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Home My WebLink About2837-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at~.J~.....Rlt.l~..~O~¢l, ...................................... Street conforms substantially to the Application for Building Permit heretofore filed in this office doted ................................... Aug.us~ ....... 9. ...... , 1~. .... pursuant to which Building Permit No..~3.~...~ doted .............................. Aug.u,s,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 issued is ........ (owner, lessee or tenant) of the aforesaid building. H.g.Approval Nov. 10, 1965 NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at -N:/~-..~th,.,R~d ................................. ' ..... Street conforms substantially to the Application for Building Permit heretofore filed in this o~fice dated ...................................... A~tg.*....,.c) ........... , 19..6~.. pursuant to which Building Permit No..~...~ dated ............................ ~§ ........ ~ ........... , 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 The~dc~.a T~p. tdy. ...... Ow~e~' . ....... (owner, lessee or tenant) oF the aforesaid building. H.D,Approval Nov..i0~ 1965 b~ R, ¥il!a Building Inspector/ FORM NO. 2 TOWN OF $OOTNOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 2837 Z Date .................... &~i~,~.t .......... 9 ............. , 19(~... Permission is hereby granted to: .~. *bt..t z. ....... A~-~.~'&..Zt~. ........ ......................... ~latt~tu..ek .............................. to ...~1'1 d..~w..one..£~L~v....d,w~,l~r~ .................................................................................... at premises located at ..........~/~.....R~lt~..~l~ .................................................................................. ........................................................... i~.t,~-t,~lil~. ................................................................................. pursuant to application dated ........................... A~I~ ....... 9 ................. 19...6~, and approved by the Building Inspector Fee $...~OO ........ Building Inspector SUFFOLK COUFrY DEPARTMENT OF HEALTH Date~~_~.~ Bldg, Permit No.~ TO WHOM IT MAY CONCE~q: The sewage dispesal facilities for a structure located at have been inspected by this Department and found to be satisfactory. ~ ~mgimeer ..... FO~M NO. 4 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOL~ N.Y. CERTIFICATE OF OC:CUPANCY No..,~..,2~9.Lk ........... Date ........................... THIS CERTIFIES that the building located at .]'~.~...l-~:tzJ~lq....-[-~.o¢~c] ................................. Street Map No... ................. ~ ... Block No...~:Z:~ .......... Lot No....X:~ ......... £~a.~.~li.t~)L~.~;.~...]~.o.~.~ conforms suJ dated ......... of the appli The certific ~tantia~ry to the Application for Building Permit heretofore flied in this office dated ................~ ..~.~.! ..~.......~ursuant to which Building Permit No...~:~.Z,..~.~ ./~'t'tZr~..t..~...[--.,l~osissued, andconformstoalloftherequirements ,~e p?v,s~ns, ~ th~e~.-~7~ occupancy for which this certificate is issued is ........ c].w~. ~...] .~,i~,~ ............................................................................................. is issued to . ~]~:~.0.~].O.~..~ .T!'~.~,~ .................... 0.~.~Z/ ......................................... ~'~'"~'~ ~ (owner, lessee or tenant) of the aforesaid building. 1-~,]).A~m..o¥~Z ]~ov. 10~ 196~ by ~. ~]'illa Building Inspector/ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ...................... ./....J ............. , 19 ........ Permit No. ~.~'~..~...../....~' APPLICATION FOR BUILDING PERMIT 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 thi~ 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 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, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. ...... Ed~....Al~tz ................................................................ (Signature of applicant, or name, if a corporation) ...................... ~tt ~utttek .................................................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi'neer, general contractor, electrician, plumber or builder. ............................. ~ ........... C~,~t ~,~e-t~ ............................................................................................................................... Name of owner of premises ..'.~eCJf]Cv['~,"'~;~ .............................................................................................................. 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 No.: ......... ~ ....................... Lot No.: ..~ .............. Street and Number .... ~.¢~..~Oa~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. NatUre of work (check which applicable): New Building .... ~3[~1;~.... Addition .................. Alteration Rel~iir .................. Removal .................. Demolition .................. Other Work (Describe) 4. Estimated Cost ............ ;I~4;XIO ................................. Fee ...... 3. O~00 .......................... i (to be paid on filing this application) 5. If dy/elling, number of dwelling units .......... ~ ...........Number of dwelling units on each floor If garage, number of cars 6. If business, 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]enslons of same structure with alterations or additions: Front .................................... Rear Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ..... ~8 .......................... Rear ..... .~J~ ................. Depth ....... ]J~ ....... Height .................... Number of Stories ........ .~11~ ......... 9. Size~ of Io~t: Front ..... ~Ol~ ............... Rear ............. 100 ............... Depth ....~8~j ..................... 10. Dat~ of Purchase ................. -.~ ...................................... N~me of Former Owner ........ ~.~,ltl.~;J.~.ltJ~ ............... 11. Zonle or use district in which premises are situated ............ ~,~'"(J~'l~ ........................... 12. Doe~; proposed construction violate any zoning law, ordinance or regulation? .............. 13. Na,me of Owner of premises ....~J~lll. O~J~'B.....]~Jl~JJ~'Address ...........J~.t,.~,~lJl~ ........... Phone No. Narhe of Architect ...................................................... Address ............................................ Phone No. Name of Contractor ....[d.'~..&J3~.t;l~ .......................... Address ........... J/~.t,~;l.~tl~J~ .......... Phone No. I.ocai property I whether i.r PLOT DIAGRAM clearly and distinctly all buildings, whether existing or proposed, and indicate all set~back dimensions fr ~es. Give street and block number or description according to deed, and show street names and indic erJor or corner Jot. % \ STATE OF~ NEW YORK, } ¢ ¢ COUNTY jOF ....l~.~"~O~C, .......... ,f '~*'~' ................. i ................ ~..~k~.J,t, lll.......i .............................. being duly sworn, deposes and says that he is the appli( '(Name of individual signing application) abow; nar'heal. He is the ................. ~J~l,l.t,~.~l~ .......................... j (Contractor, agent, corporate officer, etc.} of said ortner or owners, and is duly authorized to perform or have performed the said work and to make a.nd this application; that all statements contained in this application are true to the best of his knowledge and belief; that the wprk will be performed in the manner set forth in the application ~ therewith. Sworn to Before me this /~/ ~, ................ ............... ............. , ' ~,;~ ~ ,/ ~ /O~ ~ ,w....~(~,.~~.~ ....... ~.~,~..~..~;..~ .............. Notary Public, ...,(~?~.;:.;~:~Z.g...L~(/...~?:~... Coun~ /~ (Signatur~ of applicant)~