The URL can be used to link to this page

Home My WebLink About2631-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ,Z,.,P_38~I ............ Date ........................... ,Ttl~r. ......... ~. ....... , 19~,~... THIS CERTIFIES that the budding located at ~/.~...~I~"~.i~.w..A~I~..W~.~ .............. Street Map No. ~ ............ Block No ......~ ..... Lot NcCE~I:~ ........... ~O~f,~lO~...~,.~, ................ conforms substanhally to the Apphcation for Buddtng Permit heretofore filed ~n th~s off~ce dated ................................ FJe~u~'~......~.., 196.~... pursuant to which Budding Perm,t No doted .................................. ~e~ ....... ~J...., 19.~., was issued, and conforms to all of the requirements of the applicable provisions of the law The occupancy for which this certificate ~s msued ~s ........ .../~t~at e...one.. ~amfl~7..~lwelli~ ....................................................................................... The certificote is issued to .... ,~4B~:.t~]&:..~***]~U~I? .............. Ow~e~- ......................................... (owner, lessee or tenont) of the aforesaid building. ~,D. Approval July 1, 196~ by R, Villa / ............. ..... Budding Inspector Jk 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? 2631 z Permission is hereby granted to: ~!a~..B,...1~_ _,t.t~.... ~!f~.... ~de: l~,l~..~,...B~u~ to ..~i~..~e~..~..~.~..d~t.t~ ................................................................................... at premises located at ..~....~~..~ ..... ~.$~..P~k~-..l~...~6 ................. ...................................................... ~¢.h~ld.r ~.~ ...................................................................... pursuant to application dated ............................. ~~.....~. ..... 19...~.~, and approved by the Building Inspector Fee $...~.OC~ ........ muilding inspector ~, S-9 SUFFOLK COUNTY DEPARTMENT OF HEALTH The se%rage d~sposa], facilities for a structure located at ' (Give d~ have been inspected by this Department and found to be satisfactory. District Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ...... ..... ......... Approved ........................................ , 19 ........ Permit No ................................. Disapproved o/c ............ ........-~;>~ ..... ._.._._..._~ .................. ~ ............... Application No. c:~ (~ -~ / (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................ ~~'.....'..~.... ~, 1 INSTRUCTIONS a. This application must be completely filled in by typewriter or ~n ink and submitted in duplicate to the Buildin Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets c areas, and g~wng a detailed description of layout of propertymust be drawn on the d~agram which is part of this applicatio, c. The work covered by this apphcat~on may not be commenced before issuance of Building Permit. d. Upon approval of th~s apphcation, the Building Inspector will issue a Building Permit to the applicant. Suc 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 Occupanc shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the ~ssuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe, The apphcant agrees to comply with all applicable laws, ordinances, building code and regulations. (Signature of applio3nt, or name, if o corporation) .......................... ...... ( dress at appdcant) ~ State wh~ther opphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde, If apphcant 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 ~ ~ ~ ~ ~- ~ ~ ~ Mumc~paliW 2. State existing use and occupancy o~premises and intended use and occupancy of proposed construction: a. Existing use and ~cupancy ..~.~.~(.~,..~ .................................................................................................. b Intended use and occupancy . ..~.~ ............................................................................................................ 3 Nature of work (check which applicable). New Bu~ld~ng ~'- Addmon Alteratcon Repair ................. Removal .................... Demolition .................. Other Work (Describe) .................................... '~ "''~' O ~ ~ .................................................................................... 4 Est,mated Cost ............ /....~. ........................................ Fee ~'/~ ~C) (to be pa~d on filing th~s opphcation) 5 If dwelhng, number of dwelling umts ....... ../.. ................. 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 D,menslons of ex,st,nD structures, if any: Front ......'~......'~.. ........... Rear .....~...'~....-~... ........... Depth ....3....~. ......... Height ...... ../...~' ............. Number of Stones .............. ~ ............................................................................................ D~mens~ons of same structure w~th alterations or additions' Front .............................. Rear ............................. Depth ........................... Height .............................Number of Stones ....................................... 8 D~mens~ons of enhre new construchon' Front .......................... Rear ............................Depth ......................... Hmght ..................... Number of Stones ........................ 9. S~ze of lot Front ...~'.~..~.,~~ ~Rear ...... L./..~ ............. Depth .... ~.~....~.. ............... . 10 Date of Purchase ...... ..-?,~-~(~t~~..~. ...... Name of Former Owner .~'./.../.~...~.~j....~...:..?...,~.....~../..../~.. 11 Zone or use district in which prer~lses are sltuated....,~.-.-.-~. ................................................................................... 12. Does proposed construction wolate any zoning law, ordinance or regulation:) ...................................... 13 Name of Owner of prem,ses ..~......~......~.....~....~.)....~..~/J~.Address ~'~..~.....'~..~...6 ~' ~ .~.~, Phone ixio .................... Name of Architect .................................... .~ .............. Address ......................................... Phone No ................ Name of Contractor...~.~..?..~.~..,~.~......~....~...~-.~.4T~'ddress ....~..~...~.....~.....~....~....~...~..~..:.~l~hone PLOT DIAGRAM Locate clearly and d~stmctly all buildings, whether ex~sting or proposed, and ~nd~cate all set-back d~mens~ons fro~ property hnes. G~ve street and block numbers or description according to deed, and show street names and mdicat whether interior or corner lot IV' . ~..~,/ STATE OF NEW YORK, ~ S S. COUNTY OF ............................ ............... i~l'~'~"~"[~J'~i~l~i"~i'~"~l~l~'i[~¥','~i ............... being duly sworn, deposes and says that he ,s the appl,ca, above named. He ~s the ...................................................... ' ................... ........................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the smd work and to make and th~s apphcat~on, that all statements contained ~n th~s apphcat~on are true to the best of his knowledge and behe and that the work w~ll be performed in the manner set forth in the apphcat~on filed therewith Sworn to before me this ...................... ~ - '- ~ ~ ~ ~ ,?tg~ R, - ~ - ........ Notary Public, .~~ ........... ~ ...... ~'"~uBt~c (,-' (S,gnature of appJ,cant)