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Home My WebLink About2610-zFOI~[ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. 'Z'"~i'~'?g. ............. Date .................. Oct'obe~"}.'].' ........... , 1965'" TI:IlS CERTIFIES that the building located at ~./~ 'Oal~x:~o~t"l~'ei" ~Ott~,,hot'c}-. · Street Map No ..ii,IX- ...........Block No ......... ~ ....... Lot No ............ .~ ....................................... conforms substantially to the Apphcahon for Building Permit heretofore filed m this office dated ................................ · De~elll.b~ar~'".l:5 .", 19~5... pursuant ta which Budding Permit No. 'it6r-l'O"fil' dated ......................... Detzeiltl~...t5 ...., 19 65-., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is ~ssued is ........ .................................. ~cU.t~i~>~...~:o...d~..e:Li~g .......................................................................... The certificate is issued to ..DI,;...~Ii. Ct..I~,ii~._...S;.~....p~,~i~.;,..[~.;~.;;.~;;.~;~.~i ............................. of the aforesmd building FORM NO. 2 TOWN OF $OUTHOLD 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? 2610 Z Date .................... ~.flt.~.tl~l~. ....... ~. ........ , 19....~.. Permission is hereby granted to: · ..~d~th..S~..~.~enet. ..... ~..~,.. ~tty to ........ ~..~..~t. tien..o~..~..e~t~t~E..d~..~t~ ................................................. ct premises located of ..... ~.....~...~ ........................................................................... ............................................................ 8.~~ ............................................................................. pursucnt to cpplicotion dated .............................. ~ ......... ~ ....... ]9...~, end opproved by the Building Inspector Fee $'~'~01~' ............. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ...... ........ Approved ........................................ , 19 ........ Permit No ................................. ...................... i ~fi.,.f~i;;.~.. i ;~;~fi/~i~;;.[ ................................. Application No ........................... APPLICATION FOR BUILDING PERMIT Date ...... .'~...~ ....... /.,,~..'Z. ...................... , ~9....C...'./.. INSTRUCTIONS o. 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 issuance 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 or used in whole or in pa rt 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 issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, 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. ............. d~:~:..~ ,~.,,:,.:,.,. ~...i.i~?~.~ .?......(7:.b?.:..,'..'./..:_~ZT~ .r.,. (Signature of ~pplicant, or name, if a corporation) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde .... .(. }?.../,/.-.~. :.:~..c.z.c.:./~ ........................................................................................................................................................ ........ · ,, .¢., Name of owner of premises ..z:)~...:g..~J..J<;~. ......... .~3=: ...................................................................................... If opplica~t is a corporate, signature of duly authorized officer. 1. Location of land on which proposed work will be done. ~ap No' . ........................................... Lot No: .................. Street and Number . ~/~Q./~'~..'~....;.'..'4~.~ ...... .F.¢..~.~...~/r~,~ ...... ~..&.>2~!~,~. ....................................................................... Munic~polit~ 2. State ex~sting use end occupancy of premises end intended use and occupancy of proposed oonstruction: o. Existing use and occupancy ...... ~'~,.Sx'.,~.&~.~. -.~ ............................................................................................. b. ,ntended~seandoc~uponc~ ........ .~.~.~a//.~7.. ........ ~...~..~.~ ....................................................... 3 Nature of work (check which applicable): New Building .................. Add,ban .... ~ .......... Alteration ................ Repair .................... Removal .................... Demolition .................... Other Work (Describe) ..................................... 4. Est,mated Cost ............................................................ Fee .......... m.~ ........................................................................... (to be paid on filing th~s apphcation) 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~mens~ons of ex,st,ng structures, if any: Front ..... ,~.~.i.~.i'. ......... Ret3r ~/{(~'~.." Depth .._~.2.....?.. ........... Height .......... /.~-..7~Z.- ........ Number of Stories ........ /. .................................................................................... ; .............. D~menslons of sa~me structure with alterations or additions' Front ........ .~.~..[...~...~'. ......... Rear ........ ~..,r......~..]'. ........ Depth ..... ~.~..~..~..: .......... Height .............................. Number of Stories ........................................ 8. D~mensions of entire new construction: Front ............................Rear ............................ Depth ........................... Height ............................ Number of Stories ............................ 9. S~ze of lot: Front ...... : ..................... Rear ............................ Depth ................................ 10. Date of Purchase ) '~ -..~.~.f /~.~ - ) - ~; ' ' ..... .......... ..y. ......... /. ......... Name of Former Owner ...... .............. 11. Zone or use district in which premises are s~tuated ...... ~;~z~;/.zZ}f~J-~A~. ......................................................... 12. Does proposed construction violate any zoning law, ordmance or regulahon? .~'.(4 ............................................ 13. Name of Owner of premises ~.~.;..."l~*.'~'.,..t~.Z~J~[./ ......... Address .....~..-~C.~.~.~.J(.2.L..~...~../~l..k.~.; .... Phone No.~...~.?.~.~..~ Name of Architect ...................................................... Address ............................................ Phone No ................... ~,~j ;:.~2~ .~.~. h~ Z ?~.....'~ .L...~...?Z...~..~]~..J.. Ad d r ess , Name of Contractor ..... ~..~..: ...... Phone PLOT DIAGRAM Locate clearly and dmtinctly all buildings, whether exlstmg or proposed, and indicate all set-back dimensions fror property lines, give street and block numbers or description according to deed, and show street names and indicat whether interior or corner Jot. STATE OF NEW YORK, ~ S.S. COUNTY OF ................................ ~ .......... /.~..~.~J~. ......... ~.~...~.k~.....J,.J.'~ ........................... bemg duly sworn, deposes and says that he is the applica (Name of individual s~gning application) above named. He is the ..... ~.~.~[~.g..~.~ ............................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and ~s duly authorized to perform or have performed the said work and to make and fi this apphcation; that all statements contained Jn this application are true to the best of his knowledge and bell, and that the work wdl be performed in the manner set fo~h in the application filed therewith. Sworn t~efore me this. 1~ Notary Pubhc, . ................... x ..... ~.~ ...... ~ .......... ,~t),,.~ '~-';:;~ (S.gnature of apphcant)