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Home My WebLink About2833-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .~T~r~h..~a~3?i.sh..gl:~.~.et ........ Street Map No..l~/~r.e ......... Block No .......... ~ ........Lot No...,10[ .......~D.l~,.~ho,~,.d.t.......~.,]~ ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................................. .~...lJ~..~.~..~..3.., 19.~.6... pursuant to which Building Permit No....~..~.~.~....,~. dated ................................. ~1,lg..~.~.~..3...., 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 ........ ....... ~rl.v.a~e...one..£a~i.ly...d~ellin~ .......................................................................................... The certificate is issued to ~.~.~ .~..0,~..~.1~.~.~. ~.~,.~..~.~..e.~ .0...~..~.e~ ................... (owner, lessee or tenant) of the aforesaid building. H.D.Approval Mar. 1966 by R. Villa Building Inspector 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? 2 8 3 3 Z Date .......................... ]k'~g~S~.....~ ............ , 19~.. Permission is hereby gronted to: Tho~. g.... ~1. shs~.... ~O ....... !~ s...D~'etJ%9' .... gatthe~s ......... ~4att$.tue~ ................................................. to ....btld,l~,..l~..Gl~...~.8~l$.~.y..dw~.~.:~l~ ................................................................................... at premises located at ...lid/~...~.i~Z~I~...]}F.'LIII, Oy .................................................................................. ...................................................... Sm~t,~u~],d~ .....tl~.~, ........................................................................ pursuant to application dated ................................ J~I~U~;......~ ........ 19.(~.., and approved by the Building Inspector Fee $.].lgeQO ........... sUFFOLK COUITrY DEPAHT~ENT OF HEkLTH ~^R ~ 9 1966 Date Bld~o Permit Noo~ TO WHOM IT NAY CONCE~: The sewage disposal facilities for a structure located at , ~. ~~ ~.;~. ~,~~~ ,, ........ (Give deed locatiom) , , ..... ~, ,~ ........ have been inspected by this Department and found to be satisfactory. Dist~iot Engineer District Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ............. ......... ~r~ ........................................ , 19 ........ Per. it ~o ............................ 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 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, b~uilding~ code and regulations. ( ignature of app~,'or name, if a corpo~'<~'t'io'~) .... C ........ ................................ (Address of app$i~ant) Slate whether applicant is owner, lessee, agent, architect, engi.neer, general contractor, electrician, plumber or builder. Name of owner of premises ....................... 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 ..................................................... 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. Natuie of work (check which applicable): New Building .......... Addition .................. Alteration ................ P, epai~ .................. Removal .................. Demolition .................. Other Work (:Describe} ....................................... 4. Fstim~ted Cost ....... ~..~/.~'~. ............................. Fee ........................................................................................ ! (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor .......................... If ga?age, number of cars ........................................................................................................................................... 6. If bqsiness, commercial or mixed occupancy, specify nature and extent of each type of use .......................... 7. Dime.~sions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Heigl~t ........................ Number of Stories ............................................................................................................... Dimensions of same structure with alterations or additions: Front ....................................Rear .......................... Dept~ ................................ Height ............................ Number of Stories ................................ Height .................... Number of Stories ............../....././.~ ........................................................................................ 10. Date jot Purchase ........................................................ Name of Former Owner ..................................................... 11. Zanejor use district in which premises are situated .................................................................................................. ~2. Doeslpraposed construction violate any zoning law, ordinance or regulation?,t ~ ............ '"~"~' ..................... ' ................ PLOT DIAGRAM Locotejdearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro property liqes. Give street and block number or description according to deed and show street names and indica' whether i.nterior or corner lot. / STATE OF :.NEW YORK, COUNTY OF ................................ (:Name of individual signing applJcatio~i ......... above named. He is the ......................... ~--,~R.....~....~.~...,~..~.~..~....~... ............................................................................ J ] (Contractor, agent, corporate officer, etc.) of J;aid owner or owners, and is duly authorized to perform or have performed the said work end to make and f thisJ application; that all statements contained in this application are true to the best of his knowledge and belief; a tha[t t ~e work will be performed n the manner set forth n the app ication fi ed therew th Sw6rn to before me h~s No ar PubJic /.../.~.....C~.~-~,..C.'~,A~ . Count ~/, (Signatu of applicant) ........ LI.L I I~ 1: . ' '2% '2' ' ' _... DONALD A. BECKEIR~A]A I ARCHITECT RICHARD P. ARE:LT DESIGNER -- ASSOCIATE EAST S ETAU K ET, N C~ &4 ?,/,., ~ ,.', ,' ?,.,-' ,i ] _1 ~, . ..l ",', ,Ar.,. t ,' ...... / -4 , DONALD A, BECKER-AIA ARCHITECT RICHARD P, ARELT DESIGNEER -- A$$OCIAT~ EAST SETAU KET, N. Y. DONALD A,,BECKER'AIA ARCHITECT RICHARD P. ARELT DeSigNEr-- A$SOCIA~I~ '1 DONALD A. BECKER-AIA i ARCHITECT 1 ~tCHARD P. ARELT DESiGNEr -- associate I ARCHITECT RICHARD P, ARELT DE$IG. NER-- ASSOCIATE V~,qT~ L AV' DONALD A. BECKER-AIA ArChITECT rICHArD P. aRELT. DESIGNER -- ASSOCIATE