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Home My WebLink About2765-zFO~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S O~:FICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at '--.~/~"~e'~'~'t~...~O~(~, ........................... Street conforms substantially to the Application for Building Permit heretofore filed in this gffice dated dated ............................... ~r.....2.t ........ , 19...~.~, was issued, and conforms to all,of the requirements of the applicable provisions of the law. The occupancy for which this certificate is i~sued is ........ Lowner, lessee or tenant) i of the aforesaid building, i H.D.Approval Dec. 29, 196% by ~. Villa i ! Building Inspector I~ 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? 2765 z Permission is hereby granted to: Gold~.tl~..l~$.l~l.~.ng&...Con~t.~uet~ ...... .~/C ~ohn Volos~k~ .......... 5o~thotd .................................................. to Iltttl6 .. l,,e~ ..erie ..£e~t..ty.. ~l,,ee.].~ ~.~ ....................................................................................... at premises located at LO~'"'~'j ....... 'P~Uorl~u"HUl~'l ...................................................................... ....................................................... ~.eaon&a.r.....N..g. ......................................................................... pursuant to application dated ..............A. pl~ .:~ ....... ~!i~'"'~ ........... 196~..., and approved by the Building Inspector Fee $...~1 .O.,.O~ ......... 3-9 SUFFOL~ CO~ DER&R~E~r OF HEALTH Da%e DEC 2 9 1965 TO WHOM l~r MAY CO~ICEB~I~ The sewage disposal facilities for a structur~ located at have ~een inspected by this Department and found to be satisfactory, D s r c Eng er -- NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Appreved ........................................ 19 ........ Permit D~sapproved a/c~ .............. APPLICATION FOR BUILDING PERMIT Date ................... Y/.~.. :..~. ......................... 19...~.,~.~...,. -/ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted Jn duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this location. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue o Building Permit to the applicant. Such permit shall be k, ept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole o.r~'in port for any purpose whatever until a Certificat, e of Occupancy shall have been granted by the Building Inspecto[. ~* ~ APPLICATION IS HEREBY MADE to the Building/J~epartment for the issuonoe of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold?$u{~oJk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additior~s or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ...... ..... (Signature of applicant, or name, if a corporation) .; ...................... .......................................... '.. ..... (Address of applicant) State s?heth,er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... .~.~.~ ~.~-~: ............................. ................................................................ : ...................................................................... Name of owner of premises ...... ~/.'~.J~ ........... ~.~..../~J.~/..~(J. ............................................................................................... If applicant is a corporate, signature/~/~uly authorized officer. ....... ',;; on,~ ;hie of' ~rp' ........ ;;~' ";i ................... 1. Location of land on which proposed work will be done. Map No:~'... ........................................ Lot No: ..Z ............. ~7' '~ '~ ~' ' Street and Number ....~.~. ............ ~.~ ............. /--/~,...~.~...(j~:", ......... ~'('?/~' ....................................................................... Municipality . 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. Natuire of work (check which applicable): New Building .................... ddition .................... Alteration ................ Rep6ir .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estin~ated Cost ................. '.~.../¢.~.~.¢~.... ......................... Fee ...:.~.,/..¢..:..~.?.. .................................................................. ~ (to be paid on filing this application) / 5. If dv¢elllng, number of dwelling units Number of dwelling units on each floor ........ ........... If garage, number of cars ............... (. ....................................................................................................................... 6. If ~usiness, 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 ........................................................................................................ Dim,~nsions of same structure with alterations or additions: Front ................................ Rear ............................ Deplh .............................. Height .............................. Number of Storfes ~/~' f~'~ ...... ,~...~..;...~..". ......... Depth .....~..~...*..~.'. 8. Dimlmsions of entire new construction: Front......,,'.~..,~'. ............ Rear ....... Hei!~ht ....... /..~..~. .............. Number of Stories .......... ~ ................ 9. Size' of lot: Front ....... /...~'..'~..' ......... Rear .....~...~..~..-. ........... Depth ...~...~.. ................. 10. Date of Purchase ....~/~.~.~.,....¢¢//~¢,/~ ............. Name of Farine Ow, ncr ~.~,,zV'_~.~.. ........~Z.~.~'.~('.. ............. 11. Zon; or use district in which premise~' are situated...~,~-5/./24~..~h'~..~/./:~.(- ...................................................... 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? .../~. ...................................... 13. Na~e of Owner of premises...~.C-~..~'......M'..C..k.~f../~. ....... Address ..4¢...¢..~..~-..~.~..¢..,.....~...¢: ........ Phone Name of Architect ........................................................ Address ............................................ Phone NO ................. Name of Contractor..'~.'C./,,C',i/,~..~..~f..~.,.C....,?/f£.Address ..,,~x.2.~/~¢--,~.~,/.~.~.~..: ........ Phone NO.--~C..;T..~'..-..Z..¥. PLOT DIAGRAM Locat~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr, property !i~.es: Give street and block numbers or description according to deed, and show street names and indic, whether m~renor or corner lot. ' STATE OF NEW YORK, ) S S. COUNTY: DF ............................ ) ..... ~....~.~.~/~ ............................ ., ............ being duJ,y sworn, deposes and ,says that he is the applic (Name of individual signing application) above named. He is the..~4~ ........................................................................................................................... k (Contractor, agent, corporate officer, etc.) of said ow er or owners, and is duly authorized to perform or hove performed the said work and to make and this applicbtion; that all statements contained in this application are true to the best of his knowledge and bel and that t~e work will be performed i~,~.~ se~ ,~orth in the applicat~n, filed therewith. ,_ Sworn to b fore me th s ';;~,3u~, state ~ ~e~ .o,. ~~ .......... &.L~ ....... ~y of .... z~.;~;;;~;Z~;,~.~?¢L~.. ,¢ (~nature of applicant)