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Home My WebLink About2565-zF~RM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..~/.~.....G~athw. ah.~..Rol~: ................... Street conforms substantially to the Application for Building Permit heretofore file, d in this office dated ........................................ ~'e~'~ ....... '~ ........ 19.(~. pursuant to which Build!,ng Permit No ..... dated ................. Oa~ ........... r.~,. ............ , 19..~, WC~S issued, and conforn?~ to all of the requirements of the applicable pr0visibns of the law. The occupancy for which this ,(:ertificate iS issued, is (owner, I~ssee or tenant) of the aforesa,id building. / ~ Building; Inspector,l-, FOK~ NO. ~ 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? 2565 Z pursuant to application dated ................................. ,,~e.p~-.....].. .......... Building Inspector & ~d Appe~].lle Permission is hereby granted to: · .. J~h~.-~o...Gl~a~d~r ........................................ ............. Gret~aht..~ld. ..................................... ..................... ~a~..Su~s'o~k ............................... to ..... A~Lt er-. · an~,...l~t id · · e~n.. ~ad~ ~.t~.on.. on. · ~ -.~ ~ ,~ n~.. d~e.,c ~.~r~ ............................ ct premises located at ..~/l~....g~athwh.1...Read ............................................................................. ................................................. N~,v.. 8u,~£c~!c ...................................................................................... 19...(~¢, and aF~proved by the Build ng nspecto-r Examined ......................................... 19 ........ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No. c>~ ~q~_4 (a ~ Disapproved a/c .............. .;~ ..................... ., ...................................................... ...... ........ ...... ................ .......................... ........................ : ........ APPLICATION FOR BUILDING PERMIT Date .............. ~T. V4~..~ ................................ , 19.....6~-t .... 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 propertymust 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 ar in part 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 or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building c~de gad regulations. (Signature o~p_~o~nt, or name, if a corporation) ~rathwohl Road, New Su£folk~ NY (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................... ~.~...~.P, .......... Name of owner of premises ............. .~..°..h.g...O.~...-O..1..a..a..d.-e.~ ......................................................................................................... If applicant is a corporate, signature of duly authorized officer. ............ .z..e. ........................................................ (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................Lot No: .................... Street and Number ......... ..0.??.~...h...w..°,~h,,~,.,?:.°-,8,..d,:.,..~..e..w....~..u.rf.:f..°..1..k.~...~. .............................................. ] ............................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: -Private dwelling a. Ex~sting use and occupancy ....................................................... b. Intended ~se ond oceupane¥ .-.P.O~.o.h....~.ql....b.~..~..~.~..~~g~ ............................................................................... 3. Nature of work (check which ap Je): ,New Butldlng .................. Addl ..... .x. ........... A~teratlon .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 2,000 . ee 4. Estimated Cost ........................................................... F .......................................................................................... (to be paid on filing this' applicatJan) ,5. If dwelling, number of dwelling units ~- .......................... Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................. ~t~&.~ ............. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ,B.£.i..d.a..,1..,qgn.9..u..1..t..a..nt k0 ' hO ~ 2 2 ' 7. Dimensions of existing structures, if any: Front .......................... Rear .......................... Depth ............................ Height ............................ Number of Stories 1 Dimensions of same structure with alterations or additions: Front )40~ Rear 40' Depth 32~ Height ............................... Number of Stories 1 t ~ O~ 8. Dimensions of entire new construction: Front ............. 3J~ ........... Rear ....... ~.~, ................ Depth .....~. ..................... Height ............................ Number of Stories 9. Size of lot: Front 1QO ...................... Rear .......... .~?. ............. Depth .......1.~..O. .................... 10. Date of Purchase .............. 19~:l .................................. Name of Former Owner ........................................................ .... Agr~cultura]. residential ] 1. Zone or use district in which premises are s~ruarea ................................................................................................. ]2. Does proposed construction vJolote any zoning law, ordinance or regulation? ...~,.,0. .......................... 13. Name of Owner of premises .J..9..h..n....G.......G..1..a..n..el.~ ......... Address New Suf.t'olk, NY Phone No. PE 4-52?8 Name of Architect ...................................................... Address ............................ . ................ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all 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 NEW Y' ~RK, } S ~ COUN~ OF ................................ ~ .o. ... Jo~ .~.~..~ .................................. be ng dul~ sworn, deposes 'and says ~hat/ is the applicant ............. ~'~'~; of individual signing application) · / ab me' He s the ~ ~a~us (C?~.~r~?tor) t ~ , (Contractor, agent, corporat~etc.) of said owner or owners and is du'ly, authorlzed to perform or have performed the said work and to make and file this application; ~hat all {tatements contained in this application are true to the best of his knowledge and belief; and that the work will be p~rformed in the manner set forth Jn the application filed therewith. Sworn to before me this ~ ~ ~ / ~