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Home My WebLink About3641-zFOI~M l~O. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ..... Z...3.L4~ ......... Dote .................... . .J...u...1.y ........ .9.~. .............. , 19..6..8... THiS CERTiFiES that the building located at .W/.S...S.tll],w~.t;e,l~..~.V..~., ........................ Street Map No ....................... Block No .....: ................. Lot No....C:u.tch. og.ufL,...~.W....¥.~:[f}f. ..................... conforms substantlally to the Application for Building l~ermit heretofore filed in this office dated ........................ Sep%em~e~..,..2~, ......... , 19..~7.. pursuant to which Building Permit No...~..~..4.~.....Z. dated ............. S.eptembe~;.....2.6, ......., 19...6.7., was issued, and conforms to all of the requirements of the applicable provisions of the law, The occupancy for which this certificate is issued is ........ ......... p:c. iVat~..6ne.., f~m£'L.y...d~.e:L]~ iz~g ...................................................................................... The certificate is issued to ................ 19'~Lc}zolas..Saba ...................................................................... (owner, lessee or tenant) of the aforesaid building. Health Dept. Approval, July 3, 1968~ Robert Villa ~, , ,r~ ~ " /~,¥"-~J '- ~ ~ (--~' ~- ' "' ~/ Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. ' BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 364:1 Z Dine... Permission is hereby granted-o. ., : ,, , - -, , '~ ot premises located ~t ~o ~I~.~. A~ ,. . ............... ; .. - . '-j ..... . : · ........................................ :....~0~ ................... : ............. ~...; ................................ : .................. : .... pursU~ to *pplic~tion dotod ......................... ~$~ ....... ~.~.....:...., 1~..~., ond ~pprov~ ~y tho Building Inspector. FeeS.. !.0..t.~. ......... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Examined'" ........... 'Approved ........................................ , 19 ........ Permit No ........................ Disapprov~.~~~~ ............. ................................. APPLICATION FOR BUILDING PERMIT Sept 26 67 Date ............................................................ , 19 ............ 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 Js 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 o,~f applicant, or name, if a corporation) New Suffolk (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................................... ..................................................................................................... Name of owner of premises ...~.~.g.~.o..~.~...~... ~.ft.b..~ ................................................................................................................... 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 No.: ....~.~ .............. W S ' ' ~ v Cutcho ue Street and Number .... /.~. ....... .t;.~W.~.~.~.~...A...~ ......................... .~ ........................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy vacant larld b. Intended use and occupancy o~e family., dwelling 4. 5. 6. 10. 11. 12. 13. property ~ whether in Nat ~re of work (check which applicable): New Building ....~.~.X.... Addition .................. Alteration Repair .................. Removal .................. Demolitian .................. Other Work (Describe) (to be paid on filing this application) If dwelling, number of dwelling units ...... .o..~...q ............... Number of dwelling units on each floor If )usiness, commercial or mixed occupancy, specify nature and extent of each type of use Din ~ensions of existing structures, if any: Front ............................ Rear ................................ Depth Hei ht ........................ Number of Stories Din ensions of same structure with alterations or additions: Front ....................................Rear Depth ................................ Height ............................ Number of Stories ................................ Dimensions of entire new construction: Front ....~.0. ......................... Rear ........... ,~.0 .......... Depth ...... 2.~ ......... Height .................... Number of Stories o~te Dat~ of Purchase ........................................................ Name of Former Owner Zor~e or use district in which premises are situated ...!]~.]]...c~;LS.t~ ........ Doe's proposed construction violate any zoning law, ordinance or regulation? ..... z).O ..... Name of Owner of premises ..~.$.g.~.q.~k~,.$...~..~,]q~, ...... Address ............................................ Phone No. Naive o~ Architect ...................................................... Address ............................................ Phone No. PLOT DIAGRAM Locat,, clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr nes. Give street and block number or description according to deed, and show street names and indic :erior or corner lot. STATE OF NEW ~OgK, COUNTY i OF ..... 9.g.~)..]'..0. · .~..~. · .......... .f ""~' ................ '~ .................. ..~..~..~..~!.i}..?....t.!.O..Z'.~.O..Z.t. .............................. being duly sworn, deposes and says that he is the appli¢ j(Name of individual signing application) · (] ~ o above na~ed. He ~s 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 this appli,:ation; that all statements contained in this application are true to the best of his knowledge and belief; that the ark will be performed in the manner set forth in the application filed therewith. Sworn to efore me this .................. ..~..6.. day of ................. ~.e.~..t. .................. , 19...0.2. Notary PL blic, .~..~-&c//-~....~/~...:.../~,~7~.-:~ounty (Signature of applicant)