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Home My WebLink About883-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CL~RK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUP/~NCY No.. ~....1002. Date ............ ~~. ........ TH~S CERTIFIES that the building located at .8/~ A;Lt~aI~' Dz:~, ]~g~;~tll~reet Map No ....... ~,~,. Block No .... ~,~. Lot No .... ~ ................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ..~...~O.~..~.r...~..~.. , 19..~...9.. pursuant to which Building Permit No ..... ..~ dated ....... O~...~..O]~..~. ~.~. , 19..~..~., ~var issued, and conforms to all of the require- ments of lhe applicable provisions of the law. The occupancy for which this certificate is issued is .... ~.....~..~.?~....O~.....r~..~-~..~...~ ............................ This certificate is issued to . .~..:...]~..?~,.~: ~...~.C..k~..~f...~.?.~. .......................... (owner, lessee or tenant) of the aforesaid building. FORI~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT fi.HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 883 z Date .................,OG~.Q~f~..~.~. ........ 19.~... Permission is hereby granted to' Z. ~arker 'Jickha~ ..... A~1,~m,~.. !Tz'l~r.e ....................................... ...... ~tt~;~l~ ~e~..~.~ ........................... to ..... .b..~..~ .~..~....~..~. ~.~ ~..~ .q~ ...~...~.~.~..~.[1~...~.T~.. ~.{~1~... ~.'eP~ ~.. ~.~. ~; ......................................... at premises located at .... ~.(?..~...~....Z~.. ~...~...~..~.?..?.~....0. ~.Z.~....~..e..~.....~...~....~.O..~..,.~.~.~.~ ...................... pursuant to apphcatlon dated ............................ ...0~..~?.~..?......~.. ............ 19...~.9., and approved by the Budding Inspector ' Fee $~. ~.Q~I...~. Building Inspector FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Approved.....~...~.~l 9. ~.?~e rmit No ........ ~../~..~... Disapproved a/c ..................................... ......... (Building Inspector) Application No ..... ..~.....~...~... ........ APPLICATION FOR BUILDING PERMIT 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 is part of this location. 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 Jn 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 build!rigs, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. .... _ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of p rem scs .~' ..~~ X/-f~'~~ ......................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on whichpropos,e, d work will be done. Map No:. ,4' "~ // ,, ,///")'; ................. · Lot No: .................... Street and Number ...~..~.'~'(~,~..~r..~.~.:...~iit~.~~~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ........ ~.~..~ ....................................................... .......ntended use and occupancy ........................../' M /~ f /r ~.~ ~../.~....~...~.~ b / Nature of work (check which applicable): New Building .................... Addition ......... .I-~.......Alteration .................... Repair .................... Remo~,al ....... ~.,~ ...... ,Demolition ............. .~.....Other Work (Describe) .................... Estimated Cost .......... ..~TT......v_~..Z~. ............... : ................... Fee ...... ..~...¢.....~.. ....................................................................... (to be paid on filing this application) If dwelling, number of dwelling units ................ ./.. ........... Number of dwelling units on each floor ............................ If garage, number of cars ........ ./c..~ ....... ~ck',~'....... ........................................................................................................ If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ --'"'~'";;"'7 Dimensions of existing structures, if any: Front .......... ~...~ .......Rear ............. .~..Z ...... Depth ..~X.~..~....... Height ............................ Number of Stories ............... ,/. ................................................................... ./.. .................... Dimensions of ,~ame structure with alterations or additions: Front ..... ~...~ ..............Rear ........ Dimensions/'--of entire new construction: Front ............/..~.. ............ Rear ............... /,..~, ..... Depth ......~_~ ................. Height ............................ Number of Stories ......... ../. ................ -~- , .~- ,,, Size of lot: Front .......... ..'~c....?....'<.;~...__,o ~// Rear ....... .~c~...~'.. ....... Depth ..~/...r...-....-.../ ~ · , / t // Date of Purchase ............/....?....~Z'...~.. ............................ Name,~f ~,Fo~r,mer O~*~er .....~,/ , ~......(..~...'~..'....~~ Zone or use district in which premises are situated ........... ~.. ......... ~..~.~.~.....: ............................. Does proposed construction violate any z onii~cl Igw~ 9rd~ance or ,re~u~....~...: .................................. Name of Owner of premises~..~'..~:~--,~...~..~~ ........ ~! ............: ........... Phone NO ..................... Name of Architect ..................................................... .~.Address ............. ~....,.....M~ ............... Phone NO ..................... Name of Contractor...~-,~..,~..~ss ........... ~~....Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from Jvc street and block numbers or description according to deed, and show street names and indicate or corner lot. ? 10. 11. 12. 13. property lines, G whether interior STATE OF NEW )~R~K~,./~./ ~ S S COUNTY OF ~) ' ~ above nam(eN~~~~i.~.~i..:~ I. ................................................................................................................ (Contractor, agent, corl~orate officer, etc.) of said owner or owne~, and is duly authorized fo perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the ~st of his knowledge and belief; and that the work will be performed in the ~nner set forth in the applica~iled therewithj Sworn to before methis ~ . ~ / / ~ /, / ............ ~.~.~ay of Z...~~..~... 19..~..~.~ ~UmTH L- ~.. -- (Signature of applicant) ~OTa~ ~UDIIC,~~.~-:~~.0344~63, Suffolk County ,