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Home My WebLink About4028-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ~z..3u301:) ............. Date ................. O~t.~..1K, ............. , 19..~a~. THIS CERTIFIES that the building located at ~J/~..~J~t~t..~lJ;~,~,,oll~..~V~,OI3..J~t~ ....... Street R. O. W. Map No ....................... Block No ....................... Lot No....~Cttt,13J:tC~&,...ll~...~, .................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................... JO~IMIIJ~i¢.....,~., ............. , 19...~.~ pursuant to which Building Permit No..4.~..2.1]J....~.. da{ed ............ ~J~i~.....~t6 ........... , 19..~.., was issued, and conforms to all of the requirements of the applicable provisions of the Jaw. The occupancy for which this certificate is issued is ........ .... .g.~&gg....(]~g~,~.~.~#.. ~.~'oJs. ao,t']'.. ~b~.~l:Jx~g~ ........................................................................ The certificate is issued to .........~...O....RIt~, ......................................................................... (owner, lessee or tenant) of the aforesaid building. ...... .......... Building Inspector FOR. itl NO. t, 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? 4028 Z Date ....................... Saint .......... 7. .......... ,19..68. Permission is hereby granted to: ~J...,!}.,e.e..~......~ ..~.......~.e~....~..~ ...~.e.e.'Je. ............... ~tt~laDgae ........................................... 2y~il Private garage at premises located at ..... S/...~. ]Je.~..,.~.~..~..l~;~l~ .~..~'~. ................................................ g.~tal~o&me ......... ~i.Zo ....................................................................... pursuant to application dated ...................... JJ~--]).~. .............. 7. ........... , 19.61111.., and approved by the Building Inspector. Fee $...I;,.i;~. .......... ~uilding ~nspector t. '~ BLI!.LOING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved .......: ........ ~.~. ........... : ....... , 19..~...I.. Permit No...~....~... ~....~.......~'.. Disapproved a~.......~ APPLICATION FOR BUILDING PERMIT Application No. 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 property must 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/v~ADE 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 all applicable lows, ordinances, building code, housing code, and regulations. (Signature of applicant, or name, if a corporation) C~teho~ue (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi.neer, general contractor, electrician, plumber or builder. Co~r&ctor Name of owner of premises .~[l~n3~;...~.~..~ell~.~e ................................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: .................................... ::!:~ ' '~" ~ Lot I~1o.: ........................ Street and Number .... $/~ ......~'~Ii'..~II~.~I[..~.T.~I...Q~..~.~.~..~.,.~..~..~....~~ ............... : .................. Municipality 2. State existing use and occupancy of premises and intended U~:e and '~:dpancy of proposed construction: a. Existing use and occupancy ..~..l~...e,l~..~..~ b. Intended use and occupancy ............... .I....a~..?....l~..~.t..~....~l..T..t....l$..a~..a..l~.e. .............................................................. 3. Nature of work (check which applicable): NeW Building ...3:3[~ ..... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ....~.~.~ ............................................... 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 ...... ~10~11 ............................................................................................. ................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, Jf any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .....1..~.. ........................... Rear .....!..~. ................... Depth ...... .2...~. ............. Height .................... Number of Stories .... ~ .......................................................................................................... 9. Size of lot: Front ...,~. ................. Rear ............ 1.0.Q ................. Depth ....... '~.+......1.~O 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ................~..~...~...~.~..I...~. .................................................................. 12.) Does propo~ec~.~Hst~uct on violate any zoning law, ordinance or regulation? ............................................................ 13. Name of Owner of premises ..][,e~l....0.1..l~.e.~....Address .............. .~.lg,t~e~¢l~l~l.e ........ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ....~..l~..~....~..e...e.~.e.. ........................... Address ....... ..~..~...~.~.~..O.~.~..~. ............... Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. (Name of mc~w~clual s~gmng application) above named. He is the ........................ .(~O~,~,~&¢.1~)~.. ........................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or' I~ave performed the said work and to make and file this application; that all statements containe~d in this application ,are true to the best of his knowledge and belief; and the work w II be performed n the ma~nner-set for}h ~n ~e app ~ca~on fi ed therewith. Sworn to before me this MARION A. REGENT ' NOTARY PUBL C State of New York No. 52*3233120 Suffolk County/...2~. Term Expires March 30,