The URL can be used to link to this page

Home My WebLink About2482-zFOl~I~f NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ......... Z..21119 ..... Date ...................... ]~br.u~l~..../ ....... , 196,5_. THIS CERTIFIES that the building located at ..... Gag~n..Latld~]/'..jJoad,,...,~otzthald Street Map No ........... .-..-...-..-...-.'~lock No .......... .-..-...-..-..-... Lot No ......... .~...-..-...-..-.. .............................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. A~4J.g,~.t..6. ................................. , 19.6d~.. pursuant to which Building Permit No. dated '"~t~[ttS~"~ ................................. , 19..6~., was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ................................................................................ ..................................... The certificate is issued to ................. He~tl.lx..l~,la&thh .......................................................................... (owner, lessee or tena.nt) of the aforesaid building. FORM NO. 2 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) N? 2482 z Permission is hereby granted to: 0oldsmith ]~.~l.d.~Xlg...~..~g/l~.t~..~.~..~i.g..~...]~.n.g.......~..C....He~y Smith ......... ~ au~al~l,d ................................................... to ..I/ulld.. n~l;lan.....on..axl,st, tn~...d~tel/ing ..................................... ot premises located ot~.s~.....l~en..!,nrld~r~..H~/~d ....................................................................... .............................................. ~.o.~hcld, ....... .I1,.1/, .............................................................................. pursuant to application dated ................................... ~t.....6 .... 1~...., and approved by the Building Inspector Fee $...~......0~... ........... TOWN OF SOUTHOLD BUILD'lNG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exami ned ................ ~. ................... 19 ........ Approved .................... .~.! ................. 19.....~...Permit No...........C~t'~' c~......., ...... ......7~ AP~I.I~ATION FOR BIJII. DING PI~RMIT Application No. ¢:~ L.( 1~7~.~ 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 property must be drawn on the diagram which is part of this location. 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 a Iterations, or for re'oval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. c, ......... (Signature of applicant, or name, if a corporation) (Address of app~iccnt)° State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ........ ....................................................................................................................... Name of owner of premises......).~. ~t,~.~ ........ ..~...~/.~..t~......~. .......................................................................................... If applicant is a corporate, signature of duly authorized officer. ~(Name a~d title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............................................Lot No: .................... Street and Number ....~....~]~...~......~.~..~.~.....~d.~...~...~..~ ....... ~unicipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... ~.~ ............................................................................................. b. Intended Use and occupancy.....~.) ..................................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition ..... ~ ...... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost......~.~T'.~t~.-....~.. .................................. Fee ....~..~..,.....~.. ......................................................................... (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 ........ ~?.~fi~ ..................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .............................. 7. Dimensions of existing structures, if any: Front ........ ~.O..~..~...~:. ...... Rear ....... .~.~..~..~ ...... Depth ...~,,~.../. ............. Height ........(~..~ ............ Number of Stories ............ ~.. ............................................................................................. Dimensions of same structure with alterations or additions: Front ...... ~,.~..:~..~..~.t. .......... Rear .....~.~..~.?..~ .............. Depth ........ ~..~...~. ............ Height ........ ./...~..~. .............. Number of Stories ...... f(.. ....................... 8. Dimensions of entire new constructio Height ............................ Number of 9. Size of lot: Front ......x(./O.../ ........... 10. Date of Purchase ............................... 11. Zone or use district in which premi,, 12. Does proposed construction violate 13. Name of Owner of premises.~.t~k~, Name of Architect ............................. Name of Controctor.~r~.O~,~lbf..~! Locate clearly and distinctly oH buHdit property lines. Give street and block numb~ whether interior or corner lot. ~: Front ............................ Rear ............................ Depth ............................ Stories ............................ ),ear ....... ././...~.. ~ .......... Depth ..... /.~,~..~ ........... ........................ Name of Former Owner ........................................................ es are situated ...... ~,.~-~lb/~.-'~mt..JTtJ~. ......................................................... ny zoning law, ordinance or regulation? ...~kO ............................................ i....'~i.P,6,.~,~(c......Address .~,lD.~.T~.'k~bJ~ ..................... Phone NO.,-,~,~:~..'.~,,.ct~.. ........................ Address ............................................ Phone NO ..................... ~*~SJL .:~,1¢,. Add re ss .~.¢~U.T~'t~,D ....................... Phone PLOT DIAGRAM gs, whether existing or proposed, and indicate all set-back dimensions from rs or description according to deed, and show street names and indicate ,l I L STATE OF NEW YORK, ) S S. COUNTY OF ............................ ) ..l'~JJ~'.~,,~J~ ....... J~ ........ (~O.J~O~fI~,I.3TITJ ................................ being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the.....~.~.~ .............................................................................................................................. (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 file this application; that all statements contained in this applidation bra true to the best of his knowledge and belief; and that the work will be performed Jn the manner set forth in the application filed therewith~ Sworn ta before me this ~ ~t , / . _/ ~:~ day of ~ 19~. ,,,... ~ ~Signa~ure of applicant) ............. :~ .... ~ ~- / NOTARY P.L ';, :, , ' .......... ; ~ ~ - ~-- ~ount,' No 5~.~,,' , ,,