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Home My WebLink About2948-zFOPoi~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPAIklCY No. ~*,.2,.~.~ ............. Date .. ?'.t.....~.~,~,~: \~. , THIS CERTIFIES that the building located at .-W/~..;~O~.~.~e... ........... :~,: ................ Street Map No ....... ~. .......... Block No. ~ ................. Lot No ....... ~.," ..~.t~Og.~:t...~[e ........... conforms substantially to the Application for Building Permit he,refgfore filed in t~is office dated ....................................... ~o~e~e~..2~., 19..~. pursuant to w~ich~ Building Permit~o, ~..~, dated .......................... ~.~.....~ ............ , 19.~.., was ~ssued, and. conforms to all of the ~qu~rements . .. ~ .... }~ of the apphcable prowmons of the law. The occupancy for which th~s certificate is is~fle~ is ........ ..... ~.~e..en~..~y...~.~.~$n~ ................................ : ....................................... .....'.,~ ............. The certificate is issued to .~h~fl~...0~].DN~ ........ ~..m..~.~$~ ........ :.h ........ ~ ............ (owner;, lessee or tena,nt) ~ 1966 by R. Villa ...... '"' ...... '"'"'"'Building'"'"'"'"'""'"'"'"'"lnspector ,,, ~,'"'"'"'"'"" of the aforesaid building. FORM NO. 2 '[OWN OF$OuTHOLD , BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUT,O',. N. V. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UN'ElL FULL COMPLETION OF THE WORK AUTHORIZED)' N? 2948 z Permission is hereby granted to: '" ~e~t~...O~3,~sici ............................................ ................ ~hog-ue; ........................................ at premises locate'c{ at ...... ~'l~.....~!~,~,.~ntD ....................... ~ ........................................ ................. ..................................................... ilu~,~b~Ue ~,....N,,~,.....:..;...~ .................. ; ......................................... pursuant to opplicafi'on ~latect ....... ' ........ ......'.L.L.JJJ~t/~3e3R..~ ....... 1S6.~...., and approved-by the Building Inspector Fee ~, ,0. ,e, .,,0~,, ............. -Building Inspector s-9 SOHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Atl 29 1961 Date TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at · "~/ / (Give deed 16cation) " have been inspected by this Department and found to ~e satisfactory. District F~lginee~ Distri'ct Engineer "~'~ NO. 1 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19.....k...Perm~t No. c Disapproved a/c ............................................................................................ ..................... .................... (Building Inspector) [ APPLICATION FOR BUILDING PERMIT Dc,t,, .......... ..................... , INSTRUCTIONS o. 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 ar public streets or areas, and giving a detailed description of layout of property must be drown on the diagram which is part of this applica- tion. c. The work covered by this oppIicotion 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 opplico.nt. 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 po rt for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS H.EREBY MA~DE 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, alterations, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable laws, ordinances ond~regulations. ,-m ~-- ....................... :..5...'.?,/:.. ............... (Address of ~pplicant) -- State whether applicant is owner, lessee, agent, arch tect engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...................... ~.~ .............................................................................................. If applicant is o corporate, signature of duly authorized officer. Street and Number ..~,,,L~..'~....~.._~.......'T...?..~.~:.;..~....J.:..~...~..~...~. .................................... q~unicipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use one occupancy ..~.~..~ ....................... b. Intended use and occupancy .................................. '.../,.... ....................,~.1. / 3. Nature of work (check which applicable): New Building ................ Addition .................. Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................. 4. Estir~ated Cost .~ "~'"~ Fee ~ ~ (to be paid on filing this application) 5. If dwelling, 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 Heig~ht ............................ 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 ....... S~....~.~... ........... Depth ....~....~ .............. Height ...... ~..~..~. ............ Number of Stories ..... ~ ........ 9. Size pf lot: Front ....... /../'....0. ............ Re_or ....... /./~...~. ................. Depth L . .~...~~~ 10. Date': of Purchase ...;~./...~....-~...'~... ........................ Na,m~ of Forme';'~wi~ ................. ~.c,~ 0 11. Zone, or use district in which premises are situated. 12. Does]proposed construction violate, any z,,onir~ law, ordinance or .... ~ ..-. 13. Name of Owner of prem scs .~.~....e~...°Address ...~,,..~~..~,/..,.¢. Phone No./~..-~..~ Name of Architect ......... C¢~ ....................................... Address Nam~ of Contractor .........~ "'"'- Address .......... ~ ........ z.... Phone No. ................................................ Phone No. PLOT DIAGRAM Locat, e clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr property lilnes. Give street and block numbers ar description according to deed, and show street names and indic whether interior or corner lot. STATE OF .NEW YORK, ) COUNTY OF ............................ ) S.S. .................................... being duly sworn, deposes and says that he is tho applicol (N, ame of individual signing application) above named. He is the... ~ ~' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sa d work and to make and file th application;;, that all statements contained in this application are true to the best of his knowledge a.nd belief; ar that the work will be. performed in the manner set forth in the application flied therewith. Sworn to before me this~ , , ~.- (/~, . ~. /~, ~.~. ,',. ......... .~.....~, ..... day of ....... ~..., 19..~..,~. Notary Pub',,lic ~;~ ....... ~/~... ~mty~,, ~',~ '?'I, 'ii'l~ri~ ....... i~'i'~'~'t'~';~'~'f"~'~ii~'~'~'~i ..........................