The URL can be used to link to this page

Home My WebLink About2604-zFOI~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANC'Y THIS CERTIFIES that the building located at ~/.~. Q.~.f~.~,~.. $.~0. ~ ~a~...O...~.~.~..O. ....... Street ~op ~o ...~ ........... Block ~o .....~ .......... kot ~o~ ......... ~e~g~, ..... ~ ............... conforms substonhol~y to the Apphcation for Bu~ld~n~ ~erm~t heretofore filed in th~s office doted ................................... ~.~h~..~ ...... ~ 1~ .... pursuont to which Buildin~ Perm,t ~0. ~.~....~ doted ............................ ~.~., ........ ~. ........ ~ 19..~.~., w~s ,ssuod~ ond conforms to ~11 of the requ, rements of the applicable provistons o{ the I~w. The occuponcy for which this certificate is issuod ~s ........ ..~~..~d~..~..O~T~e.,...cl~..~c~.~...e~...~.~r...gp.~...~p~.~ ......................... The certificate is ,ssued to ~.~.~.9~...~.~.~...~. .......................... ~ ......................... (owner, lessee or tenant) of the aforesaid buHd~ng. NOTEI Approved by ~/ A~pea!e H.D,App~ov~ A~ust 12t 196~ By R. Villa ..... ................... BuHdm~ 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? 2604 Z Date ..................... ~o~llJ~;~ .......~ ........ , 19...(y1+ Permlssion is hereby grcnted to: .... Cabe~on...l~.ot~r.~s...~_~ ...................... ................ ~. u~l~gmu ......................................... to ........ ]hlLla · .n*~.. · · utl.l.t.ty.. St~. ~..& ..l~ff~[~e ..£~,.. G~ .t~. · ~lour~ ~ ..................... at premises located at ..... ~)J~-~'"'~Jl~tlJl~'" '~al~J~"i~;'~]~l~J~"~l[d .................................................. .................................................. .t~n~;~hal:u~ ~ ..... N.,Z~ ....................................................................... pursuant to application dated .............................. D~i~]~.....9 ..... 19...(~1~ and approved by the Building Inspector Fee $..-?J-O.,OO ........ Building Inspector( S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Eldg. Permit No.,~O ~ '7 , sewage disposal facilities for a structure located at ~j~ive d~ed losation) have been inspected by this Department and found to be satisfactory. District Engineer FO~M. NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ................................. APPLICATION FOR BUILDING PERMIT Date ............................ I:Ja~embem. .....9 ..... ,19.~..LL- ...... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of propertymust be drawn on the diagram which is part of this application. 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 Building Permit to the applicant. Such 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 Occupancy 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 the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The apphcant agrees to comply with all applicable laws, ordinances, building code and regulations. Russell Case ~g..~a~Q~..~mQ~e~ias...Iaa ................................... (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 builder. ............................................ IZLun~r...,~..~u~lde~ ................................................................................................................ Name of owner of premises ...... .Caber. on..~r.o, per. ti~s...~e ......................................................................................... If appli,ga~tis acorpora/t~e, sxL~nature of duly authorized officer. ........-xw. - --- x_: ................ 1. Location of land on which proposed work will be done. Map No .............. ~ ...................... Lot No: ...~: ........ Street and Number ..Q;('~..Q.~.J~.e...~a~e..&..g.ea.dm.~..]3.oa~, ..... C,u~,.h~§u~?...N,.~ .......................................... Mumclpality 2. State ex~sting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... ~.c.a~..'l~ztd....-....pnr.:ls...a~...~Dp~e.d...&o3,~'..~,o~.~ ................... b. Intended use and occupancy ......... ..~..~g~..i.~;y...~.b..~$.~k~.~[~.~F~`~;~.~.¢.fL~.~".Q~.~ ................... 3 Nature of work (check which applicable): New Building ........ ~.. Addition .................. Alteration Repair .................... Removal .................... Demohtion .................... Other Work (Describe) ..................................... 4. Estimated Cost ....... 3~Z~.Q.O.Q..~./.i~ ............................ Fee ..... .~..0.....0...0. ....................................................................... (to be paid on filing this application) 5. If dwelhng, number of dwelling units ..... ~QD.a ............. 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,mens,ons of existing structures, if any: Front .......................... Rear .......................... Depth .......................... He,ght ............................ Number of Stories ............................................................................................................. D~mens~ons of same structure with alterations or additions: Front ................................ Rear .............................. Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ..... .6Q. ................. Rear ....... ~Q. ............... Depth ......... ~,,~ ............ Height ............................ Number of Stories ...D,Q~. ................. 9. Size of lot: Front ..... ]L6Q ............... Rear ........ 'I6.Q ............ Depth ......~LSD. .................. 10. Date of Purchase .............~b96~ ................................. Name of Former Owner ...... CLg. s~,..~C,a~,e. ..................... 11. Zone or use d~strict m which premises are s,tuated ........... ~.~.~'!..~l.$s.~z:J.c:.~. ....................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? .~Q....-...~D.'P.[.9.~..~.~....'9.~....~/..~... 13. Name of Owner of premises .... ..Q.~..~..e.~..Q~..~.~..o. zq. ...... Address ......... .Q~g..~..q~.D.~ .............. Phone No ................... Name of Architect ...................................................... Address ............................................ Phone No ................... Name of Contractor ...,~.pZ~1,..~,:1~.7~,~ ....................... Address ........... ~l~.J;.¢~}Zf~t~.g.e ........... Phone No ................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex~sting or proposed, and ,ndicate all set-back dimensions fro, property hnes. Give street and block numbers or description according to deed, and show street names and mdicaJ whether interior or corner lot. STATE OF NEW YORK, S.S. COUNTY OF .... ~.tz.f'£cul~c ......... ~' ...................... .D.~.~.~$~].~...4~&~e ............................ being duly sworn, deposes and (Name of individual signing apphcotion) above named. He is the ......................... .QO~...0~e~. ............................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perf~m or have performed the said work and to make and th~s application, that oll statements contained in this application ore true to the best of his knowledge and bel and that the work will be performed in the manner set forth ~n the application filed therewith. Sworn to before me this .................... ~... day of .................... ?e~e~be~...9, 19....6~ ~ _ ~ , , ~ ~ .' ,~ .: ~/,,~Lo~ c,:,~,~,~ ........... ~.Z.~.C.~..: ................... Nota~ Pubhc, ,Z~(.C.~.~~~..~o~ount~~ ~ (SiZable of appl~t) says t~at he is the applio