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Home My WebLink About3735-zFOI~M ~0. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..~.,,O.~..~.~...~.e...a....D...~.~.~,e. ................................. Street Map No Orient- Block No. Lot No...7.,6.......0..~..:1,..e..~...~.,...~.~.~.....~.~.~¢~ ..................... By-+5~"~'~ ................................. conform~ substantially to the Application for Building Permit heretofore filed in this office dated ........... .?,e,.,c.e....l~...e..z.......6..~. .......................... , 19...6..7.. pursuant to which Building Permit No. ~.~..,,~...~.. dated .?..e...~.?..-m~,. e..z.......?.¢ ......................... , 19....6..?., was issued, and conforms to oil of the requirements of the app][icable provisions of the law. The occupancy for which this certificate is issued is ........ ................................................................................................ The certificate is issued to ....~...a..1...~..e...~.....[~.~.....[...~..c... .............................................................................. (owner, lessee or tenant) of the aforesaid building. Health Dept. Approval, J~uly 2, 1968, Robert A. Villa Building Inspector ~k FOEM NO. 2 TOWN OF ,SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON ,THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ....... premises located at ~Dt ?6 O~t ...~.' t~ Bea See ;I:Z ~ .................... llo~th..ll.ea.3~l~ ............ O~.~ut ......... Jli~.~. ................................................ i ........ pursuon,t to application doted .......................... '..J)~J~!l~J'.....6....., 19..J~., and approvecl by the Building Inspector, Fee $~0.~0 ............ Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH ~ate J~L - 2 t~ Bldg. Permit No. 3~ ~ TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Give deed location) have been inspected by this department and found to be satisfactory. JUL - 2 DistriCt ~ngineer District Engineer FOItM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ................................. Disapproved a~~ APPLICATION FOR BUILDING PERMIT Dote / . 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 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 o 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 o 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, os herein described. The applicant agrees to comply with all applicable lows, ordinances, building code and reguJ,p,tipns. ........... ............. .............. ......... ' ...................... .................. State whether applicant is owner, lessee, agent, ,g~chitect, engineer, general contractor, electrician, plumber or builder. _ r/)/i Name of owner of premises .................~.~...~ ...... .~../. ........ ~ ............................................................................. If applicant is a corporate, signature of duly authorized officer. , o rk , I be done Ma o ..~.'..~..~.~ ~ ~ ~ 1. Location of land on wh'ch proposec~wo w'~, . p N : ...,~....;:......~_.c~ ......... ~-. Lot No: .................... Street and Number ........ .~......~...~ ....... ~.'.~..' .~... ......... ...~...~..-. ............... ...~.~...~.'.~ .................................................. Municipality 2. State existing use and occupancy of P~d i~d~ed use and occupancy of proposed construction: 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ....... ~ .......... Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... /7. aaa Fee .......................................................................................... 4. Estimated Cost ................... ¢.+ ..................................... (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 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 .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ......... ..~.Z../..~.~. ..... Rear ......... .z~..~.(,..~.. ....... Depth ........ .-,~..O..../.O. ........ Height /~ ~ ............................ Number of Stories / 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 1. Zone or use district in which premises are situated ................... ~ ......................................................................... violat~ any ~oning law, ordinance or reaulationP ,Z/¢~ ....... ,; ,, ,%,. . Name of Architect ................... ~ .................... Address ....................................... Phone No ..................... Name of Cant ractor ~..~...~ ..................................... 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 show street names and indicate whether interior or corner lot. STATE OF NEW..-,YO]~,,~ / c ¢ COUNTY OF . .. ~ ...~ ....................................... being duly. sworn, deposes and says that he is the applicant ......... iNome(~pf individual signing application) d~ ... above named. 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 a statements contained in this application are true to the best of his knowledge and belief; and that the work wi be performed n the manner set forth in the application filed therewith. Sworn to before me this -~, /,~,,~/~//?,~, .~..... day of. ~ ......... , 19..~..~.. /~,.~,*~, ' ....... ×:,., of opp,icant, NO, 52-3233}.20 Sullolk