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Home My WebLink About2632-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..~a~D~.~dL..&.~lL~]a~t.s..~ ................ Street Map No....~ ............ Block No ......... ~ ...... Lot No ..]E~. ......... J~r,e..$t;.i.tt~e,]rl ..... .N,.~,~ ............. conforms substantially to the Apphcation for Budding Permit heretofore filed m this office dated ......................................... I~.el~, ..... .c) ..... , 19.6~,.. pursuant to which Building Permit No. ~(~...Z. dated ............................. ~.e~.....~l, ......... , 19..(~..., was msued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is msued ~s ........ ........... Busimes~..hnilding .............................................................................................................. The certificate is issued to ..... Wm, ter.,.Jr.,.&..Ctther,a ................... t ez . ........................... (owner, lessee or tenant) of the oforesmd building. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNT(L FULL COMPLETION OF THE WORK AUTHORIZED) N°. 2632 Z Dote ............... ~,~.~..zo ................. , ,9..65 Permission is hereby granted to: H,l~,.~tee~e..&..t~o~...:T~e.....~G-..l~r~el~..~/~..&* other~ (Gobll) .......... ~t;:t.t;~ki... t~ ;. T ;. ................................. to ~[-]~d-..~,.. e~dd':[ ~:o~"on" ~" ~:l:s~;:~r~"bu~r'Zn~ s~'.bu~d I~ ................................... ct premises located at ..... ~/~'-~ll,~_'"l~:l~d' ~ ~t~'[~"~.~/[~ahz~"]F~ ........................................... ...................................... - .......... lt~.~t~,-., tI~-'~: ............................................................................. pursuant to application dated .......................... ..~..e.~...B~..~....~.. .......... 19...~'. <:nd approved by the Building Inspector Fee $...~'.,~01~ ........... Budding Inspector ~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No,~.~..~..,...2~'.. ....... 'Approved . ........................................ t9 ........ Permit No ...................... :...: ...... D~sapp roved a/c ~~. --- APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Th~s application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildir Inspector. b. Plot plan showing location of lot and of buildings on premises, relahonship to adjolmng premises or public streets areas, and giving 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 apphcation 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. Suc permit shall be kept on the premises avadable for ~nspection throughout the progress of the work. e. No building shall be occupied or used in whole or m part for any purpose whatever until a Certificate of Occupon~ 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 tF Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances , 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 an~.uJations. ......... '('~'i'~'~ ~'~'re o ~ '~l~[i~ n ~'~:' ',¥'~ '~;1~;~; ~i ....... ....................... ~B..,-~51,1 i auz.~t~aet.,..~e~..2lo~,..a~T.....¥ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde O~ne~ Name of owner of premises .............. l&r~Z~,~..~...~.~J;fl~.,..,Z.~. ........................................................................................ if applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer} 1. Location of land on which proposed work will be done. Map No ............................................ Lot No' . ................ Street and Number ....... Z~Z~.~:~d.~l,.E]~.3~h..T.,~u~...~lE~t~.~.~;uc~ ................................................................ Mu,mcipality 2. State ex~stmg use and occupancy of premises and intended use and occupancy of proposed construction: a. Ex~sting use and occupancy .~.~0.a~s..n.~T~et'ce.r. sb~[~ .................................................................................. b. Intended use and occupancy ............. ~.(].91.~.~.O~ ................................................................................................ 3. Nature of work (check which applicable): New Budding .................. Addit,on ......~,~ ........ Alteration ................ Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................................... 4. Eshmated Cost ...~2.~,.0.0. Q..9].~S ............................... Fee ...... ~5..DD. ...................................................................... (to be paid on filing this application) 5. If dwelhng, 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]3usJ, ru~ss ............. Inventory, stor. 7. Dimensions of existing structures, if any: Front ...... .~D.'. ..............Rear ......... ~[~ ............. Depth ..... ½~f.. ........... Height ..... 12/. ................. Number of Stories ........ .ar~, Dimensions of same structure with alterations or additions: Front ...... ~.0.] .................... Rear ............ 802 ............ Depth ........ J, 2.0.! .............. He[ght ....1£! .................... Number of Stories ..........9..n.~ ........................ 8. Dimensions of entire new construction: Front ........ ~0.~ ............... Rear ........ A(].~ .............. Depth .......... ]-20). ......... Height ....... .~2~.t ............... Number of Stories ....... Q~e ............... 9. Size of lot: Front ....... ~.~.O.] ............. Rear ........... .z~Q.0.~. ........ Depth ........ .2.80]. ............... 10. Date of Purchase .................... J..9. fiJ. ........................... Name of Former Owner ........ P..r.o¢~ns...I~e... ..................... 11 Zone or use district in which premises are situated ........... ]3~sizzess. .................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... ~Tp. ......................................... 13. Name of Owner of premises .~r£]3~.m..J....]3a;;te~...Address .&~..%t~%lJ, ia.cr~..~t.~.~...~T......¥ phone Name of Architect ...Go~.dozz~.hler~ ..................... Address ...Ja~e~po~.~.,.N;,,...Y. ...... Phone No .................... Name of Contractor ~%V.~[f].~.e. fL'C,e..~,.~Q]~.~ .......... Address ....2~Iattitzzck,..~I,..~. ......Phone No .................... PLOT DIAGRAM Locate clearly and d~stinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fron property hnes. Give street and block numbers or descriphon according to deed, and show street names and ind~cah whether interior or corner lot. SEE FILED PLANS STATE OF NEW YORK, ~ ¢ ¢ COUNTY OF ............ .,., .................. % .... .~..~....~ ...... ~ .~'~ ..~...~ .................................................... being duly swam, deposes and says that he is the applicon .... (Nam.~/f. in,cti/~l signing application) above named, t~e is t~e ................................... C. Qp.f~..a~l~z' ................................................................................................ (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and is duly authorized to perform or have performed the said work and to make and ill, th~s apphcation; that all statements contained in this application are true to the best of his knowledge and belief and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ......... ~).t,h ........... day of ..... ~e.bru~,r.y .................... , 19~... _-- ....................... .............................................. ' ~'J ar ~,~ thtt ~ N~w Y~r~ / I n Notary Pubhc, .,'.'~..,:.'~¢,~?.,~....L2~Lt,~/~. ?..~.,~Uzs~0; / (~ig at~/e of applicant) Quahhed ,n h'm§~ Co.nt¥ / , Commission Expires I,~arch I I I "1 L.,