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Home My WebLink About2537-zFOEM NO. ~ TOWN OF SOUTHOI.D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ~..2;1~:8 ............. Date ..................... ~J~.ll....2~. ............. , 19..i~.. THIS CERTIFIES that the building located at ...,~/~ ..... }~J~p.'t~..A~g~ ............................... Street Map No. X~JX ............. Black No ....... ~ ......... Lot No...:1~1~ ....... SO1A.$hOld. r..~,,.~.~ .................. conforms substantially to the Application for Building Permit heretofore filed in this office doted ....................................... J~o.pt~.....2~ ....... , 19J~.. pursuant to which Building Permit No .... 2~3~...Z dated ............................. ~J:L.0~,~;:.:~'.., 19.~.., 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 ........ ~iY.~ts...o~e..~mil~....~w.elli~g ................................................................................................ The certificate is issued to .... ~.~,~l.~l~..~...J]l[l~l..~,~l, ................... 0',~e~. .......................................... (owner, lessee or tenant) of the aforesaid building ~.D. Approval Dec, 190+ by R,Vllla Building Inspector 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°. 2537 Z Date ................... J[~t,~]~l~ .......... ~ .......... , 19..(~l- Permission is hereby granted to: W~, .t~,..~.tk.....A~,~.-..~,.W.~...iSa. i.~l~ ............... ............... ~ont~t~4t ............................................. to ...]ia.tl~..new..et~e..~'a~'L;l~..~ve[.]:.j..ng ................................................................................... ct premises located at ..... ~....t~,~,..~ ............................................................................. .............................................. ~xd;ho:7~d ~ .......... ]~oY.. ......................................................................... pursuant to application dated ..J~]p:~..~Hl..~..lel~l~,e~....~t,.-.~ 19...(~1., and approved by the Building Inspector Fee $.JL~,~ ........... Building InspectorI $-9 SUFFOLK COUNTY DEPARTMENT OF HEALTH Building Permit TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at (Give-deed lOcation) - have been inspected by this Department and found to be satisfactory. District Engineer FORM ~(~. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y. ROTICE OF DISAPPROVAL File No .......................... Date ., September..~9 .... To l~m. a. ~m~th. ~.C .W~lliam..W.. Smith ..... 8outhold,. N.~. .............. PLEASE TAKE NOTICE tha~ your application dateg ~eptembe~ · for permit to construct . .d~e~ at thc pr~m~ses located at ............................ ~S .. ~le ~ ........................... Street 8outhold~ ~ap . .. ~ Block ..... ~ Lot returneO herewith and disapproved on the followinf, ground .... ~t ~m~nt~o~s do ~o~ ma~h.deed~ Appli~ati~ not stg~, ....... .N.0~..~ ...... ~s...~ ha~. over t2~ s~ ft ~ ~d requires ~ll"sid~ yar~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Application No .......................... Approved .................. ~ ................... 19 ........ Permil[ No ................ ~r...: ........... D~sap.mfbl~.d/,.~' c~.,~_~a/c ....... !c'j'~ ...... ~'('/'~ ....................... .-'¢..~jq~ .............. ~( .......... '~ ...... .............................................................................. ..... (Bu~ldinfl Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or ~n ink and submitted in duplicate to the Buildinf 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 detmled description of layout of propertymust be drawn on the diagram which is part of th~s 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 Buffding Permit to the applicant. Sucl 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 Occupanc~ 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, addmons or alterations, or for removal or demolition, as herein described. The apphcant agrees to comply with all appl,cable laws, ordinances, building code 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 ........... ~~ ...... ...~.....'....~ ......................................................... If apphcant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) t. Location of land on which proposed work w~one. Map No .......... ~ ...... .~..~.... ............... Lot No: ..~ ....... Street and Number .~/..~ ......... ~..,,.. ~ .................................. // Municipality ' 2. State ex~stmg use and occupancy of I~,e'mises and intended use and occupancy of proposed construction: a Ex,st,ng use and occupancy b. Intended use and 3. Nature of work (check which applicable) New Budding ..... .~.. ......... Addition ................. Alteration Repair .................... R~e,.~n~ oval .................... Demolihon ................ ;~ Other Work (Describe) ..................................... 4 Estimated Cost ........... ~. ~....~......~....~......'7~... .................... Fee ............. ~...~. (to be pa~d on fihng th~s apphcot~on) 5 If dwelhng, number of dwelling units .......... /. ............... Number of dwelling umts on each floor ........................... If garage, number of cars ........................... ~.. .......................................................................................................... 6. If business, commercial or m~xed occupancy, specify nature and extent of each type of use ............................... 7 D~mens~ons of ex~stmg structures, ~f any: Front ..........................Rear .......................... Depth .......................... Height ....................... Number of Stories ............................................................................................................. D~mens~ons of same structure w~th alterations or addmons Front ................................ Rear ............................. Depth .............................. Height .............................. Number of Stones ........................................ 8 Dimens,ons of ent,re new construction Front ..... ~.....~..~..~.. ...... Rear ...... .~....~...~...~. ....... Depth .....~....~.'-- ........... He;ght ........................... Number of Stones ............................ .......................7~, .~. R ..... O, ...... ......... Dept ........... ........ / .~ _ 9 S~ze of lot Front i~ear. ~.. ~. h ~ v~ 10. Dote of Purchase ....... ~ ........ ~ .................... Name of Former Owner .......... ~ ............... 11 Zone or use d~stnct m which premises are s~tuated ........... ~ ................................................................................ 12 Does proposed construction wo~te~:r~,zomng law, ordmanc~ or regulation:~ ...l..~ ....... 13 Nome of Owner of premises .~..~.~ ............. Addres~¢~...~..~.~~ Name of Arch,tect ........ ,. .... ~~3 ........... ,Address Phone No .:~q-'"......~. Name of Contracto~,~~...~...~.~Address ii~iiiiiiiiiii Phone No PLOT DIAGRAM Locate clearly and d;stmctly oil buddings, whether existing or proposed, and indicate all set-back dimensions fro~ property hnes Give street and block numbers or description according to deed, and show street names and ind;cat whether interior or corner lot ~? ~ '~ STATE OF NEW ~.R~,./,, ~.~ ~ S S COUNTY .._ ................. ~~.....~...~~ ................ being duly sworn, deposes and says that he ~s the applica (Name of individual ~ ~bove named ~e ~s the .... ~~~ ........................................................................................................ (Contractor, agent, corporate officer, otc ) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and f~ th~s apphcat~on, that ali statements contained in this application ~re true to the best of his knowledge and bel~ and that the work wdl be performed in the manner set forth in the application filed therewith. Sworn to befCe me this .......... .... ......... Notary Pubhc, ~~~~~~nt~7 / --Z (S,gnature of applicant) /~ ~ota~ pub~, State o~ ~ ' No 52 0344963, Suffolk Count~ ~omm~mon Expires Ma~ch 30,