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Home My WebLink About3738-zNO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No....Z..,~2.75 .......... Dote .......... Se[3tembe:¢..;13., ............... , 19.68... THIS CERTIFIES that the building located at O~¢~,ha~c%.~Latl~(~v.~.,~cc~o.o~£.,,~.a..~,~.~ Street Mop No..,.C.~l~,~ ....... Block No ....................... Lot No...~.9.....S~.uthol~J,...N.e.W...Y~.~ ............... Beach Park conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................... l~e~,em~er...,1,3, .............. , 19..62.. pursuant to which Building Permit No....3.].3...~..,.~ dated ............ ~.~elllJ31~l~..,J,~J~ ............. , 19...~..~.., wasissued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ...pr~,~a.te..~ne..~a~;~y..a~ell~n~ ........................................................................................... The certificate is issued to ...]~a~3cer~e...P....Braall~Lgan ............................................................... (owner, lessee or tenant) of the aforesarid building. llealth De,pt. Ap..Pzoval, Febzuar:y 15, 1968, Robert Villa FORIVI NO. 2 TOWN OF SOUTliOLD BUILDING D£PARTM£NT 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) ? 3738 Z D~e ..... ~ ............ ~).(~......)a., ...... , '~9..~.. Permission is he~?by granted to; ..... tt~,~J,~a.~.~..~....~..~..'~ Building Inspector.r · .Fee $,J..M.::..,'*..,~.~,.,' ' ~', ' ~: S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH ~a~. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Give deed loc~ation) have been inspected by this department and found to be satisfactory. District Engineer District Engineer FOEM NO. 1 ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......:~--r..'~... /....~' ....... , 1 9.....(~. Approved .......................... [..) .......... , 19...JMPermit ~o....~...~...~.~L.~ Disapproved a/c ......... ~,~?~. ....................... ~.~,~. ............................ ~,,~ ....... / , c,~' ................................. APPLICATION FOR BUILDING PERMIT Date ......~...~...~.-~.~..'..../', .~... ......................... ,19..~..Z... 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 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 shah have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the i~suance 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 ~r alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws,' ordinances, building code and r~lations. (Signa~r~,of applicant, or name, if a corporation) (Address of app icant~~ State whether applicant is ow_net, lessee, agent~ architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises ..................................................................................................... If applicant s a~u;~oorate, signat~ure of duly ~thorized of.~er. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map N~' ..~....~....~....~...~....~.....~...~.~..~...~. Lot No: ,.~-.~... ............ Street and Number ....~~....~~i~ji~~.....~....~..~.~ -- ~ - - /'~' '~ ~~ ~ ......................... 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 ....~..~ .................................................................................... 3. Nature of work (check which applicable): New Building .................. Addition Alteration ....... Repair .................... Re~l~...,~,T-~.~e~Demolition .......... __ ~¢:~ (~J~ Work (Describe) ........ 4. Estimated Cost ............................................................ Fee .......................................................................................... ~ (to be paid on filing this application) 5. If dwelling, ndmber 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 existihg structures, if any: Front .......................... Rear .......................... Depth ............................ . Height ............................ Number of Stories ............................................................................................................... Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height ....................... .~..~umber of Stories ...,~, ............................ 8. Dimension~jl~tire new construction: Front ...¢~:~,'~.,,~ ........... Rear ............................ Depth ............................ Height ................... .~..~:~.l~Number of Stori~,,,~..~.. .................. 9. Size of lot: Front ............................ Rear ............................ Depth ...................... 10. Date of Purchase ........................................................ Nam,e,.,r~F,~'mer Owner ........................................................ 1 1. Zone or use district Jn which premises are situated ....................... ~ ...................... ~ ............................................ 12. Does proposed construction ~li~law, ordinai~~j~n.~,.~'~ .............................................. 13. Name of Owner of premises ................ .~. ................ Address ............................................ Phone No ..................... Nome of Architect ....,~,.l~'~..,~,~...,/,,~l~.Address ...~ ........ Phone No ..................... Name of Contractor ........ ............................................ 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 N EW.,.-.Y~ORI~',~S~ ' c ou. .............. ;~ ........... ;":"": ............... ~ ............... ' ........ being duly sworn, deposes and says that he is the applicant u~ame aT md.vidua ~~ 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 th s application; that all statements contained in this application are true to the best of his kno~edge and belief; and that the work will be performed in the manner set forth in the a~cation find therewith. ~ ~ Sworn to before me this z ~ [ L ' ~ ~ ~ ........... ;..~ ........ day o,r.~.~,~.~.~ ................ , J~,,~.~, ~ ~- ' ................................................................... Notary Pubhc, ~r.¢.~., ~Count~ (S.gnature of applicant) . ,,omm[ss,on Expires r~!z ',) ' ~ '~ :