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Home My WebLink About1974-zNO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY I%io. Z.. 1~.9 ............. Date ........................ ~...2~ ................. , THIS CERTIFIES that the building located at "W'/~'"0~'l'a~";A~'~'"~ ...................... Street Map No. (}a. ffert .......... Block No ....... XL~ ........Lot No.TJ~ ............ ~.O~At~lcl~..~.y~ .................. conforms substantially to the Application for Building P:ermit heretofore filed in this office dated ................................ Deeem~e~'.....~6....., 19~... pursuant to which Building Permit No. ~['9~"' dated .......................... ~l~r~ll&~.~r.....[.O., 19..~.3.., 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 ........ · ' [:~1" ~.'~e,.~e...o~e ...~am~. 'ly.. ~we~'l'JznE ............................................................................................ The certificate is issued to ....~O~.&~..~,...~&h&l~.C%~ ................. ~l~.el~ ........................................ (owner, lessee or tenant) of the aforesaid building. H.D. Approval- FORM 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.o 1974 z Date .............. Permission is hereby granted to: ..... P~.erhead ..................................................... to.. Bull~l..1%ew...One .. f. am~ ly... dw~l 1~1~ ................................................................................... at premises located at ..~/~.S.....l~lkJ. a~l~..Altta..~;~-~ .......................................................................... .................................................. S. outh~ld .......................................................................................... pursucnt to cpplicotion doted ............................ D~]~ ....... ~....19..~4~., end cpproved by the Building Inspector Fee $..1~,0~ ......... FO~iTI NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Examined .,..~.**..~....I,,..~. ........ 19..~.:~ SOUTHOLD, N. Y. Approved "-' ~' 19 ........ Perm t No. Disapproved a/c .......................................................... ........ ; (Bui dl ing InspeCtor) Application No. / ~ ? c/ 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 drawn on the diagram which is pqrt of this applica- tion. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon a~proval of tbis application, the Building Inspector will issue o 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 o 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 o1: buildings, additions, alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ord~t:~es and regulations. ........ ................ (Signature of applicant, or name, if a. corporation) ........... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~ O~ c-~ ~ .......... '...~. ~, ~ ~ .-~.., If applicant is g~corporate, signature of duly authorized officer. (Name and ti-fie of cSrporate officer) Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ...................... Street and Number ........................... ~..'~..~.....~ ......... .?..~... ....... ~.~..~......~.('.~..~. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction. o. Existing use and occupancy ......... ~C"'Z~'~.~,~ ........................................... ... b. Intended use and occupancy ~ (- ' 3. Nature of work (check which applicable): New Building .................... Addition .................. Alteration .................. Repair .................. Remova! .................. Demblifion .................. Other Work (Describe) .................. Est mated Cost ' ,/~2 C)~,4JL-¢2 ' . Fee ~.. ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... .(7.~ .......... 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 ................................ Depth ................................ Height ................................ Number af Star/es ................................ 8. Dimensions of entire new construction: Front ......... .~..~. ............. Rear ..... ,~.¢:~. ................. Depth ....~.~Z- ! Height ........................... Number of Stories ........ ~ ........ 9. Size of lot: Front ..........~......~..--7..../. ....... ,~,., ,,Rear 2 ..'~.7~. ........Depth .......... 10. Date of Purchase ....................... ~/.~'~'.~ ............ ....... Nam~ of Former Owner 11. Zone or use district in which premises are situated ............. 77/" 12. Does proposed construction violate any zoning ]aw, ordinance or,r,e.g, ulation? .............................................................. t3. Name of Owner of premises ,,.~-..4~.~.-¢~....-~. ....... Address .....~.i....~M~....'~..~'~'~' ..................... Phone No ................... ..~ .~.(~!...~v...,.,..~...,...~.. ......................... Address ...~,~.'..~...-A..~;~...~t. ......... Phone No ................... Name of Architect Nome of Contractor~"....~..~:'..¢:.~ ...... .f.~.-~..~i.:... Address ...Z..~...;~(..!.~'..~,'P?:..~..~..~....,~....~.... Phone No .................. PLOT DIAGRAM Loao,te clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or des~r, jip,tion according to deed, and show street names and indicate whether interior or corner lot. --/ ~ STATE OF NEW ,YORK,/./,/'Z~ e S COUNTY OF .... ;,~4K~...~..;...~.~a' ' ....... x,-ac,..~,..v.~,/.m.....: ....... 14~,4.:..'.'..,) .......... /.....;..~.Z. ................ being duly sworn deposes and says that he is the applicant . · (Name of individual signing~plication) ~. /; above named. He is the .... ~"'~"~-~ (~'~'~-"/~ ~ ~'~ * (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 this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed Jn the manner set forth in the application filed therewith. Sworn to befor~ me this [~, -'~ ~ -- ~ ......... :7.,.(~....7. day 9t ............. k,~g.~,~,~.,4..~</~.., 19...~ ILIDIlll T. [I[)tt12~ J_~ -- , ~ Notary Pubhc ~.~[.~ & ~.Z ~a,&~, ~ ountM, , ,ret, ~gture of apphcant)