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Home My WebLink About2635-zTOWN OF SOUTHOLD BUILDING DEPARTJ~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .... .~,/S...~.~a~%.~.&.~.~D~..~.~. .... Street /~eqp~j~r~...~...h..°...z'...e,?.... Bloc~ceh~i..O...D/....~. ........... Lot No ...~ .......... 0r=ee,~p.C~l,...~^Z~ ............. conforms substanhally to the Applicahon for Budding Permit heretofore filed ~n thru office dated ........................................ ~.e~e,~.~..]..~ 19.(;x%.. pursuant to whmh Budding Permit No..2~...~. dated ............................ %/eeb"'"'l.~" .......... , 19.,6~., was zssued, and conforms to all of the requirements of the applicable provisions of the law The occupancy for whmh thru certificate is msued is ........ ....... Private .. ene..~'aatt, ty...d~e llta~ .......................................................................................... The certificate ,s issued to ...~,.+~l~a,~,..~t.~=.]lde~'-s..,T.~rt~ ..................... .0~r~.~..~. ........................ (owner, lessee or tenant) of the aforesaid building, H.D. Approval April 196% by R. Villa B~ii~in!a FO~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDIN(~ PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2635 z Date ....................... JJ~13t~.~ ....... 3 ~....., 19...6~' Permission is hereby granted to: Ton;F' No~3rZL-~_ ..&...T~ sepl~ ..S~iLder .................... ........... · g~,im~j.s...~l~.~, ........................................ at prem,ses located at -~L49~.~..~I~...._~J~J__~I&~II..~J~JO:IL'~II .................................... : ............................ ..................................... ~leCann...La.. &. 4B~tten..]Pl. ........... ~re. enpor t-j... ~ '~. ...................... pursuant to application dated ............................ j~ ...... t.~T .............. 19.6~., and ?rpproved by the Budding Inspector Fee $.3 I~0fi .......... SCHD SUFFOLK COUNTY DEPARTMENT OF ~ALTH Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at (Give deed-lOcation). have been inspected by this Department and found to be satisfactory. District Engineer TOWN O~ SOUTHOLD BUILDING DEPARTM£NT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .... ..... ......... Approved ........................................ , 19 ........ Permit No. & 6 ~ ~'~' ................ .................................. APPLICATION FOR BUILDING PERMIT .......... ,. ........... ............... INSTRUCTIONS o. This 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, relationship to odjmning premises or public streets areas, and giwng a detailed description of layout of propertymust be drawn on the diagram which is port of this applicatio c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Bu,lding Inspector will issue o Building Permit to the applicant. 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 port For any purpose whatever until a Certificate of Occupan. 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 tl 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 applicant agrees to comply width all applicable laws, ordinances, building code and regulations. '~'~i~. 'gf o~ii~;T.'T:T. T,Z,~';;",'f"~,"/:Z,~g;-Z,;i'/~F,i ...... ............................... iXg~';;~";¢"~'~p~ca'"'" ";Ii~' ....................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build. Nome of owner of premises ............. t e f th f e ~ If applicant is a corporate, signa ur o duly au orized o fic r. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No' ~'~ ,c~'D,4'-~-~' Lot No: ............... Street and Number .,~.?..?,.~...~,.....~....~.....c~.,...~~.~~ .......................... Municipality 2, State existing use and occupancy of premises and ~ntended use and occupancy of proposed construction: o. Existing useondoccupancy...~..I.~ ....................................................................................................... b. Intended use and occupancy . .~ ........................................................................................................... 3. Nature of work (check which applicable): New Budding.. ............. ~ . ...... Addition ... ...... ..... Alteration ................ Repair ................... Removal .................... Demolition .................... Other Work (Describe) .................................... 4. Estimated Cost ........................................................... Fee ........................................................................................ (to be paid on fihng th~s 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. Dm~ensions of existing structures, if any: Front .......................... Rear .......................... Depth .......................... Height ............................ Number of Stories ............................................................................................................. D~mens~ons of same structure with alterations or additions: Front ................................ Rear .............................. Depth .............................. Height .............................. Number of Stories ........................................ g ' z. ..... 8 Dimensions of entire new construction: Front .......... ~ ............. Rear ....................... Depth .......................... Height / '~' ! Number of Stories ...... ~ ................... 9. Size of lot: Front ...Z...~....o....L ......... Rear ..../.....~..?....~ ......... Depth / Z' ~' ¢ 10. Date of Purchase ..... ~...-~. .................. ./.~....~..~.~-. ....... Name of Former Owner .~.....~..~ ...... 11. Zone or use district in which premises are situated....,~ ............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ...~ ..~.. ..................................... 13. Name of ~ner of premises~.~~~dress~¢.~.~~. Phone Name of Architect .................................................... Address ............................................ ~one No ................... Name of Contractor ~.~~~~ .......... Address ....~~~~ ................. Phone No.~T~.~ PLOT DIAG~M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro, property hnes. Gwe street and block numbers or description according to deed, and show street names and indicat whether interior or corner lot. t~O~ STATE OF NEW YORK, ) COUNTY OF ............ { S S. ............... ."~...~.Z~..~.. ...... /~...~./~..~.~..~'.. .................................. being duly sworn, deposes and says that he is the applica, (Name of individual s~gning apphcation) above named. He is the ................................... ~.~...~...~.....~...~...~..~....~....~. ............................................................................... (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 fi this apphcation; that all statements contained in th~s application ore true to the best of his knowledge and belie and that the work wdl be performed in the manner set forth in the application filed therewith. Sworn~.~...~.~..to before me this ../~..~/~...~., 19.~...~.. ,'"¢'~ ~,~ ~,~ ~~~ ........................ Notary Pubh . ~.. . Fp~unt~ ~/ (Signature of applicant)