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Home My WebLink About2545-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ....~.... 2...2..~.'/. ......... Date ................. ~lC~Obe~...l~, ......... , 19.6;~.. THIS CERTIFIES that the building located atO~'~'ta,$~..JiX~J,...BO~lt:J~:~[ .................. Street Bexe~clon Map No .~.t, Ct,~.e~ ... Block No ........ 3 .........Lot No ..........2...a13,~.3 ...................................... conforms substantially to the Apphcatlon for Butldmg Permit heretofore filed in this office dated ................. .O~.t,O~e~..JL.Q .............. , 196.4 ... pursuant to which Budding Permit No .,~4,~...~ dated ............ I~l~.t,O]~JJ~...l~O ................ , 19~.~ .... was ,ssued, and conforms to all of the requirements of the apphcable provisions of the law. The occupancy for which th,s cerhficate ~s ~ssued ,s ........ ............................ ............................................................ The certificate is ~ssued to ..........[~....~i~..e..~...~.~. ¢l,....J~.J.~.~'.ktl..~...~.l~.q.t~ ............................................. (owner, lessee or tenant) of the aforesaid building. Building Inspector FOKM NO. 2 TOWN OF $OUTHOLD 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? 2545 Z Date .................... OI;!k~;Oj;Je~..... ZO. ............ , 19..~. Permission is hereby granted to: .~a~_~ e.1 ..& .. Na~..~oz'.~a....llil s~n .................. to ..... ]tai3d:t.. a.~.. acI~t~on.. ~n.. _~_~..e~:l,~tr~.. 4we~t. -~ ............................ : ....................... at premises located at ...O~h~a~..~l ....... ]~J~.-~ ......... ]Jle~4:loll..J~ll.t~,~el~ ..................... ..................................................... ~ol~.,..X,~, ......................................................................... pursuant to application dated ........................... IJ~3t, o~.....~O ....... 19..,~, and approved by the Building Inspector Fee $...,~,~I~K) ........... Building Inspector ~0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUT.OLD, .. ¥. Examined ...... ~ ..... ./...,~. .......... 19..~....~. Approved ........................................ , 19 ........ Permit No ................................. D~sopF roved a/c ..... .................. ................................. APPLICATION FOR BUILDING PERMIT Date .............................. ..... .Z...O..,., ..... INSTRUCTIONS a. This application 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 this applicatio 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 Build,ng Permit to the applicant. Su~ permit shall be kept on the premises available for inspection throughout the progress of the work. e No budding shall be occup,ed or used in whole or in part for any purpose whatever until a Certificate of Occupan. shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Budding Permit pursuant to t Building Zone Ord,nance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulahons, for the construction of buildings, add,hans or alterations, or for removal or demolition, as harem describe The apphcant agrees to comply with all apphcable laws, ordinances, building code and regulahons. (Signature of apphcant, or name, if a corporation) (Address of applicant) State whether apphcant is owner, lessee, agent, architect, eng,neer, general contractor, electrician, plumber or build Nameofownerof premises 'r. rJOCl , L. 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 .... .B..e..x.,.e..t..d-...°.~.~..E...s..C'...8-..t..e...s.. Lot No: /(.,J)r O_ Street and Number ...... Cm.e~.~..~oa~,; ....... ~o%t+~_o.l.¢~ .................................................................................. Municipality State ex~sting use and occupancy of premises and intended use end occupancy of proposed construction: o. Ex,sting use and occupancy ............ ..~..~...e..]:..]...$.~.j[ ............................................................................................. b. Intended use and occupancy ................. s~me.....~[/...~.d~l.i.tioi3 ................................................................ 3. Nature of work (check which applicable): New Building .................. Addition ..~. ..... Alteration ................ Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................................... 4. Estimated Cost .... ]~.~.Q. QQ...]?/..~i ................................. Fee .......... ~'. ........................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... .On~ ........... 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 ..........................Refzr .......................... Depth .......................... Height ............................ Number of Stories ............................................................................................................. Dimens,ons of same structure w~th alterations or addit,ons: Front ................................ Rear .............................. Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ......... 3,3 .............. Rear .....'1.~. ................... Depth ......~. .................. Height ............................ Number of Stories ........... .O1'~ ......... 9. Size of lot: Front ............................ Rear ............................ Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ...................................................... 11. Zone or use district in which premises are situated ............ ~..A..?...~:~.t¢ ................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ................... [¢~ ........................... 13 Name of Owner of premises ...D.,...~il. SDZt ...............Address ............................................ Phone No .................. Name of Arch,tect ...................................................... Address ............................................ Phone No .................. Name of Contractor .~,../r-_o.w~]-Stc[ ......................... Address ........... ~(>tt¢~e].~l ............. Phone No .................. PLOT DIAGRAM Locate clearly and d,stinctly all buildings, whether ex~sting or proposed, and indicate all set-back dimensions fro property lines. Give street and block numbers or descnphon according to deed, and show street names and indica whether interior or corner lot. STATE OF NEW YORK, ~ S.S. COUNTY OF o.,~[~:~'~.,~.~' ........... ~ ..................... · ~-~.Or.~..-.~.]..S~ ................... : ................ being duly sworn, deposes and says that he is the oppli, (Name of indlvidua signing app ication) above r~amed. He is the .................... (~v~ ................................................................................................................... (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 apphcation; that all statements contained in this application are true to the best of his knowledge and be and that the work will be performed in the manner set forth in the apphcot, ion filed therewith. Sworn to before me this.~,.O., of Om..tc~be~. 19 .. "~1 ~ .,~ ~. .. . _. :. .. .=/j . . .. .. .z ...~....~.'..~ ................ .... day ............ ............... , ..... c, ~.~ ~11 '~,d-Z- ~-~,1. ! , (Signature of applicant) ......... Notary Public, .,..Win ...... q~IOTARY