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Home My WebLink About2279-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .~/,~..J~t~tl~S~,..J~.V.e ............................ Street Map No....~f ............ Block No..,lg~f ............. Lot No. ~ ....... .(}~..e.~.~...O.~.:.~..t.....~.:.~.:.~...~.*...~.~... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................................ ~..~J~!~fJ~.~'......3.., 19..~.~.. pursuant to which Building Permit No....~..~..~..C)..~.... dated ............................ ~l,~.g-ft~.~.....3...,, ] 9...(,.~./ was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ......... ~usSn~s ~...t~t.,l~ ~ ................................................................................................................. The certificate is issued to ...~.t;.f~'.~g...Jj~.q~'...~.~.~,~...~.l~,~. ................... ..0...I~.....~.?.. ................... (owner/ lessee or tena~nt) of the aforesaid building. Building Inspector FORM NO. 2 TOWN OF $OUTHOLD BUILDIHG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥, BUILDING PERMIT THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL :OMPLETION OF THE WO.RK AUTHORIZED) 22,79 Z permission is hereby granted to: ..... L · ~t~e~ee~-t,..~ve ..................................... ..... .......... ~.eenl~e~,.~ ...................... ~ ............... ~. to ...a.t~emh...a~..e6~t~o~..o~lt~-an...ex~st~ng..t~.~a~g .................... ~....!.....17....-....7. at premises located at ..M~..~i~,-~A.V~ ............... ;;...,,i .................. ~.'......'...~ ................... ~ ........ ....................... ; ............................ ~ee~:pO~'~...~b,-~.,.-, ....................... ~ .............. ~,.. . .............. '""'"'"': .......... ; ........ '"'"'7 ............... ' .................. !"~ .......... ~i ....... ~;"'":"": ............. ;"; ................. by the pursuafit, to ~l~plication dated .................... ~...J~t,~.....~ ............. 196~..., and approved Bu ding Inspector - Fee $.~'.*00..~:~... ..... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , ]9 ........ Perm t No ................................. APPLICATION FOR BUILDING PERMIT Date January 2 19 64 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and ~ubmitted 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 property must bedrown on thediogrom 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 o 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 pa rt for any purpose whatever until a Certificate of Occupar~cy shall hove 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 applicant agrees to comply with all applicable lows, ordinances and regulations. ......... (Signa~re-'b~ applicant, or name~ if a corporation) ..... '", ...... ........ :-7- / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises ...... .~.~.~.?.?...]:.~``~.~..a'~`~.~.?.~.~.~.~a.~..~.~`~..a.~..~.~.~`. ........................................................................... 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: ............................................Lot No: .................... Street and Number ...,t'vJ,~.n~a~s~:c,..A.v~. .............................. Gr. ee~p.c~r.t,,.~..,Y. ....................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ....... F. re.e~.er ........................................................................................................... b. Intended use and occupancy ........ ~.h..o...¥.~.s.....&....~.o.~.],~.~.~....~...~..~.. .. 3. Na~rure of work (check which applicable): New Building .................. Addition .................. Alteration Rel~air .................... Removal .................... Demolition .................... Other Work (Describe)..nzoue,..bldg.. to premzses 4. Estimated Cost ............. ¢. .]r. .0. .0. . .0. ; .................................. Fee ......... ~.5.,..0.Q ............ (to be paid on filing this application) 5. If dwelling, number of dwelling units .............................. Number of dwelling units on each floor If garage, number of cars 6. If ~usiness, commercial or mixed occupancy, specify natureand extent of each type of use 7. Din~ensions of existing structures, if any: Front ......... ]-.Q.' ........... Rear ..1.0..' .................. Depth .....'tB,.'.2,~! ......... Height ....~.Q.' .................. Number of Stories D mansions of same structure with alterations or additions: Front ................................ Rear Depth ............................ Height ................................ Number of Stories ........................................ 8. Din~ensions of entire new construction: Front ........~...(3 ............... Rear ....42...13 ................ Depth .....2.0..' .... Hei',ght ....... .1,.9..' ............... Number of Stories .......... ~ ...................... 9. Siz~ of lot: Front ................................ Rear ............................ Depth ........................................ 10. Da~e of I~urchase ....~..a..~'. ......................... ~.c)...5.{!$. ......... Name of Former Owner ..~.raee Robinson 11. Zone or use district in which premises are situated_....B 12. Does proposed construction violate any zon_~rb~a ordinance or regulation? ......... ~Q ................................... 13. Name of Owner of premises S.ter. l£ng..}Zi~:b~r....Address ....t~....~..h.a.D..s..e...~...~.'ff..e. ........... Phone No. o&28 ...... Na~ne of Architect ...................................................... Address ............................................ Phone No. No,ne of Contractor ..L..C~..~ ............................ Address ............................................ Phone No.0.6..6...6. ........ PLOT DIAGRAM Loca~e clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimension property lines. Give street and block numbers or description according to deed, and show street names and whether interior or corner lot / STATE OF NEW ~R~,/. COUANTY! OF ~..) ~'~' ~.,~..~.(....~..<~ .............................. being duly sworn, deposes and says that he is the ~Name of indiCdual signing application) above na~ed. He is the Corporate officer & builder (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and this application; that all statem~? contained in this application are true to the best of his knowledge and bel and that (he work w be p~[qr~i.~'t~}~anner set forth in the application filed therewith. Sworn to before~e th s ' ~ ' " ,,:r,'- ' .............. ........ Not~ry P~blic,~:~; ........ ~~,.,.~ou~ .