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Home My WebLink About2871-zFOKM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...~/~..0~1 &~m.A.~.e...~.8/J~..~To.o~e~...(Jjl,~k Map No...X~ ...............Block No..:~[ ................ Lot No. ~ ......... R;O~llt, ho]~e.....]JJ~[,' ........ : ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................................... J3.1~l~t,..,..~, ....... , 19.6~.... pursuant to which Building Permit No....~...~.~..1....Z doted ........................... ..8~,~..t'.......~.~. ......... , 19..6...~.., was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ ...... l~:l.~'a .be..one...f.m~ ~]r...d.~el lit~ ........................................................................................... The certificate is issued to ....]~.,...~.O]~Ii'I..~,I~JP~, ............................. 0~1~. ................................ (owner, lessee or tenant) of the aforesaid building. H.D.A~proval Ma~eh 9, 1966 by R. Ytlla Building Inspecf~r FORM NO. 2 TOWN OF $OUTHOLD 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? 2871 z Date ............................. I~ep~;......23 .......... 19.6~.. Permission is hereby granted to: Oee..Ahle~,s.-~ ..1~.. ~ohn...l~e s .~n~ ........... .......... Ou4~ehog~- ............................................... to ...li~1~Ic.~ .. ~,,~.. o~e...~ mn~y., d~e ~.15 ~ .................................................................................... at premises located at .-.-~. ~,~"l..&..~'o~k'e~'-~"~,etle..])z' ............................................................. pursuant to application dated ........................ ~te.TIt, ....... ~ ............... 19...6.~, and approved by the Building Inspector Fee $.~O.OO ........... Building Inspector SUFFOLK COUNTT DE?AE~MENT OF HFALTH Permit TO WHOM IT MAY CONCE~: The sewage disposal facilities for a structure located at inspected by this Department ap~ found to be sattsfaotory. District Engineer District Engineer' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ........ Approved ........................................ , 19 ........ Permit No ......................... Disapproved a/c ............................................................. DE7 Application No ................... I ......... APPLICATION FOR BUILDING PERMIT Date ..................................... 19 ............ INSTRUCTIONS a. This appJlcation 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 propertymust 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 availoble 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 lo 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. (Signature.~c~of c~/plicant,.~or name,~if a corporation).~ ............... ........ 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~ozrJ¢ will be done. Map No: ................. .,~ ............ .//.....~../l~ot No: .................... Street and Number ............ ....~...~ ........ ..,~......~.. ..................... ~~ ................................. Municipality 2. Store existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......................................................... ~.~/~. .................................................................. ntended use and occu anc b. p y ........................................ ~ ............... . .~...: .~.~,,~ ............................................. Locotd clearly and distinctl property lines. Give street and whether interior or corner lot. 3. NatUre of work (check which applicable): New Building ..... ...~........ Addition .................. Alteration ............... Repair .................... Removal .................... Demolition .................... Other Work (Describe) ................................... ....... ..4.../..)._~...O...~.. .................................. Fee (to be paid on filing this application) 4. Estimated Cost / /~,/n _~ umber 5. If dwelling, number of dwelling units .......... ~ ......... ;,,,,N of dwelling units on each floor ~.~.~...,.~...~...~.. If garage, number of cars ........................ ~7w ............................................................................................................ 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 ............................................................................................................ Dimensions of same structure with alterations or additions: Front ................................ Rear ............................. Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ............. .~....~.... ..... Rear ....... :...~....~.. ........... Depth ........~..~. ............ Height .......... ,~.~, ......... Number of Stories .......... .~. ............... 9. Size ]of lot: Front ......... ./..?....'~.. ......... Rear .......... ./2....~. ........ Depth ................................ 10. Dotel of Purchase. . ~..~...~.../.~,.5" ..... Name of Former Owner 11. Zone or use district Jn which premises are situated ............................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ................................................ f . r o;,. S;'/ A one 13, Name o Owner of prem,ses ..~..,....~.~ ............ .~.~.T:.,....q/~kddress ..... ~.~J..~..¢ ....... .~,..,.~..c[ ....... Ph No ............... Nar~e of Architect ...................................................... Address ............................................ Phone No ................. Name of Contractor .~...~.~ ..... C~ .................... Address ..... m ................................ Phone No ............... PLOT DIAGRAM ' all buildings, whether existing or proposed, and indicate all set-back dimensions f ack numbers or description according to deed, and show street names and indic¢ 7.s' ,j a c. Zc c- STATE OF NEW YORK, '~ . .. COUNTY ]OF ............................... ~ ~'~' .... sworn, deposes and says that he is the appli, ........ "" ~ame or'individual si~ning ap"p'i[~being duly above:' nar~ed. He is the ............................ - ~ ............. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and this application; that all statements contained in this application are true to the best of his knowledge and be and that ~he work will be performed in the manner set forth in the application filed therewith. Sworn to before me this n ~-- ..... ..... day Notory Count, ,,0, ^. nature of ~ / /~ ] NOTARY PUBLIC, State of N ] ~ No, 52-3233120 Suffolk County , Term [xDires March 30, 19