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Home My WebLink About2544-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE: OF OCCUPANCY No ~"'22'74 .............. Dote ................. O~,e]~e~...~l,.~. ............ , 19.6,~.. THIS CERTIFIES that the building located at . ..]BC~I~t,,~&U. ~t~¥...l~t~¥,O]L~ ...... Street Map No ...... ~ ....... Block No ~ ........... Lot No ......... ~ ................................................ conforms substantially to the Applicahon for Building Permit heretofore filed ~n this office dated ....................... Oct:;O~L~"'"/ ....... , 19 '64 pursuant to which Building Permit No -.-2J~44..~ dated ...........................~t~...~.O..., 19.~4.., was issued, and conforms to all of the requirements of the applicable prows~ons of the law. The occupancy for which this certificate ~s ~ssued is ........ ...................................................... ~d~t,~,.o.~...!¢~ ~e~,.~.~ ........................................................ The certificate is ~ssued to -(le~g~"al~c~"~Taaa' ~telt~e'~aa~ ........................ : .............................. ~owner,/essee or ten~qt~ of the aforesaid building 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*O ~5~4 Z Date ........................... O~i~ ....... ZO ..... 19.~. Permmsion is hereby granted to' .......... a~o..Btm~eZa-t~ ...................................... ................. ~,~.~t~;L~ ........................................... at premises located at .... ~J;-.,.-]~lg~¢~lU&~,..&Ve ............................................................................ ........................................... ~f,~o;L~ ................................................................................................. pursuant to application doted ................... O~.~ .........~ ....................... 19..~,, and approved by the Building Inspector Fee $...~...00 ........... FOI~M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. am ned ...... ........... Approved ........................................ , 19 ........ Permit No ................................. (Buildin~i'lnspector) Application No..?.'.,...~..?...~,. ........ APPLICATION FOR BUILDING PERMIT Date ............... ........................ , INSTRUCTIONS a. This applicahon must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildir Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets, areas, and giwng a detailed description of layout of propertymust be drawn on the diagram which is part of th~s applicatio, 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 Budding Permit to the applicant. 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 m part i~or any purpose whatever unhl a Certificate of Occupant 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 t} Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulahons, for the construction of buildings, add,hans or alterahons~dor for removal or d~iolition, as herein describe The apphcant agrees to comply w~th all applicable laws, ordinanc, eS~,/building code and regulations. (Signature of applicant, or n~me, ~f a corporation) .... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build: ow/ .......... Name of owner of premises ..C~.. j~....c?~,.(~. J~b 5 ~-/~.t,.J ~) F=hJ c-i F= LAc./F~ If applicant is a corporate, signature of duly authorized officer. (Name and htle of corporate officer) 1. Location of land on which proposed work will be done. Map No' . ...........................................Lot No' . ................ Street and Number ...~...?~....k~..~.......'~....~...~.) ..... ..~..?..i..~..~..~.~...cl....?..~..?....~. ........ .~..c?....~....o...~..~.......k...!.:.....~..'.~.: ............... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .....................E..L...L.!...~...~ .......................................................................................... b. Intended use and occupancy ....... ..~.....x~... ~..L...L.) ..~.....~....~(/l..~~ ....................................................... 3. Nature of work (check which applicable): New Budding .................. Addition ...... ~ .......Alteration ................ Repmr .........~7... ....... .~emoval ...~ .............Demolition .................... Other Work (Describe) ................................... 4. Estimated Cost ..........!.,.o..?,.?, ...................................... 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. D,mensions of existing structures, if any: Front ...,~.,.~,~.:..~..'.'. ......... Rear ...,%.,.~...;..~ .......... Depth ......................... Height ............ ~ ............ Number of Stories .................. ,~ ........................................................................................ .... 'L"~ - 'L*-~ Dimensions of same structure with olterohc~ns or additions: Front ................................ Rear ............................. 4o- o . 'ZG - · ~ /~- Depth .............................. H.e~ght .............................. Number of Storms ........................................ 8. Dimensions of entire new construction: Front ..... ~,~.',;,~.'; ........ Rear ......~.~.'L,~.~'. ...... Depth ........................ Height ....... (~,~..~ ............ Number of Stories ......... ~ .................. ' . Ioo.oo~ IoO, o~' ~,oo~ 9. Size of lot. Front ............................ Rear ............................ Depth ...1~ ........................ of .... .................... of 1~. Zone or use district in which premises are situated...~.~).~.~.Z..~.~,~.~ ........................................ 12, ~es proposed construction violate any zoning Iow, ordinance or regulation~ ..... ~, ....................................... 13. Na~ o~ ~er ~. ............. ~ ...................................................................................... phone No .................. Name o~ Arcfijtect ...................................................... ASdress ............................................ ~one No .................. Name o~ Contractor ................... ~,~.~ .................. Address ............. ~.~, ............... ~on. No....~.~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions ftc property lines. Give street and block numbers or description according to deed, and show street names and indict whetl er interior or corner lot. Ir~5,o~ / STATE OF NEW YORK, ~ S.S. Mz~.O~ T/_~TH~LL. J COUNTY OF ................................ ............... . .~..,~...,...~,,.~..~.~.,.~,,c...~.."-~.. ...................... be ng duly sworn, deposes and says that he is theI appli, (Name of iqdividual signing application) above named. He is the ................................................ ..C~....,.x~.....~,..~ ............. i: ............................................................. (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 th~s application; that all statements contained in this oppli.cation, are true to the besjkof his knowledge and bc and that the work wdl be performed in the manner set forth in the a!:~licahon filed ~h~irewith. Sworn to before me this ......... ..n. ............. ....... ......... ........ · MARqEF, ~ ~ ................................... ~-:7" ~ ........~ ........t ............................... Not~l~r~EdoJic,!/.~_/~?.~.(~/~(~:wz~.4.~/~.;.':~....,l./~../.~,..I.~ Count}' (Signature of applicant)