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Home My WebLink About2587-zFORM NO. 4 TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE: OF OCCUPANCY No..g..Z~.O~l. ............ Date ...................... ~.e~U~F...2 .......... , 19...65. THIS CERTIFIES that the building located o~'~J:~3 ..D~.~v.e..&...Z~e.~..D~v.e ....... Street Map No .-.,.-..-....-tr...-...-..-,..'. Block No ..,.'~...-...-..-...-..-..'... Lot No ...... .~...-...-..-...-..-...-..-..-.. ....................................... conforms substantially to the Applicahon for Buildmg Permit heretofore filed in thru office doted ............. J~Q~/~m~..~[ .......................... , 19.6/[.. pursuant to which Building Permit No.25J~...~... doted ,..~(:~.~i1~..2,8, ....................... , 1 9~.~ ..... was Issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this cerhficate is issued is ........ ..................................... .............................................................................. The cerhficate is issued to ..~'~Jlit~l~..Ja,~J~t,~l~ ................................................................................. (owner, lessee or tenant) of the aforesaid building Building Inspec(tor FOR~ 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) 2587 z Permission is hereby granted to: ~t~l~a.,~a~.,,.. ~/~3 .... ~laal~..,, ~o~t e~t ........... to .._l~-ttlP/..~.~i.t,~.O~..~..~..~.~t~.,~l~..~,l~7~;~a,.19~ ....................................................... at premmes located at ..... ~,~t,..~lf ..... G~t~'-~J~..lE, lll~. ............................................................... ........................................ ~a;t~al. &...~Zii.t..D~ ............................................................................ pursuont to opplicotior{ doted ............................... ,~'~ .......~ ........19~/~***, ond opproved by the Building Inspector Fee $.~.,..~... ............. FOI1D[ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ................................. spector Application No. ~ ~'(:~- ~ APPLICATION FOR BUILDING PERMIT I NSTI~UCTIONS 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 giving o detailed description of layout of propertymust be drawn on the diagram which is port of this opplicotio 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 Buildmg Permit to the applicant. permit shall be kept on the premises available for mspection throughout the progress of the work. e. No bu~ldmg shall be occupied or used in whole or ~n part For any purpose whatever unhl a Certificate of Occupan, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Buildmg Department for the ~ssuance of a Building Permit pursuant to ti Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulahons, for the construction of buildings, additions or alterahons, or for removal or demolition, as herein describe The applicant agrees to comply w,th all applicable laws, ordmances~ buildmg code and regulations. (Signature of app~ant, or name, if a corporation) . · ~ .~. · ..~- · · · -~¢~d/.~.~p.~.,.i.~ ~ ~;fi ............................. Name of owner of premises .~ ,~..~.....~...--~.. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Location of land on which proposed work will be done. Mop No~. ............................................Lot No' ...(,..?.....'~...,. Street and Number ...... ..'~...~... ...... ~'frf~.~ ............~..~ .~..~......¥...~.~...¥...z~....7/......~...///...~.../..'./~...~.. ......... Municipality 2. State existing use and occupancy of premises,,D~. '/and ,intended use andj,/~occupanc,y of proposed construction: a. Ex,st,ng use and occupancy ............ ~~,~-~f.¢¢~ ........... .../.....~....~. ............................................. // b. Intended use and occupancy ...................... ~ ................ .~.'. ................................................................. 3 Nature of work (check which applicable): New Building .................. Addition ~ Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................................... 4. Estimated Cost ..... .~..e...O.......~.¥....... ................................. Fee ........................................................................................ (to be paid on filing this application) 5. If dwelhng, 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 ex,sting structures, ,f any: Front ....... .~......~...~..... Rear ....... ,..~,...~...~..... ........... Depth ........~.....~-T..,~ ..... Height ............................ Number of Stories ..........~ ....................................................................................... Dimensions of__ ~,-same structure with alterations or additions' Front .......... ..~....~...~.,~, Rear ....... .~.....~...~E~.... ..... Depth ....... ..-~.....~....~.~..... Height .............................. Number of Stories ..... ~ ........................ 8 Dimensions of entire new construction: Front ............................Rear ............................ Depth .......................... Height ............................ Number, of Stories ............................ 10. Date of Purchase ........................................................ Name of Former Owner ..................................................... 11. Zone or use district in which premises are situated .............................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? .~.., ...... .~...~ ............................... 13. Name of Owner of premises .'.../~./Z2.~....~.....~..(..~.~.~..~...5..Address ~..~....----------------~-~~ .... Phone No .................. Name of Architect,::~ .............................................. Address ............................................ Phone No .................. Name of Phone PLOT DIAGRAM, Locate clearly and distinctly all buildings, whether existing or proposed, and indicote all set-back dimensions fro property lines. Give street and block numbers or description according to deed, and show street names and indico whether interior or corner lot. STATE OF NEW,YORK, ~] } S S couN~ OF ,:.,.~..~ ........ ~ ~; ~~/2:~.~, ..~.:..~~ ....................... being duly sworn, deposes and says that he is the app~ .... (Narf~ of indi~al signing apphcation/~ .,~, above named. He is the ................................... ~~:~,~;..~ .............................................................................. (Contractor, agent, corporate officer, etc,) of sa~d 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 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 application filed therewith. Sworn to be/~re me this ........... ..... ............. , · ~ ~_ ~. ~ - ...... ..:/..~ ...................... ~..~ ......... ~ / ROTARY FUDLIC, S[aIo ci [:c v Y,,~