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Home My WebLink About3234-zF~R~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No....~.....3..2...8..6. ............ Date ........... .~.~.12.~..e. tl~...~.~.....2..~.~ .............. , 19..6..~.. THIS CERTIFIES that the budding located at .W~.~..~ty...8.~r~,e~ ................................ Street Map No ....................... Block No ...................... Lot No....OrJ. ent~...N_.ew...Yl:~l~k ............................ conform~ substantially to the Application for Building Permit heretofore filed in this office dated ..................... ..~..~.~..~..e....m~...e...~....~.~..f ............. , 19...~...~.. pursuant to which Building Permit No..~.~.~...~.....~... dated ........... .~..~.~.~.e....m~....e.~...~.~..~. ............ , 19...~...~., was ,ssued, and conforms to all of the requirements of the apphcable provisions of the law The occupancy for which this cerhficate is issued is ........ ,,, ........................................................................................... The cerhficate is issued to ...~.~l~..~0,e~C~tl.C~ ........................................................................... (owner, lessee or tenant) of the aforesaid building. Health Dept. Approval, October 9, 1967, Robert V~lla Building Inspector [ I~OEM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLER~K'S OFFICE_ $OUTHOLD, N. Y. BUILDING PERMIT ('rills PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 323~'~ Z Permission is hereby granted to: .~.~L'~,,~..~~.~,I~ .......................................... at premises located at .$~/.~.....]11~1~'~:..~,.~ .............................................................................................. .......................................... O.~ent, t.....~,~, ....................................................................................... pursuant to applicatior~ dat_ed ..... : ................... ~t.~---.~ ............... , 19.~., and approved by the ;Building Inspector. Fee $ ..~1. ,.(~1 .......... S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date /~/~ Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (O~ve died loca~on) /' have been inspected by this department and found to be satisfactory. FOKM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ................................ Disapproved a/c ~ ................................................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Thru opphcotion must be completely filled in by typewriter or ~n ink and submitted in duplicate to the Buildin, Inspector. b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or public streets o areas, and giwng a detailed description of layout of propertymust be drawn on the d~agram which is part of this application c. The work covered by this application may not be commenced before ~ssuance of Building Permit. d. Upon approval of this application, the Budding Inspector will issue a Building Permit to the applicant. Sud permit shall be kept on the premmes available for inspection throughout the progress of the work. e No budd,ng shall be occupied or used in whole or In pa rt For any purpose whatever until a Certificate of Occuponc' shall hove been granted by the Budding Inspector APPLICATION IS HEREBY MADE to the Budding Department for the issuance of o Budding Permit pursuant to th Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulahons, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described The apphcant agrees to comply with oil applicable laws, ordinances, building code and regulations. .......... .~Ioht, t.. · ~ r,4~l:e ~ h~ctk .................................................. ~gnorure at applicant, or name, if a corporation) 0rienl~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electncian, plumber or builde, ............................................ .................................................................................................. Nome of owner of premises ....$.Dl'~Tk..~.O~f~.e.~.O.~],~ ........................................................................................................... If applicant m a corporate, signature of duly authorized officer. (Nome and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ....... ~ ........................... Lot No:~ ......... Street and Number ..... ~T~.~.....~T.~.I~...~.~ .......... Qr.$.e..D..t,. ......................................................................................... Municipality 2. State ex~sting use and occupancy of premises and intended use and occupancy of proposed construction: a Existing use and occupancy ....v~c:,~.r~t..3 _mrtcl ................................................................................................... b Intended use and occupancy ........... ~rze...f~j.l~...c]lg~'i lJ/'~ ................................................................... 3 Nature of work (check which apphcable). New Building .~(.~ ....... Addition ................. Alteration ............... Repair .................... Removal .................... Demohhon .................... Other Work (Describe) ..................................... 4 Estimated Cost ..... ~.c)~OD...P~/2~. .............................. Fee .3~Q~.QQ ............................................................................ (to be pa~d on filing th~s application) 5 If dwelhng, number of dwelling umts ..o..~...e. .................... Number of dwelling umts on each floor ........................... If garage, number of cars .................~wo ................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................... 7. D~mensions of ex~sting structures, if any' Front .......................... Rear .......................... Depth ........................... Height ............................ Number of Stones .............................................................................................................. D~mens~ons of same structure w~th alterations or additions Front ................................ Rear ............................... Depth .............................. Height .............................. Number of Stones ........................................ 8. D,mensions of entire new construction: Front ....~.6. ...................Rear ...~.6 .................... Depth ~..~/...~ ............ Height ........................... Number of Stories ..1..~ ................... 9. S~ze of lot: Front ..... .~.1+~,8 .......... Rear ......... ~L~.3.,.~. ....... Depth .... 10 Date of Purchase ........ .3,9.(~.LI' ...................................... Nome of Former Owner ..¥..:....~..~.e.~?..~.s. ........................... 11 Zone or use district in which premises ore s,tuoted ...... ]~..~.~l...~.e...s.....cl:.i...s..~. ............................................................. 12. Does proposed construction violate any zoning low, ordinance or regulation? ......... ~O ....................................... 13 Name of Owner of premises ..Jo~:~...B~nd~.z~¢h~l~.Address ..... 0~'.ie~t ......................... Phone No ................... Name of Architect ..................... ~. .............................. Address ............................................ Phone No ................... Name of Contractor ...................... S~-m~- .................... Address ............................................ Phone No ................... PLOT DIAGRAM Locate clearly and d~shnctly all build,ngs, whether existing or proposed, and red,cate oil set-back dimensions fro, property hnes. Give street and block numbers or descr,ption occord,ng to deed, and show street names and ind~cat whether interior or corner lot. STATE OF NEW YORK, ~ COUNTY OF ...~ZI~£ol~ ........ / S.S. .................................. J~..B~--1.c~az'.~!%z~ ........................... being duly sworn, deposes and says that he is the applica (Name of individual signing apphcation) above r~amed. He ~s the ............................. ~wz~. ..... .btzil~t.ez'. .................................................................................... (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 th,s apphcation, that oil statements contained ,n this application are true to the best of his knowledge and belk and that the work w~ll be performed in the manner set forth ,n the apphcation f,led therewith. before me this Sworn to doyaf ............ rO .£/ ........................ ' ~ ~ .................. n ~"~~"'f applicant)