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Home My WebLink About2659-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 .... 'B]~'~flW..'J~..~I:..xM-JJ~.&.~QO~..~.... Street Map No ..... ~ .......... Block No....Z:iI:Z ........... Lot No .....~ ....... JJ~tt[ttz~...J[..~', .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................................... ~P~.(JJl ....... I....., 19.~... pursuant to which Building Permit No. ~,,~'~...~. doted ................................ J~[~.G~....J~....., 19..~.~'.., was issued, and conforms to oil of the requirements of the applicabl~ provisions of the law. The occupancy for which this certificate is issued is ........ .............................................................................................. The certificate is issued to ..~.~.....~.~......~.~...Q.ZT.....J.~.. .............. ~)jll~'J.~. .................. (owner, lessee or tenant) of the aforesaid building. H.g. Approv&! July 13t 196~ by R. Villa ........... L .~'.!.'" :./..: ~-.. ?.i ....... '...,/,O.~.,,~ ......................... Building Inspect% FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Iq. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 2659 Z Date ............................... Permission is hereby granted to: ~hoMas lq sher.....A/4I...Z~..l~t~me~.. ~ ........................ .......... t~t~[~u~ ..... ]~L ............................... to ....... :Ba.'t.~8...ne~..one..fa~:~:r..~'~e.l-t~L~l[ ................................................................................ ct premises located at .... ~El~l~a.~.ll.~/..:[da...~l:..x-~/jSL~aL.t~o~lt...R(~ ................................................... ............................................. I~t~,:~ talok: .......................................................................................... pursuant to application dated ............................... ](l~.t~a .......~ ........ 19..l[l~., and approved by the Building Inspector Fee $..~,O.O~l ......... Budding Inspector ~-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH ~e J U L ,1 3 fg~ , mdg. Petal% No.,~x,~"-F ~ The sewage disposal facilities for a structure located at , .... have been inspected by this Department and found to be satisfactory. Distric{ Engineer .... FOEI~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ...................................... 19 ........ Permit No ................................ D,sapproved a/c .... iii ............................... APPLICATION FOR BUILDING PERMIT .... ........................... INSTRUCTIONS a This apphcation must be completely filled in by typewriter or in ink and submitted in duphcate to the Buildm. Inspector. b Plot plan showing Iocahon of lot and of buddings on premises, relationship to adlo~nmg premises or pubhc streets o areas, and gwmg a detailed descnpbon of layout of property must be drown on the diagram which ~s part of this applicat~or c. The work covered by th~s apphcation may not be commenced before ~ssuance of Budding Permit. d. Upon approval of th,s apphcation, the Building Inspector will issue a Building Permit to the applicant. Sucl permit shall be kept on the premises available for ~nspechon throughout the progress of the work e. No building shall be occuped or used in whole or in pa rf for any purpose whatever until a Certificate of Occupanc: shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Budding Department for the ~ssuance of o Building Permit pursuant to th: Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other opphcoble Laws, Ordinances o, Regulabons, for the construction of buildings, additions or olterabons, or for removal or demolition, as herein described The applicant agrees to comply with all apphcable laws, ordinances and regulahons. (Address of apphcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, eJectr~cion, plumber or budder ............... ....... ................................................................................. Nome of owner of premises .... ~~ ....... . ...~'.......~...../..~...~../~. ~.......~..~.......~_~ ................................................. tf applicant ~s a corporate, s~gnature of duly authorized officer (Name and title of corporate officer) 1 Location of land on which proposed work wdl be done Mop No ................................... Lot No ................. Street and Number ~ .... .~...~..~....~..~...~.~.~..~.~.......~.~.~...~....~......~....~..~...~...~..~.~.¢..~....~..~.../~...~.. ,...~..~..~./.r.~(..(~,..~.. Mumc~pahty ~ 2 State existing use and occupancy of premises and ~ntended use and occupancy of proposed construction a Existing use and occupanc. //',/¢¢4~'~- ~: ¢ ,/ b lntended use and occupancy ......... ~..,~ P.~ ..~'~'~. ....................................................................... 3. Nature of work (check which applicable)' New Building ..... ..C~_.. .... Addition ................. Alteration ............... Repair ................... Removal .................. Demohhon ................... Other Work (Describe) ....................... 4 Estimated Cost .... /..~.,..~..~...O..... ~ ........................ Fee ............................................................... (to be paid on filing thru application) 5 If dwelhng, number of dwelhng units/.. ........ Number of dwelhng umts on each floor ......................... If garage, number of cars .... ~J?...~.~-~. ~ ... -~.../~.,~.~..~.. ......................................................................... 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use ........................... 7 Dimensions of ex~st~ng structures, ~f any Front ................ Rear ....................Depth .......................... Height .......................... Number of Stones ..................................................................................... Dimensions of same structure w~th alterahons or addihons Front .............................. Rear ............................ Depth ........................... Height .............................. Number of Stones .................................... 8 Dimensions of entire new construction Front ...... .~...~....~ .......... Rear ........~.~....°..../. ......... Depth ......~...~.. ............ Height .......................... Number of Stories ..... .,~ ................ 9 S,ze of lot Front .... ./. ~...~.-. ............. Rear ~..~.~.~'../ .... Depth ..../.~...,~.. ....................... 10 Date of Purchase ........................................... Name of Former Owner ......................................... 1 1 Zone or use distr~ct m which premises are s~tuated ......................................................................... 12 Does proposed construcbon violate any zoning law, ordinance or regulat~on~ ............................................... t3 Name of Owner of prem,ses ..~.q..~..~...'~,...~./.~.~ .~..~.....~A~ddress ...,,~.,~...T...~/.~...~.~ ...'~..... Phone No ................. Name of Architect ..........................................Address .......................................... Phone No ............... Name of Contract--~...~...~...~......~"..~.~.....~.~....'~..Address ...~..~'~7-fT'~ PhoneNo ..~.~....~.'.~.'.~.'.'~; PLOT DIAGRAM Locate clearly and d~stmctly all buildings, whether existing or proposed, and red,cate all set-back d~mensions from property lines Gwe street and block numbers or description according to deed, and show street names and ~nd~cate whether interior or corner lot. 9¢, o-4" / · " STATE OF NEW YORK, ) COUNTY OF ................... ) S S .......... ~ ....... T. ................................ being duly sworn, deposes and says that he ~s the applicant (Name of indiv signing applicahon) above named. He is the ...........................~..~..fief... ~...,~.A/:..C-:..~.~....~.. ................................................................. (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and file this apphcahon, that all statements contained m th~s applicahon are true to the best of h~s knowledge and behef, and that the work will be performed m the manner set forth m the apphcahon fried therewith Sworn to before me this .. O?. ......... day of ..... ...~(-..~ .............. 19.~ [. ' ~ 0TARY'~3t- r;VSl~r,"'of f ................... :...:,.r..'~.:,~,~ ................ Notary Pub ,c,~.fLz~/J3~ ....~ ....... U ~erm Expires March ~O,