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Home My WebLink About2431-zNO. 4 \ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z 20~r.~. Date ..................... .~..Q.y?.~...~.Or .. THIS CERTIFIES that the building located at ~/.~. ~}~'..~.l~..~.q~..~.....~.~.,e. ............. Street Map No...ZZ~; .......... B~ock No ...... .~..~.... ,et No. ~ ......... ~.~,~,t.~?.~.'....i:'~:.~: ............ conforms substantially to the Application for Building Permit heretofore' filed in this office dated .................................................................. , pursuant}to which Building Permit No.....2.~.]..~.....~ dated .............................. ~T.1~I~¢.....,1,~ ....... , 19...~.~.., was issuedl and confor~ to all of the requiremen!s of the applicable provisions of the law. The occupancy for which this ceri-ificate is issbed is ........ Private on.e. family, d~elling , , The certificate is issued to ~[~p.t,Qn ~omes Construct'[on~. Co ~ne A/c NoEt~~~ork ............................................... ......................................... ~.~,.~ ~.~, ~ (owner,, lessee or tena,nt) of the aforesaid building. H.D,Approval Nov, 18, 196~ by H. Villa 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? 2431 z Permission is hereby granted to: ............. .~..~.~;~ .................................................... to ..... ~¢~,..t~..oae.. £,mtZ.~.. ~et t.1~. ................................................................................. ct premises located at ..l~/s~.....Naw..~l~.£o~..Ave ........................................................................... .......................................................... r ~t ~it~ek~.....N~.:Y, ................................................................. pursuant to application dated .................................. ~T~llI~....~l,8 ........ 19~).~.., and approved by the Building Inspector Fee $.~D.O;O ........... -- Building Inspector / TO WHOM IT MAy CONCERN: SUFFOLK COUNTY DEPARTMENT OF HEALTH Date ~ ~ ~ ~%%~' Building Permit No. ~ ~//.~/ ~ The sewage disposal facilities for a structure located at have been inspected by this Department and found to be satisfactory. District Engineer FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. Approved ........................................ , 19 ....... JPermit No...~=...C.L~..~..../..,~ Application No ..... APPLICATION FOR BUILDING PERMIT Date ................................ ~T.l~Jf~..... ,1,8 ......... , 19..6.~. ..... 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 applicant agrees to comply with all applicable laws, ordinances, building code and regulations. J~es Ol s ell ~...(}litf~...ilo ~l.t~y. ................................ (Signature of applicant, or name, if a corporation) (Address of applic0nt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...I~.oI't.b.....F..o..l~.l~...~?,l~,l,d.~II.i~...l;Ilo · 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: X~ ............ Street and Number ,~,,,/,.~,,.,...~,,~...~.IL~.~.O],ti~..,~.V~t ........ ~.t;:J,:~.~O~t..,N~.t~'~ ........................................................ Municipality 2. State e~(istJi~g us~ and 0~cupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ..?.,.~..g..~..~..~.....],.~.l~..~.. ...................................................................................................... b. Intended use and occupancy ....0..~..~.....~....8~....J...]:.~..,..~...~..~...]:.]:..~..17~ ................................................................................ 3. Nature of work (check which applicable): New Building ...... ~.Y,.,Y,.,W,. Addition .................. Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) 4. Estimated Cost ........~.~0~0...~/./~. ........................... Fee ...... '~ (to be paid on filing this appl.ication) 5. If dwelling, number of dwelling units ...... O1~.O ............... 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. Dimensions of existing structures, if any: Front .......................... Rear .......................... Depth Height ............................ Number of Stories Dimensions of same structure with alterations or additions: Front ................................ Rear ............. Depih .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ...~ .................... Rear ............ ~r ........... Depth ~'6/f~.~ ............ ., Height ............................ Number of Stories .O'zlO .................... 9. Size of lot: Front .......... '~,l,a .......... Rear ........... ~..1.O ......... Depth ......'~'g(~"P~']~ ......... 10. Date of Purchase .............1.c,l~.~. ................................. Name of Former Owner ............. .~S.¥~e;]~eak. l. ............ 11. Zone or use district in which premises are situated .......... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............. ~ ................. l'iome aress o£ of£ cel' |3. N~me of Owner of ,premises l~.t~h..F, clrk:..]Bu~].d~dr~e ........ I-I~l~ton..B~y,~ ...... Phone No. Name of Architect ...................................................... Address ............................................. Phone No. Nome of Contractor ..NC~.~;h..F.O:l:'k..~L'ld~:~...,Address ...... ~U~..~ ....................... Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fn property IJpes. Give street and block numbers or description according to deed, and show street names and whether interior or corner lot. STATE OF;, NExAV__'~(~R[,_ / COUNTY OF .m..~.~.~],/~ ...............f S.S. ................. ]......~..,~ .............................................. being duly sworn, deposes and says that he is the c (Name of individual signing application) above named. He is the ......... ~e~..~f...~B~.~d~F .......................... (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 statements contained in this application are true to the best of his knowledge and bell and that the work will be performed in the manner set forth in the application filed therewith. Sworn to 5efore~...~. me this /~ - ~/~~ ................ d~[~a.efA~.....~ ................ , 19..~. . .~d~.~~ ~ ......... ......................... Notary Public .~;~,~.~... Coun