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TOWN OF $OUTHOLD
BUILDING I~EPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No..Z...&235 ............ Date .......... A~c~us.t..18., ...................... , 19.68._
THIS CERTIFIES that the building located at ..... Ro~c:.~...~£~.t:..ROa~l, ......................... Street
Map No ....................... Block No ....................... Lot No...~,~S.t..~aZ'.:i.O~,..~,,~L~O.l~,~ .................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
................................. .~e]D~;ertl~e,~..,1.8.,.., 19..67.. pursuant to which Building Permit No...:~.G.~.Q...~
dated ...................... ~e.~tel~tl~:~=...2Q,., 19...67, wasissued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is ........
· .. ~o~.~.Va.~. ¢-..ei~e...f~r~l.t .~..y.. .c~e~.~..$.~,~ ...........................................................................................
The certificate is issued to .................... ~'.ob,~...~.~.:~;.~:L~ ...............................................................
(owner, lessee or tenant)
of the aforesaid building.
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 3630 Z
~e~te~e~ 2~ 9 67
D~te ....................................................... , !
Permission is hereby granted to:
........... 6073.....~u~rAM ..iI~. ...........................
to .~..~....".~.~?...~...~...'.:~::...~.?.~.t..~.~...~...~.~.t.~..~..~.~. ..............
at premises located at ..~../.~.......~....C~....~.....~..O..-4.-..~...~...~.O..~;.~. .........................................................................
........................ ..!.~#.$...~.~.~. ...... .~.,.~.,. ............................................................................................
pursuan¢ to application dated ................................ J~....~. ........ , 19..~.., and approved by the
Building Inspector.
Fee $~.t.~.~?.. ..............
-'~- ";'~'~" I 'Ali i I
~ 4 C ~AW L
FOUNPATt ON FLAM FLOOF- PLAN
. ~",~'~ ~ ~"-o ~ ~ .....
FO]EM NO. 1
'TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOW. CLER.'S OFFICE
SOUTHOLD, ". y.
Examined ..... ~.......~... ......... , 19.6. l.-
" 79"
Approved ........................................ , ........Permit No ....
Disapproved a/c
lnspect~r) .......
APPLICATION FOR BUILDING PERMIT
Date Sept. 18, 1967 19 ............
INSTRUCTIONS
a.- This application mu-st be completely filled in-by typewriter o[' in ink and submitted in duplicate to the Building
Inspector.
b. Plot plan showing location of lot and of buildings on premises relationship to odjo n ng pram ses 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 MADE 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 laws, ordinances, building code and regulations.
..... .. .......................................
(Signature of applicant, or name if a corporation)
Michael Contessa... ~es.
........... ..6..O..7.~....~.u.~..a..e....~.~,~....~.,..~...H~A~.~.~ ......
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
A~plioant = Contractor
Name of owner of premises
If applicant is a corporate, signature of duly authorized officer.
Contessa Oonst.
....... ~Aa~el...0.~ee.s~...-....~r. es.~..m .........................
(Name and title of corporate officer) / si~-~' '
des cribe~ plot
1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No.:
Street and Number Rocky Pt. Rd. (no number) E. Marion
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 1 Faro. ]~/.
10.
11.
12.
13.
STATE OF N~'.c.Y,.D_I~I~, t ¢ e
COUNTY OF~..u.h-~?..~...~. ................. ,f'"'""'
Michel Contessa
................................................................................................. beinb dul~ sworn, d~oses and says t~t he is the applicant
(Name of individual signing application)
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 ~ke and file
this application; that all statements contained Jn this application are true to the best of his knowledge and belief; and
that the work will be performed in the manner set fo~h in the application filed therewith.
Sworn to before me t~
/
................... ..........
~ ............ ~ ..........................................................
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