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Home My WebLink About2589-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No .... ~..23.02 ....... Date ............. Nor. ember. 23 ............., 19....65. THIS CERTIFIES that the budding located atM~.zl..~oa~,...C~utr, chogue, ..................... Street Map No ...Z3~ .......... Block No .... ~ .......... Lot No ......... ~3{;X ................................................. conforms substantially to the Application for Budding Permit heretofore filed m this office dated ............................... ~(~vet~:~e~...;l. 9 .., 19..64. pursuant to which Building Permit No. 25B,9~ ... dated .................... lg~vela]~ ..3..9 .., 19.. 64, was issued, and conforms to all of the requirements of the applicable provisions of the law The occupancy for which th~s certificate is issued ~s ........ ............................. ~Dne · - .faro ~. ~..~ · · ¢[w~l A&n~ .......................................................................... The certificate is ~ssued to ..... E~ge~e..Hc~.t~o~n ..fo=..Joh~..Mal.C~nor..~kt .............................. (owner, lessee or tenant) of the aforesaid building Building Inspector/ 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? 2589 z Date ............................. ]1[~11~:~.....;~9.., 19...~ Permission is hereby granted to: to ..~'.~:~c~.. au.. ~ ~ ~ t, ln~..~.,~l~_sn~ ................................................................................. at premises located at ......... ]~e~.....~:l~l..]j~:)lii~ ............................................................................. ........................................................ ~utaho~u~ ....N..Z~ ............................................................... pursuant to application dated ................................. ~l~r.....~l~ 19..~., and approved by the Budding Inspector Fee $..10~00. ......... FOR~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 Permit No , -- Application ~o ........................... APPLICATION FOR BUILDING PERMIT Date ............................... ~P~ft~tb~, ..... 1.9, 19..6~.,.. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted 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 areas, and giving 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 ~ssuance of Building 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 ar used in whole or in part for any purpose whatever until a Certihcate of Occupan, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to H Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulahons, for the censtruchon of buddings, additions or alterations, or for removal or demolition, as herein describe. The apphcant agrees to comply with all apphcable laws, ordinances, building code and regulations. ................ ............................................ (S~gnature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build .................................................. ~ge~.'~...a£...a~z'z~'. ........................................................................................................... Name of owner of premises ....... ~To. hTz.,}./a]-,i,l'lo,~/;tci ..................................................................................................... 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 ......... Xx.X ........................... Lot No' ...:XX. ....... Street and Number ...... ~../..~. ..... .~...~.~..~Q.~..~. .......... .~..~.9.~.o.g.~. ......................................................................... Mumcipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a Existing use and occupancy ...~.~.f~,~.].iiq. g ........................................................................................................ b Intended use and occupancy ........ ~.qY..~....8, f~,.~....~.O...~l,f~1~...l~.~i,-k~l, iz~g..,].O~ ........................................... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ................ Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...~lQ.~.~...~p...~e~/. 4. Eshmated Cost ........................ ~ ............................... Fee ..~.Q,.QQ ........................................................ .]....o..o..~.~?~ (to be paid on filing this application) 5. If dwelhng, number of dwelling units ....... Om .............. 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 existing structures, if any: Front ....... ~.bc...-.3 ....... Rear ........... 3..b¢.-.~ ..... Depth ........ .LI'~ ............. Height ............................ Number of Stories ........ .~Q ............................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear .............................. Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ........................... Height ............................ Number of Stories ............................ 7 a plu /minus 9. Size of lot: Front ............................ ~ear ............................ Depth ................................ 10. Date of Purchase ....... '19.~ ....................................... Name of Former Owner .............. Ri~la~.d...es.t ............. 11. Zone or use district ~n which premises are situated ........... .~...~..~..~ ..................................................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation? ...~Q. ............................................ 13. Name of Owner of premises ...~ob~..~a'l ~.r~o~,~:~Address .......... ~.W..,St,~f~l~ ....... Phone No ................... Name of Architect ...................................................... Address ............................................ Phone No ................... Name of Contractor .............s~e .............................. Address ............................................ Phone No ................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fron property hnes. Give street and block numbers or description according to deed, and show street names and indicat whether interior or corner lot. STATE OF NEW YORK, ~ COUNTY OF ...st,~.fo]~ ............ ~ S.S. ..................... ,~.l~.e.t~...~a~.~o~. ............................................ b~ng duty sworn, fJeposes,~nd sa_~ys that he is the appllcan above named. He is the ......... ~ .................. ~.~ .......... :.~...¥...'? .............. ;..'z-'.,s(~. ............................. (C/~trac,or, agent, corporate officer~c~) of sa~d owner or owners, and is duly authorized to perform or have performed the said./~r6rk and to make and fil th~s application; that all statements contained ~n this ap_pli.cation are true to the .bj~'~ of his knowledge and belie1 and that the work will be performed in the manner .set forth ~n the application ~ therewith. Sworn to before me this ~ .................. ..~.~.... day of ................ ~.Q,~.e~b.~ ......... , 19-6.)+.. ~ ~ ....... ~,~;h;..;....'.,.T. .................................................................. Notary Publ ....~..:. .. Coun~'~TARY PU;~', . S~ , ($itgl~ature of applicant)