The URL can be used to link to this page

Home My WebLink About3043-z~OI~M 1~0. 4 TOWN OF SOU'TI{OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. CERTIFICATE DF OCCUPANCY No. Z..~.. 2622. Date ............... Deeembe~,...16. 19. ~ , , ~..~V~e~Oa THIS CERTIFIES that the building ]ooated atS~..~.~ .LAD9 .... ~assau Po~t Pro~ Map No ............. Bloc~ No ............. Lot No. ~...~aSsaR. P~l. ~u~oho~ue conforms substantially ~o the Application for Building Permit hereto~e filed in this office dated .......... Ap~.. ~ .... 19~6 pursuant to whi~ Building Permit No. ~.~.. dated ............. &p~l..~.., 19.66., was issued, and conforms to all of the require- ments of the .applicable provisions of the law. The occupancy for which this certificate is issued is .. P~i~a~e..o~e. f~t~y, d. weAt~g ......................................... The certificate is issued ~o XO~ .~ke.A/~.~a~bo~.O~ve ....... '..P~9~ ........ (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Appzoval ...... ~,D.,Ap.D~OVal. ~.~,.; .~.~..~.~6 Building Inspector (survey dated Nov. 30, 1966) FORM NO. 2 TOWN OF $OU'THOLD BUILDING DEPARTMENT TOWN CLERK'S OF~:ICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3043 z Permission is hereby granted to: 6co.. Ahle..~. s.. A~..~...~ohn~. C la,kc ..................... .......... .L]uteho&u~ ............................................... to ]3tz~1 ~!,..ne~,~'. ,.one.. ,T am J, ly,..,4t,~ ], l:f,t~ ................................................................. : ................ :,.. at premises located at ..,~&vat, e...~,~acl,..(~azLl~r.S...~ne.)'....~t~ssau...~n¢ ............... ........ ............... ~ ~r.~..~:~.~L...g~g~ ~.. ~.~, ......... :.. ~ pursuant to application dated ................................ ...... ~.,...~,., 19...~, and approved bY the Building Inspector Fee $.LO.~..O..q ........... ,,/ S-R SUFFOLK CODIITY DEPARTMENT OF HEALTH B'l. dgo Pe:n'ai% No,,.~.. OCT Z ! 196~ TO WHOM 1~ MAY CONCEPt; The sewage disposal facilities for a structure located at have been inspected by this Department and found to be satisfactory. TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 7 Approved ! X 19 ........ Permit No. Disapproved a~~~ Application No...?.....d).....t!..~. ......... (Building I nsPlJ'ctor) APPLICATION FOR BUILDING PERMIT Date ,9 ............ INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. P~ot 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 1'o 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 all applicable laws, ordinances, building code a~ns. .......... ....... ...................... ........ ............. State whether applicant is owner, lessee, agent, architect, enging,e~ general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of lond on which p~bcgo~d work wii/!2be done. MapNo~ ...................... LotNo: ..... ./..~.. ......... Street and Number Municipality (/ ........................................................ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................. ~')~;~,~ ............................................................................. b. Intended use and occupancy .........................,~.,~. ............... ..., ............................................................................. ~'Addition 3. Najure of work (check which applicable): New Building ................................... Alteration ...~ .............. Repair/ .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Esti'mated Cost ................. /~..,~..~..~'~....O. ......................... Fee ........................................................................... ~ .............. i (to be paid on filing this application) 5. If c~welling, number of dwelling units ........ Number of dwelling units on each floor ............................ If ~arage, number of cars ............................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................. ~ .............. 7. D ~ensions of existing structures, if any: Front Rear Depth Height ............................ Number of Stories ................................................................................................ ; .............. Dir~ensions of same structure with alterations or additions: Front ................................ Rear ................. ~ .............. DeR'th .............................. Height .............................. Number of Stories ........................................ 8. Dir~ensions of entire new construction: Front .............. ..~...O. ......... Rear ...... ......~'...O. ............ Depth .........~.~!..~'. .......... Hei ht .~, O Number of Stories ............/..~. .......... : 9. Siz~of lot: Front ......... /..~.J. ............. Rear ........ .~..s. ............... Depth .......... ..~..~.,6,,~,, .......... 10. Dat]e of Purchase ........................................................ Name of Former Owner ......................................... ' ............... 11. Zo6e or use district in which premises are s~tuated .................................................................................. , ............... t2. Do~s proposed construction violate any zoning law, ordinance or regulation? ....... ~ .......................... ! ............... ........... :~,...,q.....t~. ............... L~Phone No ......: ............... 13. Na~e of Owner of premises ...~,.~..,,...c~k.~.~, ............ Address L~, )~ ~/c~,~-r~/~o ~-~ : Name of Architect ...................................................... Address ............................ ................ Phone No ...... ............... Na e of Contractor ... : ....... .f.~ ................... Address . ..~.~..e....q~. . Phone No ..................... I PLOT DIAGRAM ~oca(e clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether iqterior or corner lot. I0, STATE O1: NEW YORK, ~ ¢ c COUNTY OF .............................. 7.~'°' J /~ ~'.~.~; ....... be na du sworn, de oses and sa s that he s the app cant ............ . ......................... :.. . .................__ Y . P Y [No~;[qF~idual signing apphcat.on) above na~ed. He is the ................................................... ~= ...................................................................................... [ (Contractor, agent, corporate officer, etc.) ' of said o~ner or owners and is duly authorized to perform or have performed the said work and to make and file this app ration; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to ~efore me this ~ _ ... ~ day of ....... ~ ., 19 ~.~ ........ w": ..... . ........... .............. .............. j ................ Notary P~bli~.~.~ ....... ~.....~Coun~l~ha~ ~u~ ~[;~,:~[~:~noturo.~ of oppl,c~nt)'