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Home My WebLink About2150-zFOP~H NO. 4 TOWN OF SOUTFIOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...~./f.~...,'~l~O~..~Oa~.,...~;:~C.~ ...... Street ~re,en~ort Sho~es~, , ap ~o ....................... ~oc~ ~o .......... ~.*. ......... Lot ~o ......2~..&..2~ .............................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................ ~Ltr~L~?~...i~. ........... , 19.~.~t.. pursuant to which Building Permit No.~...~..~..Q.. dated ....................... ,~Llg~l.8.¢,..16 ........... , 19..~.~., was issued, and conforms to oil of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ The certificate is issued to ..L.a...q.z:.~...~,.....~..~....~.x....o..V.P...e..r. .................................................................. (awner, lessee or tenant) of the aforesaid building. FOI~M ~0. ~ TOWN OF ~OUTHOLD BUILDING DEPART/vtENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PER/v~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2150' Z :Permission is hereby granted to: H · A. Clark..&.. ~o~..Z~.C.... Lau~.a....~a~ .................... .............. Gl, ~n.~ ol'-~ ............................................ , .~B~.~,.~... f~.. &~ ~,OELOZt.. ~n.....e~l ,.~l;£ng... ~e~ing ..................................... ~ ............. / ? at )remises located at *3.,O.~,..~.br.,~z..~.~-.-*,q,1~p~*t~,.,8~xO~-e8 ................................................... · .! ..................................... 8/~.....~hO~.o...~o~l.~ ....... (~ een~o~.t, ..................................................... pursuant to application dated ....................... ./~2J~l~,......~ ................. ]9.~..., and approved by the Buil~ling Inspectbr Fee $.. ~..,.0.0 ............ PORgvl NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×amined ........... ..~-..~..../...~....., 19...~.~ l 'Y O ................................. ]9 ........ Permit' No. Approved ....... , -,.......-....-.......... ...... Disapproved a/c~f~~ ....................................................... ~ ...... ................. ................................ ,' Application No..~)-..f..Z..~.. ......... APPLICATION FOR BUILDING PERMIT 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 odioining premises or public streets or areas, and giving a detai'led description of layout of property must be drawn on the diagram which is part of this application. c. The work coveredby 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 pa rt 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 o Building F~ermit 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 and regulations. . It, A ,Cta.~k.. &..8ohs ......................................................... (Signature of applicant, or name, if a corporation) ............. ~r.eenpor. t .............................................................. (Address of applicant) State whether applicd,nt is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................... .G'ontr. a~.t or. ...................................................................................................................................... Name of owner of premises ..La%%%~&..H..~4aI:d ...................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) .~. 'I 1. Location of la?? on which proposed work will be done. Map No: Gt t.,Sha .e. ..12.5.9 ........ Lot No: Street and NuMber ......... .~../..~......~..h..°,?...e.....~..°...a..d.~ ........ .~.~.e..~p..o..r..'~ ................................................. ........................ ! ,'~ Municipality ' ' 2. State existing ,u.,se. and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ DWe.]..3..it't~ ........................................................................................................ b. Intended use and occupancy I.I. ~/...addJ, t:Lo:R .......... ~ ......... 3. Nature of work (check which applicable): New Building .................. Addition .:.- .:l~.~3or, ..... Aiteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost '"'~00"'P/J~ ...................................... ~Fee-""~'~00 : ' (to be paid on filing this application) 5. if dwelling, number of dwelling units ......... O~ .............. Number of dwelling units on each floor If gorage, 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 .......................... Depth Height ............................ Number of Stories Dimensions of same structure with alterations or additions: Front ................................ Rear Depth ............................ Height ................................ Number of Stories ........................................ 8. Dirdensions of entire new construction: Front ............. I~ ................ Rear ........... I~ ............... Depth ...... Height Number of Stone ....... O~.~1 ..................... 9. Size of lot: Front ....... ..~,00 ............... Rear ........... ;LO0 .......... Depth .................. ~ ..................... 10. Date of Purcha.se ........................................................ Name of Former Owner 11. Zone or use district in which premises are situated .......... 12. Doeg proposed construction violate any zoning law, ordinance or regulation? ....... i ....... ti{) Narhe of Architect ...................................................... Address ............................................ Phone No. Name of Contractorl '~i'A'i{]],m:~k"&"l~O~ ............. Address ........ 0~e'/tpO~?'l;' .............. Phone No. PLOT DIAGRAM Locate clearly and. distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions fr property lines. Give street and block numbers or description according to deed, and show street names and whether interior or corner lot. STATE OF', NEW YORK, ) COUNTY OF "1~"1/~0' ']:~ ......... ) ,~ ............. ;: ........ Hq .~.~,~....~I.1.8/~...~ ........ ; .......... k ................ being duly sworn, deposes and says that he is the applica ~ ~ame or .~ividua~ signing appdcatiom above'agreed. He is;the ....... ~g~aa~O~ ............. '-~ ~ x (Contractor, agent, corporate officer, etc.) of said owner or owne}s, a~n~d is duly authorized to perform or have performed the said work and 'to make and this application; tBat oil statements contain~(~ ~h~,g~plication are true to the best of his knowledge and and that the work wil[~ be performed iq.~L~ ~e~'~r~ in the application filed therewith. ~ Swo}n to bbfore me this 'l,~o 52-0344963, Suff01k C0mtty' ~ // . /-/ ~ .7 -./~ ~ ~,t/j ~ ' Cumm~ssmn Expires ~arch 30~ 19~~ ~/~ /7' ' ~/~ ' ~ .' . ................ .Z6 dw of .............. .................. , // / , J ............. Ng~Qry Public, ...~z~i?.ar~,~..~,~.~ ....... "Co~fff~ (S gnat~e of flpp cant)