.,,,,~,.~t3.e...w~3oct,..]~Oad, ............................................................................. .............................................. ~l~e~z.,-.~e~k~.....Gu.t,e~ae~.N~,~ ................................................ pursuont to application doted ........................ ,D~C~e.1:~D~.....~, ........19/o/~..., and approved by the Building Inspector Fee ,..3,..o.,..o...o. ........... SUFFOL~ COUSIn' DEPAR~MENT OF HEALTH Date TO WHOM 1T MAY CONCERN: The sewage disposal facilities for a structure located at (O:l.ve deed locat~6n) ...... ~~~,'-.,,~-y~ ~ , .... have been inspected by this Department and found to be satisfactory. District Engineer District Engineer ....... ~'~"~' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ~c~ ~ ~. 19. Approved ......................................... 19 ........ Permit Nb .............................. ................ ';i '; '; ......................... Application No. ~ ~C~7 ~ 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 applica- tion. c. The work covered by this application m~y 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 buiJding 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 H.EREBY 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, alterations, or for removal or demolition, as herein described. The appticant agrees to comply with all applicable laws, ordinances and regulations. ~z_m __ ? (Signature of applicant, or nome, if ~ corporation) ' ................ ....... .................. Stace whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... ~ ............................................................................... If applicant is a. corporate, signature of duly authorized officer. .................. ................... 1. Location of land on which proposed work will be done. Map No.: ...<t~.....~.....~....~.. Lot No.: .................. Street and Number..~..~.~.~..~.....~...~.~.~...~.~.~.~:~..`~.........~....~.`~c~.~..~.~...~ 2 State existing use and occupancy of premises ,and ~i~,tpnde. d use and occupancy of proposed construction a Exstng use ondoccupancy b. Intended use and occupancy ....~.J.~.'..~....,~C~.~'~...~~iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii 3. Nature of work (check which applicable): New Building ...~. ........... Addition .................. Alteration .............. Repair .................. Remora! .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost ........./...~..~..~..~....-~.....~.f('~ ~-~ ......................... Fee ....... l~'" ........ ~ ........................................................... (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 .......... :...~'m. ......................................................................................................................... 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 some structure with alterations or additions: Front ................................ Rear ............................ Depth ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ ..~..~.~.../. ...... Rear ...... ~...~...'~... ........ Depth ......~....~.. ........... Height .............................. Number of Stories .............................. 9. Size of lot: Front ....,JZ/:~J ................ Rear ........ / ........................ Depth ...... /......~.....O.. .......... 10. Date of Purchase ....~/..../~....~...~..,~. ...................Nam~ of Former Owner ..~../~..~...~ ....... 11. Zone or use district inUwhich~'premises are situated../~~.....~....~.., t2. Doesi proposed construct on v o ate any zon ng ]aw, ord nonce or-regu at on? .... I,~.?.....,.......-...,.: ................................ 13. Nome of Owner of prem se~.~-~.~.~ Ir~..-~,~ Address ..~....~...~..... Phone No Name of Architect ............................................... ;. Address Phone No .............. Name of Contractor .~...~....~.1~i. Address i~ii~iii~i~.'i; Phone F~LOT DIAGRAM Locate clearly end distinctly o1[ buildings, whether existing or proposed, and indicate oll set-bock dimensions fr property I!nes. Give street and block numbers or description according to deed, end show street names end indic whether ihterior or corner lot. I\ STATF OF!NEW ~:D~(/,,,/~ ) SS COIJNT,,Y OF ..~rfrf,'~/,~.) · · . . ...~./~.....~//.~/~.-t<,~..~..~¢. ~ ................................ being duly sworn, deposes and says that he is the applica (Name of individua! signing applicatio~)~ above nam~ed. He is the ....................................... .L-~.~,,<~.(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 file t[$is applicqtion~ that all statements contained, in this application are tru'e to the best of his knowledge and belief; arid that the wc?rk will be performed in the manner set forth in the application filed therew, ith. / Sworn to b~for~ me this ,., __ ~_? zi ............ ~do,~of ..... ,.~....~ ...., 19 .~.-"~ /~ /'~/ ~ //'/'J /~' ~ /') ,~