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Home My WebLink About634-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOL~ N. Y. CERTIFICATE OF OCCUPANCY No. Z 30c) Date ~tine 3 19,.~..~.. THIS CERTIFIES that the building located ~ay .Haven @South. o, ld,. *** , ~wap ~o ......................... OIOCK INO ......................... Lot NO. ,.;~ .............................................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 13 , ......................................................... l 9.~.?,,., pursuant to which Building Permit No.....~...!,3.~ ............. dated ..................... .~.~.!~..i..,~...,.~.,~,. .............. , 19.~.~..., was issued, and conforms to all of the requirements of the applicable provisions af the iow. The occupancy for which this certificate is issued is .............. ............................................. .................................................. This certificate is issued to Albe ef~. owzie3~ (o,wner, lessee or tenant) of the aforesaid building. / / Building Inspector Hovarcl ~. ~e~lr FOR:~,rg NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS F~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 634 Z Date ..................... ..~.t~....~ .................. 19..~.~... Permission is hereby granted to: ~'iili~m....~elt~....~/~....~&~e.~.~.....~..ta~ ..................... ..................... ~uth~ld ~,... ~ ~,?, .............................. to .. ~.u..t,,l, ~.. ~, ~.,~.,l.,z.,t~.~ ............................................................................................ at premises located at ...~t~;~.t~...J~..~.~....~..l~2..~,~t,...~.~.2tc.~d ......................................................... ............ 8/.8 ;~a~. Miew..Ra~t ............................................................ ~outhold~ ~.Y. pursuant to application dated .......................... J~p~il....14 ................... l C~9....., end approved by the Building Inspector $.z..o..:.o.,o. .............. TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. · iZxemlned .............. ~....., .~... 19.~?~. .................. ......... Application No .........~....¢~..~. ,.. ...... APPLICATION FOR BUILDING PERMIT Dot e_ ..., .~. ~ .~. ,~. _ ,.~,~i. I. ................................. 10...~.?. ..... I NSTRUCT/ONS a. This application must be completely filled in by typewriter or in ink and sui~mitted in duplicate to the Building Inspector. b. Plot plan showlr~g location of lot and of buildings on premises, relationship to adjoining premises or punic streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is port 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 in part for any puFpose whatever until o 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with oil applicable laws, ordinances and regulations. (Signature of opplicanf,~nome, if o corporation) (Addre~ of o~{Jcent) State whether Opp{}cont is owner, lessee, agent, arch{tact, engineer, general co~troctor, electrician, plumber or builder. Name of owner of pram{sas ......................................................................................... 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, Mop p~o: ......... <i; ................................ t.o~ No: .................... Wa~e~,eed6e Way, tlay tiaven, tloutmh.O,~d,, 1~ Street and Number ....................................................... ;; .................................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. {:xisting use and occupancy ..................................................................................................................................... b. Intended use and occupancy 3. Nature of work (check which applicable): New Building ....... 31, .......... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4.' Estimated Cost....l~O.~O00,O0 .................................. Fee ...~j~O~O0 ......................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... ,~ ..................... Number of dwelling units 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 existing structures, if any: Front......~ .................. Rear....~r~lJ ................... Depth ...R ................... .~Height ....... ~J~.~ ............. Number of Stories ....... ;l~ ................................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front.....~.I, ................ Rear ...... ~.t. ............... Depth .J~.~.! .................... Height ........ ~l,l~.I .............. Number of Stories ..... 3L .................... 9. Size of lot: Front ....:j.~r/ ................. Rear ....'12~ ................. Depth ...3,00 ................. 10. Date of Purchase ..... ~. ~.~,~..3.3,~...3,jJ1~,~1 ................. Name of Former Owner WJ."t,I,~,J, IE..~O]..1, J ......................... 11. Zone or use district in which premises are situated ......... ]J~'illlJll,-'t~,tal~ ............................................................ 12. Does proposed construction violate any zoning law, ordinance or re~jj~l~iol~:j;[~,,[,....~O. .................................... 13. Name of Owner of premises4~.JitJ.~j..jJ~'lillll .......... Address J~JLi3J,rl, J31'Jt3L..~.II .......... Phone N~3,..&?.J~I~.~... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Nome of Contractor.]l/,t't't.tlid;IL.JJl~t;J,e .................... Address ~...J~I/llZi~...J~.CJlJJJ30,,~Jhone NO~.0...J~.-.~.~.~kt~. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE: OF NE~.,Y.Q~I~. ) S S. COUNTY OF ..1~,~,.~.0.~ .......... ) .................... ..A..1...b..1~.....~.[..~...J. .................................................. be ng duly sworn, deposes .and says that he is the applicant (Name of individual signing application) above named. He is the O.~.e...~. .................................................................................................................................... (Contractor, agent, corporate officer, etc.) 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 Jn this application are true to the best of his knowledge and belief; and that the work wi I be performed in the manner set forth n the application filed therewith. Sworn to before me th,s ,..~ ~. ~,~'g~- ~'o~ ,/~///x/ .................... aay O~ ........ ~'v ........................ ~.'~l'~vt:~,!~''' S~o~.~ ,,~, ~.~f,.? ~lgna[ure o1' appucan[~ Notary Public, .,/,,.(".4~-------------------~..~...g.'..~.~5-~..4'-.~.::? ........... Aq:.,°~i~Ptmt~:~"~ "