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Home My WebLink About2817-zFO~M NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ..... ~..-2.30'I ......... Date ..., ............... :.~l'o.v. er~..~.~.....2...3. ......... , 19.....6...5. THIS CERTIFIES that the building located at .~./S...~h~c~e..~a~er.~ L~,~., .O.~.:~.e.~t: Street Orient Map No.;El~..~tle..SeaBlock No ..... ~ .......... Lot No ................ 4.2 ................................................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................................... J--~.l.y...1.9......, 19..6,~. pursuant to which Building Permit No. 2B.],'l~ .... dated ................................. JUly...1,~....., 19...65, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ addition to one family, dw~llin9. The certificate is issued to .Thoma~..Kell1~ ....................................................................................... (owner, lessee or repaint) of the aforesaid building. FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEpT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2817 Z Dote ................................. ,]~1]..~ ......... ~,~.., 19...~ Permission is hereby granted to: ...... .T .~..a..~.. E~.~:lX. ............................................ ................... Orient ............................................... to ..... ]~.:l.d .. ap.. add$.t*z~n., on.. ~u~..e~,~t $~g.. ~lwet.l.$~ .................................................... ct premises located ct ..... ~.4)~....}~ ....... OF~:err~..~ojr..~ch~..wea.....~..,,~ ..................................... ................................................... Ihr. e~..~te~,e-.~,~ ............ Orient. ............................................... pursuant to application dated ......................... ~T~I.~.~. ......... ~1,~ ............ 19...~,~', and approved by the Building Inspector Fee $.~.* ................... FO~M NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y~. ....... ApproYed ........................................ ~ ~ ........ ~e~t ~ ............................. Disapproved~:~- - ............. · ................................. APPLICATION BUILDING Date ................................. ........ , .... 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 premi.ses 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 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 Deportment 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. Thomas Kelly (Signature of applicant, or name, jfa corporation) Orient ~ N ~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................................. ow~e~'...,,~..~t&3,de~. ......................................................................................... Name of owner of premises ..T~omas...z{e. tty ..................................................................................................................... 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 ~'~ 0:r'ie~t ~y The ~ea , . No.: ....bt2, ................ IX~£P .......................................... LOT Street and Number 'W'.,/S .Lf',~ee .wa.te~:$...la ........ Om.i~,m.t .............. Municipality 2. State existing use and occupancy of premises and intended u~e and occupancy of proposed construction: a. Existing use and occupancy ........ .cl.}!.e.~.~:i:.,~..~. ............................................................................... b. Intended use and occupancy same with a~ additoi~ 3. Nature of work (check which applicable): New Building .................. Addition ~:;gf,,~f ...... Alteration ............... Repdir .................. Removal .................. Demolition .................. Other Work (Describe) ..................................... 4. Estin~ated Cost ............ 'J..~.,qO,~...~/.~ .......................... Fee ...... ~ .............................................................................. , (to be paid on filing this application) 5. If d~velling, number of dwelling units .......... 9.~..e,. ........... Number of dwelling units on each floor If ggrage, number of cars ............... ~Z.o. ................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ........................ 7. Dimensions of existing structures, Jf any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ............................................................................................................. D~m~ns~ons of same structure with alterations or additions: Front ....................................Rear ....................... Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .......... 23. ...................... Rear .......... 2.~ ............. Depth .............. Hei§ht .................... Number of Stories ...... .o.~. ..................................................................................................... 9. Size,of lot: Front ............................ Rear ................................... Depth ................................ 10. Dote of Purchase ........................................................ Name of Former Owner ..................................................... 11. Zone or use district in which premises are situated ......... 12. Doe~ proposed construction violate any zoning Iow, ordinance or regulation? 13. No e of Owner of premises ....~']9,0o:>...Jxel. J,~.. ........... Address .......QZJ~,q~.B.'¢ ........................ Phone No .................. NonSe of Architect ...................................................... Address Phone No .................. NoMe of Controctor ....8.a?~. ...................................... Address ............................................ Phone No .................. property lilies. Give street whether inlerior or corner ~o' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions fr, and block number or description according to deed, ~d show street names and indic~ STATE OF NEW YORK, t ¢ S COUNTY OF .~t~.~m]~ ............. }o ................. ~ ................... ~T~O~I~[~.[.I'~(~'~J~j .............................. being duly sworn, deposes and says that he is the applicc J{Name of individual signing application) above named. He fs the ......................... o.~r}.e,P.......-....b.~.J.,~,f].e.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 ~Jile this applicJ~tion; that oil statements contained in this application are true to the best of his F~wledgeige arj/I belief; cJha belief; d that the w(~rk will be performed in the manner set forth in the application filed tt~rewith. /' ~ / I Sworn to bbfore me this '------, / , / ................. I....1..9 do,~of .......... ;¢...J~.~ ...... ./g., 19.~'.. Notary Pu~)lic, .~m~lT'~,.Tt:.~Countyj.................... ~ ~[~J~J;~ lr~ J (plican,) ...... ffc'rr" PubliC, State of New York