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Home My WebLink About2538-zNO. & TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES thor the building Iocoted ot ...................................................................... Street Map ~e..e..,~.....A.?..r...e.~.. ~lol~:~.~.~. .................... Lot No..~.~. ..... O~'.:[.e~t~.~...~..Z. .............................. conforms substanhally to the Apphcation for Building Permit heretofore filed in this office dated .................................... 0~.~O.~e~. ....... 6..., 19..~.. pursuant to which Budding Permit No.~.~.~a..Z... dated ............................. O~JsO~e~'.....6..., 19...6~., 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 ........ .... ~z'J.~ra.t~e... o.t~e.. ~e_nzn !-1 ~...cl.w~ l .,IJ.~ ........................................................................................... The certificate is issued to ...AI~::~G~.....S~IL~].."I~O~o.t~ ................... ~ ................................ (owner, lessee or tenont) of the aforesaid building H.D.Approval Aug. 2~, 1965 by R. Villa ! Building Inspector FOt~ 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? 2538 z Date ...............4~t(;l~F.....6 ..................... 19.....6.~ Permission is hereby granted to: ........ 420.....L~e..S~ ............................................ ............. ,l~t. ar~X:Le, ..... ~.Z. ......................... to ...... ltu~.la., ne~.. ~ne"f~eL'tr' ~'1-t ~nl: ................................................................................. at premises located at ..... ~_ll~t,.,~..~ .......... IJ]/~B~../~eiiF~l/I...J~,.OIPO~lJ~; ........................................... ..................................... l~..~/ew.. I~.&..iir~e~y..~a~t ........................................................ ........................................................... O~r~ ........................................................................................ pursuant to application doted .................................. ~J~j..~....~ 19...~1¢, and approved by the Building Inspector Fee $.-.-~LO,, O0 ........ Building Inspector SUFFOLK COUntY DEF~RT}~i~ OF HEALTH TO ',htCti IT P~Y CONCEPJ~: The sewage disposal facilities for a structure located at have been inspected by this Depar~nt and found to be satisfactory. District Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ................................ pphcotlon No ....... ~ ................ APPLICATION FOR BUILDING PERMIT Date ....................... ~.......~.. ............ ; 19~..~.. .... 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, relatio~ship 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 ~o~l~. ~ ' e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been g~anted 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; O~dinances or Regulations, for the'construction of buildings, additions or alterations, or for removal or demolition, a~ he~r~r}~described. tions. The applicant agrees to comply with all applicable laws, ordinances, building code and regula, ; (Signature of applicant, or name, if a corporation) ......................... iX ress ............................. State whether applicant is owner, lessee, agent, architect, engineer,~ ?xeneral contractor, electrician, plumber or builder. ,,remses ....~..?..'~....~...~0 ...~...{/-~L..i,~/~C..~:.~...~ Name of owner of ~, ................................... ~.. ............... ,..~ ..................................................................................... If applicant is a corporate, signature of duly authorized officer. 1. Location of land on which proposed work will be done. Map No.' ,~..~ ..~..~4~ ... : , · ........................ :' LOT r~lo.....~.. ............. Street and Number ................................................................................................ :.....~ ....................... ......................... Municipality 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 ..................................................................... ~ ........ 3. Nature of work (check which applicable): New Building .A./.~ ..... Addition .................. Alteration .................. Repair .................... Removal ................ ;... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost ...~./...~.1..~...0..~.. .................................... 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 and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front ..........................Rear .......................... Depth ............................ Height ....../.~.! ................. Number of Stories ........../. ................................................................................................... Dimensions of some structure with alterations or additions: Front ................................ Rear ................................ Depth .....~...~....~. ................ Height I o ~ .............................. Number of Stories ..... /. ................................. ~ .../.(..~....t. ................ Depth 8. Dimensions of entire new construction: Front ...~..~. ...................Rear ............................ Height ............................ Number of Stories ...... ~ ......... 9. Size of lot: Front ........... ~. .............. Rear ..... .~.......~.. ............. Depth ...................... t ~ I..~.....~./I~ me F r r Owner .uti 10. Da e of Purchase .................. .......................... Na of o me ............................ ....~.. .......... 11. Zone or use district in which premises are situated ........ ~.........~. ............................................................... 12. Does proposed construction violate any zoning law, ~o,rdinance or regulation? ..... ..~.....~ ........ ,, ............................. 13. Name of Owner of premises ~ ....... ~...?,J~d res, ,~..~.:.. ~ ............. Pho · No .................... Name of Architect ................ ..~ ................. ~......; ........ Address ............................. ,t ........... ~,.Phone No ..................... o Nome of Contractor ~~.~:....Address .~. ........................... i~~-'~ . ~ ........... 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 NEWyO..RK/,, COU N~,/~)/)~ OF ..~...,,~)~'' (Name of above named. He ~s the .....................~ · ..~.~- ........................................................................................... . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file th s application; that all statements contained in this ap, pli.cotion ore true .to the best of his knowledge and belief; and that the work will be performed in the manner sat forth in the applicahon filed therewith. Sworn to before me this ............ ...... ........... .... Notory Public, .~..k'[~tt~.~,~..M.:....f.~~^~l~', '~':~,. i~:ii ~:a,, }'c:~ (S~gnoture of apphcant) ~J J~0_. 52-32331Z0 Su,~oik Ccut~t.v ~'erm E~pires ~[arch 30, 19~.~'