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Home My WebLink About2579-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .~.~...~. ~'~i~goTt S'J; Street Mop No ...... ~ ....... Block No ....... ~ ...... Lot No ....:~:~ ......... .(}~...e..e..~.~.g?...~..! ..... ..~..,...~.t,.~....~..,..~, conforms substantially to the Applicahon for Building Permit heretofore filed in this office dated ..................................... ~2~..e.~.~.~.....~, 19...~.~ pursuant to which Building Permit No....;~.....~ dated ........................... ..~..O.?...e..~...~..e.~......~.~, 19... ~ was issued, and conforms to all of the requ,rements of the apphcable prowsions of the Iow. The occupancy for which thru certificate is issued is ........ ...... ~ ~t t..e....o.~e... ~'~. J~l.7...d,~e ~ ~g ........................................................................................... The cert,ficate is issued to .... ~.~..~..]....~..e.~..~..,...~g..~..~.g.~.....~....¥..~.~.e. ...................... I~f~.e ..................... (owner, lessee or tenant) of the aforesaid building I~,D. Approval July 19, 1965 by R. Villa .... ........ ................. Building Inspector I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUll.DING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2579 z Permission is hereby granted to: .. ¥~. ~,,e~'...~..~t,z'lel~.... a.,~,'t,~g~ ................ .......... ~oz...3~.8. .................................................... ................. G~'eea~oa~*..~ ..... 8,,.g, ........................ to .. ]J-al].~. ~e~..,m~,e..,_fam,t ~.... 4~e:~ ;L.:l,z~ ................................................................................... pursuant to application dated .......................... ~O.~'~l~]~.-...]~,.~ ...... 19..~1~., and ap~rgv~ed by the Budding Inspector Fee $..11~..0J3 ......... Building Inspecto~ / S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Bldg. Permit No. TO WHOM I2 MAY CONCERN: The sewage disposal facilities for a structure located at have been inspected by this Department and found to be satisfactory. District Engineer FOI~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD. N. Y. Examined ......... ~...(.?. ........ 19,,~.,.~· Approved ........................................ , ]c~ ........ Permit No.................................c:~ ~z~ f ~ APPLICATION FOR BUILDING PERMIT Date ~evenb~r ~$ ............................................................ , 19..~ ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and s~brnitted in duplicate to the Buildin Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets c areas, and giving a detailed description of layout of propertyrnust be drawn on the diagram which is part of this applicahor c. The work covered by this application may not be commenced before ~ssuance of Budding Permit. d. Upon approval of this application, the Building Inspector will issue 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 in whole or in part for any purpose whatever until a Certificate of Occupanc shall have been granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Budding Permit pursuant to t? Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances ~ Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe, The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. (Signature of applicant, or r~nki ,f a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engipeer, general contractor, electrician, plumber or build: Owner Name of owner of premises ........w..a..z..~.?..r..~.J.:...~.a.`f..f.~La...~..~?.?r..$.~.~..~...`T..~.~.~g~[~[R ............................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No' ..?.~.a..k..e..s.$.d..e.!! ...................... Lot No: ......8. ......... Street and Number .... ..~..a..d.~.s..e.~...S..t....~...G.?..e..e.P.~..J.~.~ .................................................................................................. Municipality 2 State exmtmg use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... ..]~..~.t.y....L..e..t ..................................................................................................... b. Intended use and occupancy . ...R..e.~.:L..d-..e.~g.e. ..................................................................................................... 3. Nature of work (check which applicable): New Budding ....... .~ ......... Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost ...........~.]-.~.0..0.0. ................................... Fee .......................................................................................... (to be paid on filing this application) 5. If dwelhng, number of dwelling units ......... 1~ ................. Number of dwelling umts on each floor ........................... If garage, number of cars .......... ..S.~.~..~..3...e....qfl.z'....~.~l~.e.~..~.~.C..~..e...~.e...~. ......................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................... 7 D~mens~ons of existing structures, if any: Front .......................... Rear .......................... Depth ........... ~ ............... Height ' ...... - .................... Number of Stories ....... ~ ..................................................................................................... D~menmons of same structure with alterations or addmons: Front ................................ Rear ............................... Depth .............................. Height .............................. Number of Stories ........................................ ! 8. D~mensions of entire new construction: Front ..... b~,~. ................. Rear ...... ~. ................. Depth ......~].! ................ Height ......~. J. .................. Number of Stories ..... ~ ................... 9. Size of lot: Front ...... 2.0 .................. Rear ....... ~.0. ................. Depth ..,~.0.!..~.~.0.! ........ 10. Date of Purchase ......... .................................Name of Former Owner ...~.~.~.e...~.~...S.~l~.¢..~ .......................... ~1. Zone or use dmtrict in which premises are situated ........... ~.~;kd.¢~f~,~.], .............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation~ ........... ~ ...................................... 13. Name of Owner of premmes ....~.:...~:...~[fl ............. Address .....C....z~...e.n...~..[~ ...................... Phone No..~.~.:....7.~.~.6.7. Name of Architect ...................................................... Address ............................................ Rhone No .................... Name of Contractor ..~.¢I,..B~..G~#o. ..................... Address ...D~.~.~.e~.li ...................... Phone No..~,~,.7..-.~0.(~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro~ property hnes G~ve street and block numbers or description according to deed, and show street names and ind~cat whether inter~or or corner lot. STATE OF NEW,,YORK,, / ~ ¢ c COUNTY OF ../....'~...~..f ~'°' .... i....~~~~..-~.-... ................. being duly sworn, deposes and says that he is the applica · (Name of indivYdual signing' ~p~cat~on) above named. He is the ...................................................................................................................................................... (Contractor, agent, co,orate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and f th~s apphcation; that all statements contained in this application are true to the best of his knowledge and beli~ and that the work wdl be performed in the manner set fo~h in the application filed therewith. Sworn to before me thru ~ J~...., day of ..~'LC~~ ........ 19..~.~ ,'~ .~ ~ -- ~_, /~ .......... ~, ..~.. ,-~..~ ........ / ~~ ~ .................. ..........................