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Home My WebLink About2521-zNO. & TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...~/.S..[{o~.~;ol=..~lt,~'e ................................. Street Mop No .... ~ ........... Block No...:X;:JOC ............ Lot No ~ .......... JJ~.t.i~'g,O~t ..... J[..~, ............... conforms substanhally to the Application for Building Permit heretofore filed in this office dated ................................. J~e[0~;e~t~ .....~t)~., 19,~J~, pursuant to which Building Permit No..~.~,1_..,~ dated .............................. ~J~t ...... ],6.., 19J~..., was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which th~s certificate ~s issued ~s ........ The certificate is issued to ...JJo~'.tJz.,Ji'o~.k..~&p%is.t..Cj~.~ .............. ~l~e~ ......................... (owner, lessee or tenant) of the aforesaid building H.D. Approval April 1, 196F by R. Villa Building Inspector FOK~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BI~ KJ~PT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 2521 z Permission is hereby granted to: ~...(It~.t,.il~J~l,l,ile~,.a..tlol*.l~,,...~....N..o...r..t...h Fork Baptist Chureh ..... ..s....~.....z.?..x. ......................................................... ...................... ..n..,..,l. ~.,...~.,.~,. ................................. at premises located at ...~....~.......~....l~....~...~.....~...~..~. ..... .(....~.......~..?..0..,..~..~.). ...................................................... ................................................ ~,.t.~....~...., ...... ~:.~,.. ......................................................................... pursuant to application dated ................... ~..e.l~...t¢~.b...~.~.....~.l~ ........... 19f~..., and approved by the Building Inspector Building Inspector """t NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .... ~....~....~. ........... 19..~..~ Approved ........................................ , 19 ...... Permit No ................................. Disapproved a/c ....~..~ (Building Insp/tctor) Application Noc~ -5'-c~ / APPLICATION FOR BUILDING PERMIT ate .............. ~ ...... ~ ................. ; .............. ,,...., INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin, Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o areas, and giwng a detaded description of layout of propertymust be drawn on the dmgram 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 Budding Inspector will issue a Building Permit to the applicant. SucJ permit shall be kept on the premises avadable for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or m port for any purpose whatever until a Certificate of Occupancy, shall have been granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th, Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o~ Regulations, for the constructmn of buildings, additions or alterations, or for removal or demolition, os herein described The applicant agrees to comply with all applicable lows, ordinances, building code and regulations. S~feway Custom Builder's Corp. (Signature of applicant, or nome, if o corporation) P. O. Box B. Shirley,New York (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Builder Name of owner of premises ................ ..N.~...r.~...~...~.~...r..k...B...a.~..~.s.~..C..~...t~..'~.~..(..~.A..Z.~...z~....?....~.~.~.~.~.~! ......................... 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 l:4~.~.~m..~p..~...g.~g....V.~..~t~r~ ~lo..S°.~ ................ Street and Number ........ ,?,¢>uth..side..eE..Ho~t~on..A~&,.s.~.t,I~.&£.~C~.~.ct, le.~ad~t~..~A ................................ Municipality State existing use and occupancy of premmes and intended use and occupancy of proposed construction: a. Existing use and occupancy ............ .¥..~..ap:..~ ......................................................................................................... b. Intended use and occupancy ...................... ~.,~..~..~,.h...~.o..?..~,.e. ................................................................................ 3. Nature of work (check which applicable): New Building ...... ~..e.~ ..... Addft~on .................. Alteratfon ................ Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................................... 4. Estimated Cost $ 10,000o00 Fee ........................................................................................ (to be paid on filing this application) 5. If dwelhng, number of dwelling units ............................ Number of dwelling umts on each floor .......................... If garage, number of cars ..............o..n..e. ...................................................................................................................... 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use .............................. 7. D~mensions of existing structures, if any: Front .......................... Rear .......................... Depth .......................... Height ............................ Number of Stories ............................................................................................................. D~mens~ons of same structure w~th alterations or additions: Front ................................ Rear .............................. Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ....... ,~. ................ Rear ........ .~ ............... Depth .....,,3.8..~..8..~ ........... Height ............................ Number of Stories ............ .2. .............. 9. Size of lot: Front ......... .]:.~. ........... Rear ..... ..1..1..~.:..]..?. .......... Depth ......]:..0..0..~......~.....]:.~.'..25 10. Date of Purchase ........................................................ Name of Former Owner ...................................................... ] ]. Zone or use d,stnct in which premises are situated ............................................................................................... 12. Does proposed construct,on violate any zoning law, ord,nance or regulation? ........... ..hq.. ..................................... 13 Name of Owner of premises ........................................ Address ............................................ Phone No ................... Name of Architect ...................................................... Address ............................................ Phone No .................. Safewa,v Custom Bldr8 .... P.O. Box B.Sb~-le,~ N.Y. No 28t-.~280 Name of Contractor .................................................... ^aaress ...................... ,.,, ..... ~.A ........ Phone ................. PLOT DIAGRAM Locate clearly and d,stinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro property hnes. Give street and block numbers or descript,on accord,rig to deed, and show street names and indica whether interior or corner lot. 7-04/ STATE OF NEW ¥~)RK. ;' ~ S.S. 7i~/2:>~z-z~ ~'~o,~:~:~ ~ T~'T' ~ 7 A COUNTY OF Albert Nussbaumex- ................................................................................................. being du[y sworn, deposes and says that he is the app[io (Nome of individual signing apphcation) above named. He is the ......... ~.~...d...~'..~.~..~..$.~.~.~-~.v..~..~(~...~.t~9~.~.~'~..~.~9.~^ ..................................................... (Contractor, agent, corporate officer, etc.) of smd owner or owners, and is duly authorized to perform or have performed the said work and to make and th~s application; that all statements contained in this application are true to the best of his knowledge and beli and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this r~ (; ,¥ ........... L~.....~ .... dayof.~~ ......... ,19 ........ ~. ~../~z~ ~ Z ...... Notary P u b I i ~.-e,-~... a~.~ .......~......'~~ ./.. ~l.tr~i? ~/~'''~-''' ......... October 21, 196~ North Fork Baptist Church Hattituckt N.Y. Gentlemeni In reply to your inquiry BE! access to your property N/S Middle Road (C.R.RTA) please be advised that the Board of Appeals has approved access to the property on the north through the private right of way and the County has approved access to the property on the south from the County Road, There is adequate are for both the Church and Parsonage and the required parking area within this entire property. Yours truly Building Inspector