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Home My WebLink About4619-zNO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE $OUTHOLD, N. Y. CERTIFICATE: OF OCCUPANCY No Z~,~8,~.c~ ................. Date ............................. J]'.'L~J.e, ....... .1.0 ..... , 19..~.0. THIS CERTIFIES that the building located at ..E/$.....~.~..ley...De~eh..~L~)a~ .............. Street Map No ...... ~.~ ............ Block No .........~:. ........ Lot No...~ ......... J/~C~,~'l~tt~k: ....... ~.i'¥~ ............. conforms substantially to the Application for Building Permit heretofore filed fn this office dated ..................................... ~e~b ......... .1.~) ....... , 19....~.0 pursuant to which Building Permit No ...... dated ........................... .~) .......... ~ .... , 19..~., was issued, and conforms to all of the requirements of the applicable prowsions of the law The occupancy for which this certificate is ~ssued is ........ .... Pmt.v.a te...on~..i%mil.~..~oi.tag, e ....... ,.~ .............................................................................. The certificate is issued to ...~'$~d...}[e,~.~L.l.~,_~ .......... ~J~'~e.~'. ........................................................ (owner, lessee or tenc~nt) of the aforesmd builchng 13~OtZg hoarse # 11+00 Building Inspector FOI~/~I NO. ~ 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? 4619 Z / '~ /~/~ 19 ........ and approved by the pursucm* to application d~ted ............................................................ , 7..~, Building Inspector. Fee $ ........................ ' Building Inspector NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ................................. 19 ........ Permit No ............................ D,sapproved o/c ............. ~...7 Z~-.. ................................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT ......................... INSTRUCTIONS a. Th~s apphcat~on must be completely filled m by typewriter or in mk and submitted in duphcote to the Buddint Inspector. b. Plot plan showing location of lot and of buddings on premises, relationship to adlommg premises or pubhc streets areas, and g~ving a detaded description of layout of property must be drawn on the d~agram which ~s part of this application c. The work covered by th~s apphcat~on may not be commenced before ~ssucnce of Building Permit. d Upon approval of this apphcat~on, the Building Inspector wdl issue a Budding Permit to the apphcant. Such perm~ shall be kept on the premises avadable for inspection throughout the progress o~ the work. e. No building shall be occupied or used ~n whole or ~n part for any purpose whatever untd a Cemficate of Occupant,, shall have been granted by the Budding Inspector APPLICATION IS HEREBY MADE to the Budding Department for the ~ssuance of a Building Permit pursuant to th-' Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o, 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, ordmatnce,~)buddmg code, housing~ code, and regulal~ons (S~gnature of opphcont, or name, ~f a corporation) ............... .... >' - State whether applicant ~s owner, lessee, agent, architect, enameer, general contractor, electrician, plumber or bu~tder ....... O L= Name of owner of premises ............. .L....~....~.....~.....~.. .......... ~..~.../~. (/-' T~J~/ .... If applicant is a corporate, signature of duly authorized officer (Name and title of corporate officer) 1 Location of land on which proposed work wdl be done Map No . · Lot No ..... Street and Number ........... L.../~/...~....~. ............. ~...~..../.L.../..~...~... .......... ..-~...~.~.6...~_....~. ........... . .~..~...~.. ~ .... Munic,pality ,/f~/,~7/- / ~J~C A 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction a. Existing use and occupancy b. Intended use ond occuponcy ...................................................................... ..~.. ....... 3 . ~'Nature of work (check wh,ch applicable): New Budding ................ Addition /~ AIterahon Repmr .................Removal .................. Demolition ................. Other ~Vork (Describe) .......................... 4 Estimated Cost ....................... 3.~... ........................ Fee ........... ~ .................................................................. (to be paid on hhng this apphcation) 5 If dwelling, number of dwelling umts ............................ Number of dwell,rig un,ts 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 ex,sting structures, if any: Front ........... {'.....~. .......... Rear ............. .~'....~... ......... Depth ......~-.~ ..... Height ........................ Number of Stories ............................................................................................................. Dimensions of same structure with alterahons or addihons: Front ................................... Rear .... Depth ................................ Hmght ........................... Number of Stones ............................. 8. Dimensions of entire new construct,on: Front ................... /..~.. ....... Rear .................. ~.. ..... Depth ............... Height .................... Number of Stories ............................................................................... Size of lot. Front ........................... Rear ................................ Depth .......................... Date of Purchase ....................................................... Name of For93. er ~wner ................................................... Zone or use district in which premises are s~tuated .......................... ~ ................ ~.. .............................. =.:; ......... Does proposed construction violate any zoning law, ordinance or reflubhon? ............. . .7).... 0 Name o Owner o prem,ses ..................................... Address ....... ;W/~.ZTi~l/.r_../~. .....Phone No ............ Name of Architect .................................................. Address ......................................... Phone No .............. Name of Contractor .................:~.....~.....A~../....L?-.'~.. .............. Address .................................... Phone No ............. 10 12 13 PLOT DIAGRAM Locate clearly and d,st,nctly all buddings, whether ex~sting or proposed, and ,nd,cate all set-back &mens~ons fro~ property hnes. G~ve street and block number or description according to deed, and show street names and ind~cat whether interior or corner I¢ STATE OF NEW(I~OJ~,/?J COUNTY OF .~ ............ ~-o.~. ....''~ .~....~...~.~-...~..~ ....... 8.~...../~..../....L.....'~...O....~.. .................. be,rig duly sworn, deposes and says that he ,, the appl,can (Name of ,nd,vidual s,gning application) above named· He ,s the ............................... ~....1:~....~....~.~.......~ ......................................................................................... ~ (Contractor, agent, corporate officer, etc.} of smd owner or owners, and is duly authorized to perform or have performed the smd work and to make and fil this apphcat,on; that all statements contained ,n this applicahon are true to the best of his knowledge and belief; an, thor the work will be performed in the manner set forth m the opplication~iled therewith. Sworn to before me this ................. ........................ .... . ............ ............. Notaw Public,re.w,. ....... _ ............ ~.~ ......... ~..~ .......... :.~."[County [LIZABETli ANIt NE~i~nat?re of applicant) (1,,,,. ,'1',OT^,¥ ,fo.. ~/ / "~rm Ezp res ['~'arJ~ 30. 19~_4~