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Home My WebLink About2614-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building Iocoted at .... ~/~ ..... I:}~.eellls~.lr...Es, T.~ ...................... Street ~t~,eon...t.~.?.?...~..~/~itio .......... x~ ....... Lot No ..... ~1~., ....... .0~.~.e.~.~., ..... ~.,.~... ................. conforms substantially to the Apphcation for Budding Permit heretofore filed in this office dated ................................... ~eoeu~be~......],.~, 19..(;~. pursuant to which Budding Permit No...~.0.~..~.....~. dated ........................ .[-~.....]~(J~e~..., ] 9...J~.~, 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 is ........ ........ t~a_~a~.. one' .i'. ami-!y...d~e.l.l.f~ ...................................................................................... The certificate is issued to ..Graellwa~...Hea1~X ....................... J)i~xe..:ff.~ ......................................... (owner, lessee or tenant) of the aforesaid building ~.D. Approval Aug. 10, 1~6% by R, Villa ....... L~.....-~......~. ........... ~...~..; ................... Building Inspector FOI~/[ NO. ~ 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) No. 2614 z Date December l~ 1 61+ Permission is hereby granted to: · ..O.~.e..e..~..~..e:..~....t.z ......................................... ................ .~..t..e.~ ................................................. pursuant to application dated ................................ .D...?.~.. ......... ~.. ...... 19...6~...., and approved by the Building Inspector Building Inspectc~ S-9 SUFFOLK COb~TY DEPARTMENT OF HEALTH Date AU G 1 0 1965 Bldg. Permit No. ge disposal facilities for~ture located at have been inspected by this Department and ~ound (Give deed i6~cation) to be satisfact~. 'Dis'~ct Engineer ...... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Ex°mined ..... ......... Approved ........................................ , 19 ........ Permit No .......................... ...~.... Disapproved a/c ......................... .~: .................................................................. ........... ('l~uilding i k-~/e'~; ~) ;i .............................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildir Inspector. b. PIct 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 prapertymust 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 af this application, the Building Inspector will issue a Building Permit to the applicant. 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 Far any purpose whatever until a Certificate 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 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. ......... Gr.e~n~m~.. ~q~a~ty .................................................. (S~gnature of applicant, or name, ~f a corporation) Orlent ~ N.~. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electncian, plumber or builde .................................................... .0.w.~.e~.....-....b.~l.d.e.~ ...................................................................................................... Name of owner of premises ..... .~.~..~.~.g.~..~..~...~.~.f~.~...t~.. ........................................................................................................ If applicant is a corporate, signature of duly author,zed officer. (Name and t~tle of corporate officer} 1, Location of land on which proposed work will be done. Map No' ....Q:E.,o,e:0.,.JL¢~..e.~...~..g~.i~tbNo: .... ..bc.$ ........ Street and Number .. .Q~..~..e.~.~.,~. .~,.~.~.,t.l ..0..~..i..e,..n.,t..~ ...... ~.?,:.,~.... ............................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy vacant 'lot b. Intended use and occupancy .............. q~e,..~.c~Tg,i~...~.e.~L]L~J~L~ ................................................................. 3. Nature of work (check which applicable): New Building ..... xXX ..... Addmon .................. Alteration ................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ..................................... 4 Est,mated Cost .... ~. ~...0..0.......P../~ .................................. Fee ......... .1.(~ .......................................................................... (to be paid on filing this application) 5. If dwelhng, number of dwelling units ...Q~f~ ..................Number of dwelling units on each floor ........................... If garage, number of cars ........... g,ri¢ ........................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................... 7. D~mensions of ex~sting structures, if any: Front ..........................Rear .......................... Depth ........................... Height ............................ Number of Stories .............................................................................................................. D~mensions of same structure w~th alterations or additions: Front ................................ Rear ............................... Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ........ .~2. ............... Rear ....... 9.?, ................ Depth ......LJ:2. ................. Height ............................ Number of Stories ........ f)il/~J ............. 9. S,ze of lot: Front .......... 1~,~. .......... Rear ........ ,1,(~3. ............ Depth ........ 'Iz3.Q/..1.P-6. ...... 10. Date of Purchase ...................... .~).~..~ ........................ Name of Former Owner ...... I~,Y.~I' ...................................... 11. Zone or use d~stnct in which premises are s~tuated .................. '.!,~:~...~$~9.~ ........................................................... 12. Does proposed construction wolate any zoning law, ordinance or regulation? ...... DO. ......................................... 13 Name of Owner of premises ..Gz'.een'~/~.~..E~e~/.%~'..Address ......... Q:~J.eD.~ ..................... ~hone No ................... Name of Architect ...................................................... Address ............................................ Phone No ................... Name of Contractor ......... ~,]~e .................................. Address ............................................ Phone No ................... PLOT DIAGRAM Locate clearly and d~stinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frar property lines. 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, ~ S.S. COUNTY OF ...Suf£o3.k ............ f ........................... ~i,...~z'.a~liah. ........................................... being duly sworn, deposes and says that he is the applic, (Name of indwidual s~gning application) above named. He is the ................. D. oz'.p..~:).f£.io~It ....................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the smd work and to make and - th~s application, that all statements contained in this application are true to the best of his knowledge and bell and that the work wdl be performed in the manner set forth in the application filed therewith. Sworn to before me this ................ ~ .... day of .............. ~e~e~be~. .......... , 19..~. ~ x,. ~_ ~ ~ ~' /~ ~. ~ ~'~ ,- ~o~ ~ ~ ~.....~...:..~:~/~~,~~ · · Notary Pubhc, . ..................................... ,~....a~Y.P~C~.. (~gn6ture of apphcaKt~ ~ No 52 3233120., S~'?kt bl~ '~ ~