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Home My WebLink About723-Z FORM NO.4 TOWN OF SOUTH OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. .....1...'7.&........ Dote ..................D.tl~g"~..3.Q..........., 19.'9.. THIS CERTIFIES that the building located at .~/~...~~~.~...~.I...!:I.9.~~~M.. Street Map No. ....8~U.thv.aodBlock No. .!.!~................ Lot No. .at.t............................................................ conforms substantially to the Application for Buil ding Permit heretofore filed in this office dated .................................1.UM..l1......., 19....19, pursuant to which Building Permit No. .......&..'123....... dated ...............................l.aM...17....... 19.J.9.., wos issued, and conforms to all of the requirements of the applicable provisions of the low. The occupancy for which this certificate is issued is ................ ................................................lRIYAU...OD..I'...MIliI.:OWLLIJG................................................ This certificate is issued to .A....G....Car~son,...O'WZUtl'.................................................................... (owner, lessee or tenant) of the aforesaid building. 'i...~i.~~~~........ BOWARD M. DRRY FORM NO. 2 TOWN OF SOUTH OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ng 723' Z Dote .................1....11.......................... 1~9...... Permission is hereby granted to: ....... .Y.... .C./Ar.bllil.................................................... Cr.1tteu. . Lane. ... .................................. ... ....... ... ... Iouthold.' .Ie.. .101'k-.. ........ .... ........ .... ............. .... to bu1U..adcUt1.n..ot..2...ar..~.'O.l.\..m~:t,j,flI..j;mll..tM~b..~1'!~m~................................ ................................................................................................................................................................ at premises located at ..~..l..d~.~..J:;:..,.j.Jt.f\~!l...4:!)!'!....!&.:L!f.~..;.,A.................................................... ... ............... ........ ..... .... ... lout "''3ai,. ..lau:tllG14.. .... .York.. ................ .... .... .... ........... ....... ... ... ... .... ... ................................................................................................................................................................. pursuant to application doted ............................r.....17.......................19.S-9...., and approved by the Building Inspector Fee $5.00................ Building Inspector Bowal'\! '0 'I'tl1'1'7 VtJ ~ JVrV 7--7 S l FORM NO. 1 TOWN OF SOUTH OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined..........~I.?19:?7. Appraved...........~/.Z.19.':?7permit No. ..;r?.:;?~........ Applicatian Na. ...;:P.;f............ Disappraved a c ..................... .........~..~t~;~t3 APPLICATION FOR BUILDING PERMIT Date.........................~~.I;Z.....19.7.. INSTRUCTIONS a. This applicatian must be completely filled in by typewriter ar in ink and submitted in duplicate ta the Building I nspectar. b. Plat plan shawing lacatian af lat and af buildings on premises, relationship toodjoining premises ar public streets ar areas, and giving a detailed description af layaut af praperty must be drawn an the diagram which is part af this location. c. The work ca...ered by this applicatian may nat be cam menced before issuance af Building Permit. d. Upon appravaI af this applicatian, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available far inspection thraughaut the pragress of the work. e. No building sholl be occupied or used in whole or in port for ony purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment far the issuanoe of a Building Permit pursuant ta the Building Zone Ordinance of the Town of Southold, Suffolk County, New Yark, and other applicable Laws, Ordinances ar Regulatians, for the canstruction of buildings, additions or olterotions, or for removal or demolition, os herein described. The opplicont agrees to comply with 011 applicable laws, ord inances and regulations. ............/.2:.~,..~......................... (Signature of applicant, or name, if a corporation) ............~~~~n~. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................................,.....~.......................,................................................................................................. h" ~ . . A. "L<.l_f:)l--;7 Name of owner of prem'ses.......ti'.h... ...>... ..~:.............. ,..~..................................................................................... If applicant is a corporate, signature of duly authorized officer. ................................................................................................. 1. (Name and title of corporate officer) Location of land on whic~..roposed work will be done. Map No~i~l.':~.... Lot No: ...dL.... Street and Number ....&tt~?:.~~.....~-r.................~~~4.......................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and accupancy.........~<?'f.'4'4?;T................ .................. ..... ....... .~....... .......... .............. ........ ..... b. Intended use and occupancy........~~~c...7.a;1/.&"U.!:.~.......................................... 2. 3. Nature of work (check which applicable): New Building....................Additian .....~..Alteratlan .................... Repair ....................Removal ....................Demalitian............ ........Other Work (Describe) .................... Estimated Cost..... .... ?"~.~.'..-=:..... ......... ........... Fee .. ~.:5.::...~ ............. ........ ... ....... ... ............. .................. (to be paid on filing this application) :: :::~~:~'n~::::r o~f :~:.I~~~~.~~~~.~: ::::~... .....~.I.~.~.~~~..~~..~.~~~ ~ ~~.~.. .~~.i~.~ ..~.~..~~.~.~..~~~~~::::::::: ::::::::::::::::::: If business, commercial or mixed occupancy, spec ify nature and extent of each type of use.............................. Dimensions of existing structures, if any: Front......:J:??.,.......... Rear ........~(!........... Depth ..~~......... Height ...... ........ ........ ......Number of Stories .. .../~:~......... ........... ... ..... ....... ........ ......... ..... ... .... .... ..... ............., Dimensions 0 same structure with alterations or additions: Front ............';1...c;f............ Rear ..........7.(P,............ DePthq?f.S..;RY.......... Height ..............................Number of Stories ................................ I Dimensi s of entire new construction: Front.....$.....~......... Rear ............~....~... Depth ....4./:........... Height ............................ Number of Stories, ......../................. ?d' . /6-7" /3Z:; - . ..;:J./~ :::z!.KfN/'<"- Size of lot: Front ......./...:....~:........ Rear ............................ Depth ...~r..,;?.~ 1. ~;./~ Date of Purchase /~~:::......................................Name of Former Owner ..~...... .....~. ........... ............ (J..;?; I' /D. ' ~ Zone or use district in which premises are situated...........,LC::.....L~;<?....:....~................................. Does proposed construction viol~te.d'ny zoning low, ordinonce j" regul~On?;(............................................... Name of Owner of premises..a,,&;.?1"~.~Address ~?;.4.-e............Phone NO. .................... Name of Architect........................................................Address ............................................Phone NO. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Nome of Controctor....................................................Address ............................................Phone NO. PLOT DIAGRAM Locate c1eorly ond distinctly oil buildings, whether ex isting or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or descriptio n according to deed, and w street name,s and indicate whether interior or corner lot. ~" ~ "... t,G~~\ ~' $~ *' ..( )- u'" '<< I '" ~ \ "5 ~ -----/31>u 1 ~ )(\\~ , t~~f~\ ~ +-14' '\ E" ~f5 "~ }, b (!;,fjf'fe n s -<- ,,}/7 t!.- STATEOFN~O' ') SS COUNTY OF .... ... ,..)~. ".................................d. ...:...........~..............being duly sworn, deposes and says that he is the applicant above na~~~:ee ~: t~::~i.~.~~:.;;r.l~.~~~................,................................................................................................ (Contractor, agent, corporate officer, etc.J 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 all statements contained in this appli cation are true elO e best of his knowledge and belief; . and that the work will be performed in the monner set forth in the applicat' n ~'Ie t ewith. fd Sworn to befor~e this . V:- c./ "'-~ ............/:Z~.;:-da of ;............... ......... ~. Q..... 'ur. (, B ature 0 applicant . ry f'l II (" fate of r:ew Yor1 Notary Pub" . ... ..... ... , ,1)3 ". if IlK Count, Co ,m,~<; 01 f ^.'"' re March 3D, 1_';].6/