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Home My WebLink About2808-zFO~M NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. 'Z 2393 Date .A.p.I!'.IL1 15 1966 THIS CERTIFIES that the buildin9 located at ..l~ ./~..Q~,lll..~Olt'.t, ll..~ ...... .............. Street Map No. ~:~ ............... Black No....lf, Xl(.....i ..... Lot No...~..~:~l~l,...~¢~i~/'..O~, .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................ ~.~l~.It...~ ................... , 19.6~... pursuant to which Building Perm t No.~..~..0..8.....~.... dated .................... ~.~J~....~. ..................... , 19.....~..~ 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 ........ The certificate is issued to (owner, lessee or tenant) 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? 2808 z Date ............................ e'"~. ......... ~. .......... , 196.~... Permission is hereby granted to: It.?, ,l~eeve &..,qe~m...Z~....AJ¢.....~,3,Z~e..o~..l~e~n~oz't, .... l~t,.~ .~.t,~mtl ..................................................... to .~ 1 c~..~? .hom~e..£c~...t~l~l.~u~...~z~.t,~..~y~t,~-~ .......................................................... ct premises located at ...]J~,.....O'l(1...~Olllt, b...JJJE~ ............................................................................ ............................................. 8et~the'~d.t ........ ~,.~.,. .............................................................................. pursuant to application dated ................................... ~T~. .......7' ...... 19.~.~., and approved by the Building Inspector Fee $~J~ .............. TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN GLERK'S Examined .......... , 19.....,,, ~ Approved ..... ~ ........................ k..., 19..:.:...Permit No. ~':~ ............ APPLICATION FOR BUILDING PERMIT Dote ,,J~..,.~..'l~- ......... .7 .................. , 1~....~.. INSTRUCTIONS a. This epplication 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 applica- tion. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon opprova~ of this application, the Building Inspector will issue a Building Permit to the applica.nt. 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 pa rt for any purpose whatever until a Certificate of Occupancy shall hove 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, alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable lows, ordinances and regulations. ........ (Signature of applicant, or name, if a corporation) ............ ............ (Address of applicant) ' StaCe whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................... ...................................... Name of owner of premises .....VI...I~,.¢,,Z~.~.~Z.......~.L.-~.......,~..('~.~"..~./~...P...~..~"~. *.~...~ ~77~.( , ....................................... If applicant is a. corporate sign~_ture of duly authorized officer. "~/~'/~' ~Name and title of ~o~porate officer) 1.Locati6n of land on which proposed work will be done. Map No.: Lot No.: ''Street andNumber '/~ .~..I~D...~.~ '- ~1~00 .... ~I~L~.........~ .. ..... ......... " -. _- "' .Municipality 2. State existing use .and occupancy of premises and intended use and occupancy of proposed construction. a. Existing bse and occupancy .~ ~ ........................ b. Intended'use and occupancy .~....~.1,~ ~... ~..~ 3. Nature of work (check which applicable): New Building ...--~ ........ Add,ition .................. Alteration Repair ................. .,~emovat .................. Demolition .................. Other Work (Describe) .................. 4. Est m?ted Cost ....?'...~ ~. ,~ ,~"~l~ ~ Fee I (to be paid on filing this application) If dw~lhng, number of dwelling units Number of dwelling units on each floor If garage, number of cars ............................................ 6. If business, commercial or mixed occupa.ncy, specify nature .and extent of each type of use ~ Dime.nsions of existing structures, if any: Front ............................ Rear ............................ Depth Height ............................ Number of Stories ................ Dimensions of same structure with alterations or additions: Front ................................ Rear J Dept~ ................................ Height .............................. ] Number of Stories ...... .................... 8. Dimdnsions of entire new construction: Front ...... ~.."]. ................. Rear ...... ~...~/..,~ .............. Depth ...... ./..,.~....X. ....... Height ....... ~..~.../. .............. Number of Stories ......... ~/ .................... Size of lot: Front ...~....'~....~.?.:]~.-~.../..... Rear .....~J~O...O...:....~...~ ........ Depth .....~....~...(~...~..~;i~.. Date of Purchase .......................................................... Name of Former Owner ZoneI or use district in which premises are situated. Doesl proposed construction violate any zoning law, ordinance or regulation? Nam~ of ,,.Owner ~f p~emises ~.t./4,~.~ ff.. P. £..~/~ J:~~/~q~:~Address ~.~...a(../~ .~ Phone Name of ~t/~.~.~.¢~.c.c.¢..tCi../~.~.].Lfi.--,~..~..~...(../~...~. ..... ~"~a'dress,~ ,~/,,'~'~.'~/"/'~'"~'~ M'~..: .......... Phone No~.'.~...".f~L~ff'7 Nam~e of Contractor/]~fi-.Q.....~,...~'r~.C'.~.¢.~..(.~./Address ZF//L~./../.~.¢../~'.¢..!.~:..,}f_ ......... Phone PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-back dimensions fr or description .according to deed, and show street names and indic 10. 11. 12. 13. property lines. Give street and block n~mbers whether iqterior or corner Iot.~ STA~' COUNTY OF ......... being duly sworn, deposes and says that he is the (Name of individua! signing application) above named. He is the ..................................................... ...(-~...' .~;~..,¢~.....,,~...¢~..~.~..4~,~.4~..~ ......... 7, · (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 application; that all statements contained in this application are true to the best of his knowled~3e and belief; that the work will be performed in the manner set forth Jn the application filed therewith. Sworn to efore me this ; Notary (Sig~ )plica,nt)~ i / :pires ~4~rch 30, [g6/~