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Home My WebLink About1982-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHO'Z.D, N. Y. CERTIFICATE OF OCCUPANCY No. Z 1693 Date September 11 19 63 Mop No ........X..~..X... ....... Block No....~.~ ........... Lot No..~.~ ....... ~0~.~9~...~9.~:~...~.~[~e ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated Feb~ry ~ 63 .................................................................. , 19 ........ pursuant to which Building Permit No....~.~.~. dated ................... ~.~.....~ ........ , 19..~].., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for wh[ch this certificate is issued is ........ The certificate is issued to Woodhollow P[,o}~el'tles ~ O'~I~e~ (owner, lessee or tenant) of the aforesaid building. FOI~M 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.° 1982 z Date ........ I~b~3~l*~ ......... ~ ................... 1963... Permission is hereby granted to: ........ Or.%e~t~...~. ........................................... to ..- ~u~.l~.-. ~n.. ~d~i.%i.o~..~n.. ~n...ex.t~t~ng...Bu~.~n~ s...b~ 3A.f~ ................................ of premises located at ,~/~.....)~I:~I.~..R~8,~ .......................................................................................... .............................................. Or~ent'"Poi~i"' N';'¥'~ ....................................................................... pursuant to application dated .................... .~1~i~11,~.. ...... '3 ............... 1963..., and approved by the Building Inspector Fee $..~,,.00 ............. Building Inspector FORM ~0. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam,ned ......... ....... Approved .................................. 19 ........ Permit No .............................. APPLICATION FOR BUlL.DING PERMIT Date .; ........... ~ . ..................... 19 (o~ 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 o d~tailed description of layout of property must be drown on the diagram which is part of thi.~ 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 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 MA,DF to tF~e 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 and regulations. ........... ...................... ................. ................................... (Sign~'l~ of applicant, or name, if a corporation) ~' (Address of applicant) -- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, p~umber or builder. · ................................................................................................................... Name of owner of premises ..................... If applicant is a. corporate, signature of duly authorized officer. (Name and title of corporate ~officer) 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot NO.: ...................... Street and Number ....~.'~...?~'..~?.~ ...... ~.~......~'.. ................. ~ff~:.~..~'~.~..~..~.~..~.~..~ ........ ..?~.~.~.!. ..................... ~unJclpaJ 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 .~.~.~-~"~..~.. Nature of work (check which applicable): New Building Addition ~'~ ' ...................................... Alteration .................. Repair .............. ~;~ R,,emova] .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost/~./..6.:..O...?..?.. ......................................... 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 ~:nd 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 of Stories ...../ ....................... , 8.Dimensions of entire new construction: Front ......... .~. .................. Rear .....~..~..~...~...~...~.~ ....... Depth Height .../...~...~..~..~ .......... Number of Stories ..../ ........................ / '- ' ...... .¢~..../..~....f ............... Depth /O ~ z 9. Size of lot: Front ..... .~../..~..~.. ......... Rear ............................. 10. Date of Purchase .......................................................... No,me of Former Owner ........................ 11. Zone or use district in which premises are situated...~..... ..... ~ ...................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? .................................................. 13. Name of Ownei' of premises .?~.,~...-~.....-"f~. Address ..... ..4~..~ ....... ~,..'~...,... Phone ~.~..~.~..:..7-'1.~i~i Name of Architect ,..~,,.~,.....~...~.. ................ Address ............................................ , Phone No Name of Contractor ..v,.~~ ....~..~ Address ..':~,~ .~..~.'~hone No'~'~';~ PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description .according to deed, and show street names and indicate whether interior or corner lot STATE OF NEVy_~Y~gR(/~0~ ) S S ~)~ c ....... (Name of in~idual signing~application) ~bow ~. H~ ~ ~h~ ..................... (~~ .................................................................................................... (Contractor, , orate o ~c~.) 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 Jn this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to,before me this(.. C.~ ........................ day of ........................................... , ............................................. Notary Public .~..' ..... ~ ............... County 4 (Signature of applicag~)