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Home My WebLink About2574-zFORi?I NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No '~"~.a't3 ............ Date ............................. AI~t~S.~ ....... ~., 19...~,~,. THIS CERTIFIES that the building located at ~/~ ..... J/~.~.R...~% ........................................ Street Map No .... ~ ............Block No .....~ ...........Lot No:~l:~[ .......Soatheld. t...N.~. .................... conforms substantially to the Apphcat~on for Budding Permit heretofore fi[ed ~n this office dated ........................... t~jOT/~l~b~91~....b~ ......... , 19.6~.. pursuant to which Building Permit No .... ~.~.~.1/~..7. dated ........................... ~O,~/.~l~bel~..~..., 19../o~., was issued, and conforms to a[[ of the requirements of the applicable provisions of the [aw. The occupancy for which this certificate is issued is ........ · .Re t.igie~s.. ~e~t. td.tr~...IChu~.ah.) ............................................................................................... The certificate is issued to ..... .~.~S~,..(~h~. O~..CLJ~'~S.~..J~-~~'~t.~-~,~ .............. gtW~L~ ........ (owner, lessee or tenant) of the aforesaid building H.D.Approval June FOIT~i 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) NO* 257~ Z Date ......................... ~a:i~ell~Jie~.....'/ ........ , 19..0J~. Permission is hereby granted to: ~.R.Reeve..&.~e~...I~e.....A/~...Fl.ret..&h~reh..ef.-Chrimt Scientist .............. l~.~.t~ ............................................ to ... ~u.i.t&..n~l~. (lhut. elr ..btt~:l ~ ~ng ............................................................................................ ct premises located at --.~L....~..~Oa.l~ .................................................................................... ......................................... 4J~thotd~r ..... lq...~ ................................................................................. pursuant to application dated .............................. JJo~.e~llJ~e~l~ ....... IF., ]9..,~Jt~ c~nd approved by the Building inspector Fee $.....~..O....J~., ........... Building Inspector SCHD SUFFOLK COUNTY DEPART~NT OF HEALTH have been inspected by this Department and found to be satisfactory. The sewage disposal facilities for a structure located at '(Giv® ~ed location) ....... Dist~ctEngineer ..... FOP,,~I NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×am ned ....... ...... , Approved ~ x 19 ...... Permit No .......................... (Building Inspector) App,,cation No ~..2...~ ....... APPLICATION FOR BUILDING PERMIT Date. Z~.~...~..~..'~..~..~.-~.~..~. ...~4 ...... , 19..~'....~...: .... INSTRUCTIONS o This apphcat~on must be completely filled in by typewriter or m ,nk and submitted m duplicate to the Buildm. Inspector. b Plot plan showing location of lot and of buildings on premises, relationship to adio~nmg premises or pubhc streets areas, and g~wng a detailed description of layout of property must be drawn on thediagram which ~s part of th~s applicat~or c The work covered by this application may not be commenced before issuance of Budding Permit d. Upon approval of this apphcotJon, the Building Inspector will ~ssue a Building Permit to the applicant Suc permit shall be kept on the premises available for inspection throughout the progress of the work e No building shall be occupied or used m 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 ~ssuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances c Regulations, for the construction of buildings, addmons or alterations, or for removal or demolmon, as hereto describe, The applicant agrees to comply w~th all apphcable laws, ordinances/and regulations (S~gnature of apphcont, or name, ~f a corporat,on) xz.x .... (Address of apphcant) State whether apphcont is owner, lessee, agent, architect, engineer, general contractor, electnoan, plumber or budde ........................... ~.~.£~.z...... ~. z'~ ~ ~. z'~ ~ ..: ................................................................ Name of owner of prem,ses .....~...L~.~..~...~.?/...~...~...~..d~. ~..~...'~..~.../...~./.-~ ./.~.~..~Z~.~ ........................ If apphcant ~s a corporate, s~gnoture of duly authorized officer (Name and rifle at corporate offlcer~ 1 Locatonoflandonwhqhproposedworkw, I bedone MapNo yf~2'd~...~. ..'.../~. LotNo. Street and Number~..'..YS .. ~.:~4.x.Z'..~.~...~..~.-... ~i~.,~/-//~.~?J.: ................................... Mumc~pohty State existing use and occupancy of premises and ~ ntended use and occupancy of pronosed construction o. Existing use and occupancy ...................................................................................... b Intended use and occupancy ... ,~.....~ ./7/~J'~'~IZ~...~. ............................................................. 3 Nature of work (check which apphcable), New Budding ...~ ........ Addition ................ AIterahon ............... Repmr .................... Rerag~al~..~/j. ~ ........... O O,"~Dem°hti°na ..... .......... ee Other Work (Describe) ....................... 4 Estimated Cost ............... ?.....~ ................................ F ..................................................................... (to be paid on filing this apphcation) 5 If dwelling, number of dwelhng umts ..... Number of dwelhng un,ts on each floor ....................... If garage, number of cars ................................................................................................................... 6 If bumness, commercial or mixed occupancy, specify nature and extent of each type of use ......... 7 D~mensions of ex~sting structures, if any Front ............. Rear ................... Depth .................... Height ......................... Number of Stones ................................................................................ Dimens,ons of same structure w~th alterations or additions Front ................... Rear .................... Depth .......................... Height ........................... Number of Stones ...................................... 8. D~mens~ons of~ntire new construction: Front..~ ..... ~ .......... ~ear ......................... Depth ~ff_~ o ~.~ ~R - - ' .......................... Height ..fi.r- ................. Number of Stones .Y..~ 9 S,zeoflot Front /~DZ O" Rear ~O~" Depth~7~'~~- 10 Date of Purchase ................................................ Name of Former ~ner ................................................ 11 Zone or use d~stnct ~n which premises are situated...::. 12 Does proposed construction v~ate any ~nmg law, ~rdjn~ce or re~lahon~ .~.~.~..: ...................................... premises~ ~-- ~/----~-- ~ ~~~~C~~C/:~C~.C .... Phone No ............ 13 Name of Owner of Name of Arch,reft .;~~.~f~.~' ... Address .~;~.~.~Z ........... Phone N~7.~.~ Name of Contractor ~C~. ~C~~Address .~Z~ ~ ~.~ ......... Phone ~kOT DIAG~M kocote cleorly ~nd dmt~nctly oll buddmos, whether ex~stm0 or proposed~ ond ~ndtcote oll set-bock d~mens~ons fron property lines Gwe street and block numbers or descr~phon occordmo to deed, and show street homes and indic~t~ whither interior or corner lot. STATE OF NEW YORK, COUNTY OF ...~l)~j'~tI~ ... I $ S N ,.'.........~.0...~j~...g~ .~,. J~. ................................. being duly sworn, deposes ar~. sa'y/that he is the apphcan (Name of individual signing apphcat~on) above named He ~s the ........ i' gA¥;'i fJ S 'g nt ;"ig;(,g;g;'g ) ........................... of said owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and fd this apphcation; that all statements contmned m this applicahon are true to the best of his knowledge and behei and that the work will be performed in the manner, s~t forth ~n the application filed therewith. Sworn to before me this ~x, ,r,x:,Rg~N -~ ~OTARY PUBLIC,sI7~5~State ~ New~~__~~Y~ / ...... .. ................. ...... motary vuo c, .//~.~ ....... ~~.~ ~J~, i~ . (S gnatu~ of ap~nt)