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Home My WebLink About2536-zFORi~ l",IO. 4 TOWN OF SOUTHOLD BUiLDiNG DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .......... ~,.,/~.....lJ(~tl~..~a~l, ....................... Street Map No ~ ........... Block No .... ~ ........ Lot No .... ~_~ ......... Gl, ee~pi~:pt.r..}I,.~., ............. conforms substantially to the Apphcation for Budding Permit heretofore filed in this office dated ............................... I~pt, eml~e,~......18., 19.1~.. pursuant to which Bu, lding Perm,t No. dated .......................... O~.t~.....3,..., 19..~a,~, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for whmh thfs certificate is issued ~s ........ · .t~:l:.~at~e..erie .-£aml4.Ir...d~e.l. lt.t~ ............................................................................................ The certificate is issued to ..'Ha~".~i~U.~;~ ................ (P~teZ' ........................................................ (owner, lessee or tenant) of the aforesaid building H.D. Approval March 16, 196g by R.Villa Building Inslector ]POR¢'~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE? PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2536 z Permission is hereby granted to: ~e~...~c~a~t....AZ.~..~L~r~r..~e~t;,~ ....... ................ .C~t;ehog,,u~ ......................................... to ....$.'~;L~.. ,~...O..r,.e...£a'~ "i 'I y...ct'~ell;L~g .................................................................................. at premises located at ...~....~l~O~.t,,~..~Olll~,~ ..... ]jl'~._.m~..~o~L~e~ .............................................. ...................................................... ~,~eenpa~;.r. 4q, .~.~. ...................................................................... pursuant to application dated ................................ ~.e~.t,, .....~ ....... 19.(aI~.,, and approved by the Building Inspector Fee $. 1 0~.01~ .......... Building Inspector S-9 SUFFOLK COUNTY DEPARTMENT OF HEALTH Oate, H$,I~ 1 6 1965 i i iq Ji} iiiL i ii Bldg. Fermit No..~,,~,,3 ~ ~- TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at (Giv~ deed location) ....... ~/.~ ,v~/ / have been inspected by this Department and found to be satisfactory. DiStrict Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Examined ......... 19. . Approved ............................ ; ........... 19 ........ Permit No ............................... ~:i~.~:.r.~...!.~~~ Application No. 2'5"'"~ ~' APPLICATION FOR BUILDING PERMIT Date.....J~Z...~ ........ ,9..~..~''' liNSTRUCTIONS 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 location. 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 o.pplicant. 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 part for any purpose whatever until a Certificate of Occupancy shall have b~en 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 Lows, Ordinances or Regulations, for the construction of buildings, additions or a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations.__ ......... name, if a c~;~i~i' ......... ................... ............ (AddressUof applicant) ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. owner of premises ........... .~.....~.......~...../~.....'~. .......... ..~...J.~..~......(~...~.. ............................................................. Name of / If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) 1. Location of land on wh.ch proposed work w,l.l be done MapN &..~....~..J::~r~'J ..~..~,.;J~ N Street and Number .......... ~..4......~....~.... ~ '..~...~. ..... ~. ~. ~ ~' J~L ..?.....~......~... "'~ ' Municipality 2. State existing use and occupancy of premise~ded use and occupancy of proposed construction: a. Existing use and occupancy ........ ~ ................ L....w...~ .............. ~ ................................... ~ ....................... , .... b. Intended use and occupancy ....... ....~.......~...c~......~.~.:~ ............. 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ................. /.~.~..~ .......................... Fee ............ i~'~'l~'''''''''~T~''''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 ................ ~, ............................................................................................. :..Z ........................ 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 of Stories ................................ "~) ~ · ...... ~....O. ............. Depth ...~... 8. Dimensions of entire new construction: Front ........ .~. ................ Rear ................. Height ......... /..~..~....('. ........ Number of Stories ........ ./.. ................. 0. Size of Jot: Front ...../.....~... .............. Rear ....... ./..~....O. ........... Depth ....../.w~..,~.~.~ ........ , 10. Date of Purchase .~/...~...~.~...?...~......Name~ ~ ~ ~-'r~°f Fo~~...~..~ 11. Zone or use district in which premises are situated ...../J.1[.~t~_~F~. ..................................................... 12. Does proposed construction violate any zoning la, Lq~_w ordinance or regulation.> ..... /.~/....(~ .................................... 13. Name of Owner of premises.~.~ddress~..~.~.~.Z~,.,-~. ......... Phone NO.~.~..'~....'~.....~.. 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 NL:W.Y~,.,RI~/,~ _) S'S COUNTY OF ' ' - ........... (~-~"~'~."~,U~'~: .............................. being duly sworn, deposes and ~s that he is the applicant ~ a~ nd~fiifig applicati~) above named. He is the ........................................~ ~c~r, ~;~'~;~;~;;; ~ff~;;' ~[;[~ ............. of ~id owner or ownem, and is duly authorized to ~rform or have perform~ the said work a~ to make and file th s application' that all statements contained in this application are true to the ~ of his ~ledge and belief; and th~ the w;rk will be performed in the ~nner set fo~h in the application filed t~h. Sworn to before ~e this ~ ~ / ~ [-- ~ ~ /J~ - / r o, ............