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Home My WebLink About2547-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the build,ng located at ...... //J'~. .... .~.~..f~.~....~.e. .................... Street Terry Waters Map No ..................... Block No .......... ~... Lot No ..... 2. ........... ~ozltho~ ..... ~,.~'~, .............. conforms substant,ally to the Apphcahon for Bu,ld,ng Perm,t heretofore filed ,n th,s office dated ............................... .Q~.~.qlfl.~. ..... ~.. ....... , 19 ..~.~. pursuant to which Budding Permit No ...... ~..~'~lr.~.. dated ........................ .O.a...~.... ~.. ............ 19..6.~..., was ,ssued, and conforms to all of the requ,rernents of the applicable provisions of the Iow. The occupancy for which this cerhfmate ~s issued ~s ........ ....,.~.;[V.~te...o~e.. f, amll~...~we.l~ ~:~ ........................................................................................ The certificate is zssued to .... ~,~.~/~..~i~Go~.sDr~ .......................Qlt/~t,e,~l~ ...................................... (owner, lessee or tenant) of the aforesaid budding H. D. Approval ~uly 23 196~ Z 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? 2547 z Permission is hereby granted to: to ...J~iXld..~e~..c~ne..~'e~,.ty:..d,~e.]:.l~[ ................................................................................. at premises located at ........ ,~.~.t~......~3~.L'~ .~r~t,,~. ................................................................. .......................................... · Zl~....~,~n~.im~..Lanes ....... S~thoZLd ............................................. pursuant to application dated ................................ /Jl~ ...... ~ ............19.~)~.., and approved by the Building Inspector Fee $....~a.(~ ........ Building Inspector S-9 SCND SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Jtl L 2 3 1965 Bldg. Permit No. The sewage disposal facilities for a structure located at have been inspected by this Department and found to be satisfactory. DiStrict Engineer FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×am,ned ........ ........... Approved ........................................ ] ~ ........ ~er~t ~o .............................. Disapproved o/c ...............7~ ........ ~ .................................. ...................... ................................. Application No ...~.....~...~..~. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This apphcation must be completely filled m by typewriter or min, k and submitted in duplicate to the BuildinL Inspector. b. Plot plan showing location of lot and of buddings on premises, relationship to adloining premises or public street_- or areas, and giving a detaded description of layout of property must be drawn on the diagram which is part of this location c The work covered by th~s application may not be commenced before ~ssuance of Building Permit d. Upon approval of th~s application, the Building Inspector will ~ssue a Building Permit to the applicant. SucJ 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 pur~)ose whatever until a Certificate of Occupano shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADI~ to the Building Department for the issuanoe of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o 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.// ~ignature of applicant, or name, ,f o corporation) ...... ...................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber' or builde, Name of owner of premise~~~~ ..................................................................... (Blame and title of corporate off~;[~" .......... Street and Number t~.~..~.~.~...~.~ ...... ~ ............................................ /~.~9-~ t,'~.~.-- ~T-~- ///Mun,cip-ality ' 2. State existing use and occupancy of praises and intended use and occupancy of proposed construction: b Intended use and occupancy ....... ~.~.~~.'~~ ......................................................................... 3. Nature of work (check which applicable)' New Building ................ Add~tion .................... Alteration .................... Repair .................... Removal ................... Demolition .................. Other Work (Describe) ................... 4 Estimated Cost..~.,~.~.~..~. .................................... Fee ..... ..~.. ~....~.~. ................................................................ (to be pa~d on fihng this application) 5. If dwelling, number of dwelling units ..... ~.~.~.~ ......... Number of dwelling umts on each floor ............................ If garage, number of cars ...... .~..~.7... ......................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, Jf any: Front ............................ Rear ........................... Depth ........................... Height ............................ Number of Stories ............................................................................................... DJmensJons of same structure with alterahons or addmons: Front ................ Rear ..... Depth ........................... Height .......................... Number of Stones ............................ 8 D,mensions of entire new construction Front .... ~.~.~. ........ Rear . ,~.~'~. ..... Depth ...~.~.. Height ..~...~?.. .............. Number of Stories ~ ...... 9 Size of lot Front .~.~. ~. ............ Rear ~...~..~. .......... Depth ,~.~?~'~. .............. .... ~..~.~.. ~ .............. Name of Former Owner .~'~,,~lr~/~ ]0. Date of Purchase ..~.~' .~.... ~' ~'~ ' 11 Zone or use d~stnct in which premises are s~tuated...,,~¢~ .................................................... Does proposed construction woiate any zoning law, ordinance o regulat~on~ ...~.... ................................ 13 Name of Owner of prem,s~. ~.~/~.~.~..~..Address~~~....~'. n ~ -- ~' ...... Phone NO .................... Name of Architect ...................... ~ ~ ~/~ ...~_-~.., ~/~' ............ j .............. Address~/ ,~.~~~, ......................Phone NO ............ Name of Contracto,~..*..~..~~~ ...... Address~:~r~J~~~ ....... Phone NO PLOT DIAGRAM , Locate clearly and distinctly all buildings, whether ex,sting or proposed, and indicate all set-back dimensions fron property hnes. G~ve street and block numbers or description according to deed, and show street names and ind~cat whether interior or corner lot. STATE OF NEW YORK, ) S S~. COUNTY OF,~,~ ......................... ) ~,,~' ~, ................ ~¢~.2~~~~ ........... being duly sworn, deposes and says that he is the applica (Name of individu~Fsignigg application) above named He is the...~~ ............................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized te perform or have performed the said work and to make and f this application~ that all statements contained in this appllcation are true to the best of his ~owledgeea~a d and t~t the w~rk will be performed in the manner set forth in the applic~ filed the~wit~ ~g~ beh Sworn to before me this ~ l~- ' ~ ~ ~ ......... ~.~. ......... aa~o~ ...... ~ ............... 19 ..... ~:~ ~ ~:~-'~ ' ~ (Signature of~pplicant) ~ lorm [xp~e~ ~arch 30, ~S~