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Home My WebLink About2372-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTNiENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z..'Ig~:I. ............. Date .......................... ~.9.p.~..~....~.2. ........... , 19.~.~... THiS CERTiFiES that the building located at .... E/.S...C~.f~,ce.l:t~...A.Y.e,, ........................... Street Map No ..... ~ .......... Block No....~.' ............Lot No...~..~c~ .......... .~.~.e..~:.~...~..~.~p...~. ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................................... ~i,[0~.~],..,..~.~. ....... , 19...~,.)-I.. pursuant to which Building Permit No. ~.'~..~..~ .... dated ................................ ~]p~;i,],.....P-~..., 19....(~.i+, 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 ........ ............. 0=e...z ez~:l,7..~.e.~,cter~ee ..................................................................................................... The certificate~ is issued to ....~ez".t..Se~].~:J.o.~fl ..~c..T,Eto...~f~eT~::[,13,~ ............ .qt,,~..s. ........... (owner, lessee or tenant) of the aforesaid building. Building Inspect;' .......................... TOWN OF SOUTHOLD BUILDING' DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST B~ KI~P'i' ON THE PREMISES UNTIL.FULL COMPLETION OF THE WORK AUTHORIZED) ~ N92372 z Permission is hereby granted to: ot premises located at ...... ~/~.'.g~ll~,e~..~i,~r~... .................................................................... ; .......... ..................................................... ~ ~,e~.'z. ,,.Ze~ ~,~t ...................................... ~ ........ ~ ............................ pursuant to application dated ..~ .................... ~.~,~ .......~ .............. 1~...., and approved by the Building Inspector Fee $..~.,.0~ ............ Building Inspector I~O~M NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ................ , 19...... I k 19 ........ Permit No . Approved, . ................................... :..., ', ........................... APPLICATION FOR BUILDING PEP, MIT Dote ..A~.ril 2~ , 196~ INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving o detailed description of layout of property must be drown on the diagram which is part of this applica- tion. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY M,~D'E to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinbnces or Regulations for the construction oi: buildings, additions, alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable Iaws, ordinances and regulati~rfs. .......~~~~lgnatur~,orna~e"": ...................... : ......................" ':~f .................. a, corporation): .............. (Address of applicant) Sro.re whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, p~umber or builder. Name of owner of premises ...... ~.e.~..~.o.~.i..o.~.~$...~..~.~...A..~.9.~.~..e.~ ........................................................ If appJicant is o, 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 ................ .g~'.~.o..e..~..A.~.e.D~9.,..,~j.~0.ez:.~..~,~..~T.~..~.~ .................. :.....~.:::....;.,~ ................. Municipa ity '~ 2. State existing use and occupancy of premises and intended use and occupancy of pr°posed,~gqp~ti~uction. a. Existing use and occupancy .......... ]~L~,~:~Le~¢.e. ................................................... ;;.....~..4.'.~...~.,.~;: ....... ,: ................ b. Intended use and occupancy .............. ~¢,S~..c~¢D.~.~ ................................................... :.; ...................... ~ ................... 3. Nature of work (check which applicable): New Building .................... Addition ......... ~ ...... Alteration ................ Repair .................. Remova! .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost .............................................................. Fee ..................... ,~,,0(} ......................................................... (to be paid on filing this application) 5~ If dwelling, number of dwelling units ......... Ozze ................. Number of dwelling units on each floor ..... ~3~e ................ If garage, number of cars ......................................................................................................................................... 6. If busihess, commercial or mixed occupa.ncy, specify nature and extent of each type of use .................................. 7. Dimensions of ex!sting structures, if any: Front ....... 3~..~.¢~, ......... Rear ..... ~-..~¢.t,., ........... Depth ...~.0....$..t,.., ............. Height .../..-.~..~ ....... Number of Stories .........f)~.~ ................................................................................... Dimensions of same structure with alterations or additions: Front ...... ."l.;~..~'t,., .............. Rear .....~.0..,f~., .............. Depth ..... 2,0.,¢..1:, ............... Height ................................ Number of Stories ............ O..z.t.e. .............. 8. Dimensions of entire new construction: Front ..... ..;~....L.'.f,..: ............. Rear .....~..0...f..~.: ............... Depth ....2..0...~.: ............. Height ..~.~..F~... ......... Number of Stories ......... .0~ ............... 9. Size of lot Front ..10.Q..ft.~... Rear ~.Q.Q..z¢..~., .......... Depth .2~1~ fl,. / 10. Date of Purchase .z~...~ ~ Name of Former ~,~,,r/,~-~¢,~-~r~/,~, ~, ~ 11. Zone or use district in which premises are situated ........ Buainesa .......................................................................... 12~ Dees proposed construction violate any zoning !aw, ordinance or regu ation~ ......... .~.o. .............................................. 13. Name of Owner of premises .B,,..,~aglio~/..~.g/'~oAddress ....,~,f~ke.~.~...[.~...~l-~...q~.~...~.,.~.,.... Phone No...58Q ........ Name of Architect ......................... ~:T .................... Address -- ~.,~.~ .,/f/2~ -- ~ ,,, ~ , .~..~ .............................. Phone No. Name of Contractor (<~..~',.'~r~.'.'~ .......... Address .~...'~... Phone No..~.~.¢~. ~ .... PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names ~nd indicate whether interior or corn~r(Iot. ,/~/~r :~ OF NEW YOR ~ ~' 3 ~ .. -- cC'4' ~J-~ ¢r¢'~-/,z~L,~ ~ ~STATE . COUNTY OF~ ........................../~'~'~ b'~' ;"~:...~.~.~ ........ being duly sworn deposes and says that he ', the app 'cant (Name of .na'.wdua] s.gm~-app~catio~) a,bove named He s the ~ ~.~ (Controctor, o~ent, corporote officer, etc.) of soid owner or owners, ond is duly ~uthorixod to perform or h~ve per{or~ed the s, id work and to m~ke ond {i[e this opplicotion~ thor nil stotements contoined in this applicotion oro true to the bost o{ his knowledoe o.nd bel~efl ond thor the work will be performed in the m~nnor set forth in the opp~icotion flied therewith. Sworntobefpr~methis ~_, ,~, ....... ............................................ ~ .. County (Signature of ~ppl~c~,nt)