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Home My WebLink About2713-zFOK~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No....~..~.3~/. .......... Date ......................... .8~.p.~..,..~..~ ........... , 19.6.~.. THIS CERTIFIES that the building located at .l~,/~.....N~,lLt,,Jl..J~,~.'J~w..~o~.d ............. Street Map No ..... ~ .......... Block No ......~ ......... Lot No .... ~ ....... J]e~1.%h~'l~ll...J~,.~'~J ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................... Aj~.:J.'I ....... ]~....., 196~... pursuant to which Building Permit No. 2~'13..Z.. dated ............................. Ap~'.~,.'t...1.~. ....... , 19...~.~', was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ... l~.i.~.at.e .. ~ne ..£a~a~l¥...d~e Zli~ .............................................................................................. The certificate is issued to ....C[ lv.e..Tyr, e.r. ............................. O~er. ............................................. (owner, lessee or te~nt) of the aforesaid building. H.g. Approval Sept 20t 196~ by R.Villa ............. ~,f.~ ...... ;~ ............ .~..,~.' ............................... '/~f:~' 'zJBbildi~ Insl~edtor 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°, 2713 Z Date ............................ &Jj~t'J. ....... J.~....:.., 19.,.~.~' Permission is hereby granted to: 0, W. ~,~l, tb.. &..Son~.. Zma.....A/tO...C.'l.'l.'~,e.. ................ So, that4 ............................................ to ...... ~u~d..~a~..~n~..£~l~..d~e.~.l.:l~-~ ................................................................................. at premises located at ........F~.jJ.....Jj,...~ll~v'.~.~i~..Road ...................................................................... ......................................................... 8 outho],d.r .....N,,.Z,, ..................................................................... pursuant to application dated ................................ Jkplt:L~ ....... ~[~ ..... 19...~ and approved by the Building Inspector Fee $. ~.0,.0~ .......... have been :'respected by thee Depa.r't~ent and fctmd to be satisfactory. District Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...... ~....ZZ....., 19...~.?..~ Approved ............. ~..(. .................... , ~.~.....Permit No...~.....~.../....~......~. Application No...~Z..Z..!.~ ............. APPLICATION FOR BUILDING PERMIT Date ....~../~../~.../:..~. ...... ../...~.. ................. , 19~.....5~'. 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 or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this applica- tion. c. The work covered by this appl!cotion m~y not be commenced before issuance of Building Permit. d. Upon o~)proval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspectign ~hroughout th~ progress of the work. e. No building shall be occupied or used in whole or in pa rt for any purpose whatever until a Certificate of Occupancy 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 the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations for the construction of buir~r~gs, additions alterations, or for removal or demolition,, os herein described. The applicant agrees to comp y with a I 6~p icable laws, ordinancesAand regulations. (Address of applicant) Sto,te whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~.Z./.~ .............. ~; .............................. :~!. ......................................... If applicant is o car orate, _sJgnatu~f. fJcer.~/ .................. ~orate~officer) ........... 1. Location of land on which proposed w~ will be done. Map No.: ...................... ~., Lot No ' . ' Street and Number .~...~...:.~. Municipality ................... 2. State existing use and occupancy of ~re~es and intended use and ~ccupancy of proposed construction. o. isting ,,se and =up°nc ..... .. . b. Intended use and ~cupancy ~ 3. Nature of work (check which applicable): New Building ....~ ......... Addition .................. Alteration .................. Repair ............. .~. Removal .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost'~...~./~..~...~........~... ............................... i. Fee ..... ..~....~.....~...~....: ............................................................... (to be paid on filing this application) 5. If dwelling, numbee-of dwelling units ........ ~ ........... Number of dwelling units on each floor ............................ If garage, number of cars 6. If business, commercial or mixed occupa'ncy, specify nature and extent of each type of use .................................... 7. Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth .............................. Height ............................ Number of Stories ................................................................................................................ Dimensions of same structure with alterations or additions: Front ..................... ........... Rear ................................ Depth ................................ Height ................................ N'~mber of Stories ................................ 8. Dimensions of entire new construction: Front ......... ~...~.. ............ Rear .....~..~.. .................. Depth ....~..~.. .................. Height ....../~.. ................ Number of Stories .~ ................ 9. Size of lot: Front ..... /...~...~J~... .......... Rear ...... .~'.....~'....~'... ............. Depth ...~?..g....?. ............ 10. Date of Purchase ........ ,~..~..~.::..~. ....... /...~...~..J...'~.. ......... Name of Former Owner ..~ .......................... 11. Zone or use district in which premises are s~tuated' ...... ..~......~' ...... ~ .-. ..................................... ...... ...... .. ...... .. ............. . .... 12. Does Drooosed construction violate any zen nn law ord nonce or re u at 13. Nam~of'Owner of premises ~....~..~L<.'... Address .~ ............. ........... ~r~"~'~'~,"~'~"~'F''' Name of Architect~' __ ~ .~'_~'/" ...................... .,;"/'"~"="~":"~' Address ................................. ""'" Phon~ "- NO Con t racto ~-~:/¢~/~ . .~..:.. ~~ Ad dress ................................................ Phone No .................. Name of PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corne,r lot. ! ~,-5-' ~ STATE OF NEW YORK, ) ¢ c ..................... : ...... ~~ ............ L ...... being duly sworn, deposes and says that he is the applicant above nome& He is the ....... .,~c~....~..~.~....t.~.. .......................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his kn~owleclge a~nd belief; and that the work will be performed in the manner set forth in the application filed therewith· Sworn to before me this ~ .......... )..~n__ day of ..... ~ , 19 ~'~ C ~ T'"r';;~-"l~3 ............... ~J.'"Tf~,~l~ Notary Publ~.......~ ...... ~.Z... ~o~j[~., s,.t.? (S,gnature of apphcant) XpUes ~arch