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Home My WebLink About2814-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDII~G DEPARTMEIqT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at -.6t~.th..D~.:i,'~e,--Ne,:~t, hv...i~{~l~.ho~.d.. Street Map No...~ ............ Block No ....... ~ ......... Lot No ........9.*/,~....98.,...99 ..................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................. J~l.~.y...;t~, .............. , 19.65_. pursuant to which Building Permit No....~Ii~.JL4..Z dated ......................... J',tZ.~..,1,~, .............. , 17..65., 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 ........ ............................................ One.. £am~Ay.. d~e~..1 .~[ncj. .,~.t,h.. add~%~on ..................................... The certificate is issued to ..{:~eo~,~Je..W.~...~.i.'c~,¥.&..-Sf~ner..£C~z...P.~....B~.$$ ........................... ~owner, lessee or renia,nu of the aforesaid building. FOEM 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) N9 281 Z Date .......................... ~ ......... .~ ........... 19...(~.~ Permission is hereby granted to: G.W ¥Sm~h..~..~o~...tne.~t~tG.....pv...B~r t~... .............. ~oxrtho~ ~'"'"I~;'Y; .............................. to ... 'Bu! ]:d" ~n"'a~d~c 1'o~" 'om" m~" ~x l's tit~ ~"'dw~ Tli~g ...................................................... at premises located at ..... -~crts..9?i...98.t...99.-..4~ose..t~eh ...................................................... ..................................... 5m~h"l~tve'""~or~hj .......... ~thot~ ................................................. pursuant to application, dated ......................... ~1'1~1~. ....... 1D .............. 19..6~.., and approved by the Building Inspector Fee $..~(~) ............ Building Inspector ~ ~ t, {'~( ~?~/~ TOWN OF SOUTHOLD ~'""~ ~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE SouT, o,D, N. Examined .................. 19 ........ Application No. c,r~u........... ......... Approved .... ..~./ .............. ~..~.....:.k...., 19.....Y... Permit No. ~./.....~...~ (Buildin~ Inspe~or) APPLICATION FOR BUILDING PERMIT Dote 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 pa,rt of thi.s 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 sh~ll 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, os herein described. The applicant agrees to comply with all applicable la?s, ordinances,, building code and ,~gulations, ~/ (Signature of applicant, or name, if a corporation) ...... ............................................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi'neer, genera] contractor, electrician, plumber or builder. Name of owner of premises ..... ~......'i;~..../'~....'./..~...~..'~ ............................................................................................. If opplican~,~,~/corporo~,,e~na,~_d~ized officer. (Name and title of corporate officer) ~ ~ c,~. 1. Location of land on which proposed work will be done..Map No.: ........................................Lot ~o.~-./.~.d....~.~...~.' ......... Street and Number .~z.~..~....~Z.~.~r.....~.~Z~/~ ....................................................................... Municipality 2. Store existing use and ~cupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~ ~ ~ ~ b. Intended use and ~cupancy ......... ~..~ ..................................................................................................... 3. NatUre of work (check which applicable): New Buildihb : ................. Addition................../ Alteration Repq~ir .................. Removal .................. Demolltian ............ ; ..... Other Work (Describe) 4. Esti~nated Cost ........... ~....~.i..m....¢. .................................. Fee L~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... / .................... Number of dwelling units on each floor If gCrage, number o.f cars ................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. DimJensi°nsl of existing structures, if any: Front ....... ¢~'.~....-~. .......... Rear ...... ~...5...'-7 ................ Depth .2,,.~ ........... Height ........................ Number of Stories ...... ~ .................................... Dimensions of same structure with alterations or additions: Front ....-5%..../. ......................... Rear ..4..%/.' ............ Depth ...,,~.../~.. ................... Height ............................ Number of Stories ................................ 8. Dimensions of entire new construchon: Front ............. .¢. .................... Rear ...... ~ ................... Depth Height ..../.¢.. .......... Number of Stories 9. Sizei of lot: Front ...... ,/.~7. L.¢. .......... Rear ....... /...~..%T..4 ................. Depth ........ (..4.~.~ ............... 10. Dat~ of Purchase ........................................................ Name of Former Owner ..~.~.c./~.../.3.~'~- 11. Zon;e or use district in which premises are situated ........ ../~..~...z~ 12. DoeF proposed construction violate any zoning Iow, ordinance or regulation? .,.~./) .................. t3. Name of Owner of premises . ,~.'.~...~...~....~../.?. .............. Address ...... ~--~.¢~...~7.___________________~.~..~..~ .......... Phone No. Name of Architect ...................................................... Address ............................................ Phone No. Nae of Contractor~...~.../~..:.:~./...~../.C....~...~..~..~..r.~ ...... Address .~,~7~/¢~/.-~ Phone No. ? I PLOT DIAGRAM l_ocat~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions property lines. Give street and block number or description according to deed, and show street names and indi whether interior or corner lot. I (Nome of individual signin~ applicotion) above no'ed. He is the duly sworn, deposes and says that he is the appli~ that the Work will be perforrj~d in the manner set forth in the application Sworn to be~f~.me this k '% /'3 (, ~ -- Notary Public~..~..~..~CCt~0f~y/~ .[O[~/f .. ~o. 52-3233120 Sullolk County ~efm Expires ~arch 30, ~9~ therewith. (Signature of applicant) (Contractor, agent, corporate officer, etc.) of said o~ner or owners, and is duly authorized to perform or have performed the said work and to make and this applifation; that all statements contained in this application are true to the best of his know and belief;