The URL can be used to link to this page

Home My WebLink About2722-zFO~ul~l NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No..Z...2~.ig+ ............. Date .......................... De~embe~......21, 19_65. THIS CERTIFIES that the building located at ~-/-~.-...01.d...l~ol,~ll..~oa~ ........................ Street Map No...~X ............ Block NO.~ ................ Lot No ........~ ...... Sau~ho].da.....N,.~.,. ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................................... A,pl~,i,],..,..~. ....... , 19.6.~... pursuant to which Building Permit No..~....~..~.....~.. dated .............................. /k~.~.....~,...., 19..(~.~.., was issued, and conforms to all of the requirements of the applicable provisions of the law. fi.he occupancy for which this certificate is issued is ........ ....1R.r.~.vat e...o~e...f.~mi l~..~twel l~r~...~.:.th...a.tt ached.. ~a~.age .......................................... The certificate is issued to ..l~,...l~.tanle~..Stene..&.W~[fa ........................................................ (owner, lessee or ter~nt) of the aforesaid building. 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? 2722 Z Date ....................... &pF.~.~.....~ ............... , 19. Permission is hereby granted to: I~...~nntey..6t~n~ ....................................... ........... Ol~l,..~o~.th...R~d ................................... ................ · outhol~w.~..~. .............................. to ... 2ttild.. an.. &ddi.tio~.. on.. &r~..eli~tin~.. dwollin~ ...................................................... ct premises located at ...~/~"~%d'"NOl'~h"~O~ ............................................................................... .......................................... ~outBold,...N,.~. ...................................................................................... pursuant to application dated ............................ Apl'~'~ .......... '~ .......19.6~.., and approved by the Building Inspector Fee $...~,~ ........... I~OR¢~ NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. omined ....... ........................................ , 19 ....... Permit No .............................. .............. ........................ "i speci ;;i ...................... Application No...,,~,.,,~,..,,~,..'~,, ......... APPLICATION FOR BUILDING PERMIT Date ....................... ~ ....... .( ................ , 19..~..~ .~. .... INSTRUCTIONS a. 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 propertymust be drawn on the diagram which is part of this application. c. The work covered by this application 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. 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 part 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 buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable laws, ordinan~ ~ co~)C~ons. (Address of applicant) State whether appli~ is ow~essee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................... .......... . ........................... Name of owner of premises~,,,~,.~,,,~,,~,, ~-~'~/y'~/'I~-7~-- / ..~...~,7.~...~... If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) Location of la~,~/r~wh/~/proposed wor_k will be done. Map No: ............................................ Lot No: .................... Street and Nu~M~/e~..~..~'.~:...~.....~)~.. ....................... ~....~...~....~.,~.~ ....................................................... Municipality State existing use and occupancy of p~mi~s and intended ~se and ~cupancy of pr~osed construction: a. Existing use and ~cupancy. '. ntended use and occupancy. ~.. ~Z./~.. ~>~:~(~-- ......... ........................................ , ~... ~~....'~ ...... 3. Nature of work (check which applicable): New Building .................. Addition ......[. ....... Alteration .................. Repair ............. .~ Remo.v~ ....................Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost ..../Z~... ........................................... 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,~pe of use ................................ 7. Dimensions of existing structures, if any: Front ..... .~.~.. ............. Rear ...... ..~'...~'.. ............ Depth ......... ~ .............. Height ~.. ~ Number of Star es [' (../....~.. .......... ............................................................... ;'9 Y ........................... Z2" ....... D~mens~ons of sam9 structure w~th alterat~o~ or aad~tlons. Front ........... ..~..../~......: ...... Rear ............ ~... .............. Depth ........ ~..~.. ............. Height ....... ..~.....~... ............. Number of Stories ..........~...'./.~. .................. ! 8. Dimensions of entire new construction: Front ............ ~...~.. .....Rear ....... :..~..~,,~ ........ Depth ........~.....~.. ............ Height ....~....~'...'. ............. Number of Stories ........... J~ ............... oo' o/' / 9. Size of lot: Front .....~. .................... Rear2,.~.. .................... Depth ...................... ~r.'~ .~P ../ 10. Date of Purchase 4~/~..e~........~...~............................. Nam.el, of Former OwDgr ........................................................ .... I 11. Zone or use district in which prem.ses are situated ........... ~ .............. ~'L~..a ....... ':"I'll, ............................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ........... .~..,/...~.. ................................. 13. Name of Owner of premises ..~'.~..~...~. .................... Address ............................................ Phone No ..................... Name of Architect ............... .~'~;~1~...~. ..................... Address ............................ ................ Phone No ..................... Name of Contractor ............ 5407....~....(.. ...................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all 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 shaw street names and indicate whether interior or corner lot. STATE OF NEW,,. ~"~';"~ ~,~ ~i~r"~ORK ~_ ] ~.~.,-. ~ COUN~ OF ~.~ ...~...~L..~ ............................. being duly ~orn, deposes and ~ys that he is the applicant ~ ..... ~Name of/individual signing application) above ~med. He is the .... · ........................................................................ (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 Jn this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the ~li~tion filed th~with. ~ ~ Sworn to before me this , ~ I J // ~ I / I I// Nota~ Pub~.~...U.:.....(~'~.~i~m~°rLct'~ - (?nature of appl,cant)