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Home My WebLink About2238-zNO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...~,...~-~0 ........... Date .............................. Of}t;l>Tee~.....~..~, 196~... THIS CERTIFIES that the building located at .W/¢.S...ga.]:l/.os.t...~ok...R~a(~. .................. Street Map No..H.~,~ ........... Block No .....;3f3r~ .......... Lot No.:~l[.....J~ell~h~'l.d.t...~o..~., ......................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................... ~(~Ve~be~.....)*...., ]9.~.. pursuant to which Building Permit No ..... 22.38._?. dated ........................ ~'I~lZ.~.....~. ............... , 19~.~..., was issued, and conforms to all of the requirements of the applicable provisions of the law, The occupancy for which this certificate is issued is ........ · . ]~.;[,~.a.~e.. on~.. Sar~.i..~.~'... d.~/e&.l ;Lng ............................................................................................... The certificate is issued to ...~&[.~h...~.$h ......................... Ot4~oP ...................................................... (owner, lessee or tenat3t) of the aforesaid building. FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THi~ PREMISES 'UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-° 2238 Z Date .................... ~o~.oiil:~ ....... .~. .......... , t9..~. Permission is hereby gronted to: ~ Riverhead to ...~uild..a~..~:~d£tior~..o~..an..~x&~Zng...d~e.t-~.i.~g ...................................................... at premises located at ..... S~...,.Ca~Lve~..l~e~..t~)a~ ................. .- .................................................. ................................................... P,o~th~t~.---.~-:Z-~ ........................................................................... pursuant to application dated ................................ NO.~.~, ...... ~. .......... ~9...~, and approved by the Building Inspector Fee $......,~,,.?.,0. ........ Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. (Building jlnspector) Application No. ~....~..~... ....... APPLICATION FOR BUILDING PERMIT Date ...................... ~.~t .~.eJ~]~.e.r......~. ....... , 19.6..~ .......... 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 application. 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 purpose whatever until a Certificate of Occupancy shall have been gr,anted 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 alterations, or for removal or demdlition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. " Ruscon Con~truct.~.on,,Corp (Signature of applicant, or nome, if a corporation) .......... .......... .a..,a. ........................ (Address of appficant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......................................... Cau.tr.a~om. ................................................................................................................................ Name of owner of premises ........ ~a.l. ph.....~.s-h ............................................................................... "~ ................................. 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, Map No: ......... .L..~.B.......H..~...~..~. ........ , ...... ~'Lot No: ...~ .......... Municipality State existing use and occupancy of premises and intended use and occupancy o~c pro~:osed construction: a, lCxisting use and occupancy .... ~.l~.e~Li,l~ ................ b. Intended use and occupancy ti -'-W/ $,d¢]~G 3. Nature of work (check which applicable): New Building .................. Addition ..... ~ ...... Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ........LI-.t0.O0. ........................................ Fee ...... ~i'. (to be paid on filing this application) 5. If dwelling, number of dwelling units .............................. Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front....7.0 ................. Rear ...... .~.0 ............... Depth Height ............................ Number of Stories Dimensions of same structure with alterations or additions: Front ................................ Rear Depth ............................ Height ................................ Number of Stories ........................................ 8. Dimensions of entire new construction: Front ..........22, ................. Rear ..... 2.~, .................. Depth ..]..ii, ................ Height ............................ Number of Stories.....Ol~e ...................... 9. Size of lot: Front ................................ Rear ............................ Depth ........................................ 10. Date of Purchase ........................................................ Name of Former Owner 11. Zone or use district in which premises are situated ......... 12. Does proposed construction violate any zoning law, ordinance or regulation? ................ 13. Name of Owner of premises ..~.~..~..~..~....F..$.~..~. ............. Address ............................................ Phone No. Na.me of Architect ...................................................... Address ............................................ Phone No. Name of Contractor ....... ~i.llS~,Ot~..C~.ot'l~tZ'.~ ........... Address ............................................ Phone No. PLOT DIAGRAM Locate clearly and distinctly all 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 indic whether interior or corner lot. ! STATE OF NE.~,.. YOR_~, ) COUNTY OF ~'.1,~'~.O~1j; ............ ) S.S. ......................... (~.~...]~:~T?~ ........................................................ being duly sworn, deposes and says that he is the (Name of individual signing application) ~ , abow named. He is the C[O,~.~...O¢~,.~.(~.f~. .................................................. '~ ................... 'i (Contractor, agent, corporate o}ficer, etc.) : of said owner or owners and is duly authorized to perform or have performed the said ,work anc~ ,to make' and this )pplication; that all statements cor]ii¢it~pfit, iB3~t~is application are true to the best Of his knowledge 6nd and that the work will be performed~4n~$hle, r~t~ee~e~eto~fcrth in the application filed therewith. / ............ ~.... day of ................ No~e~b~ ........... 196~;..Pm' r~-~ ~ ¢_ ' ,' ~ ~ ...¢ ., / ..'--"',z~;" / ~-'""~;'~'.h?l:'""'~'"'"'-'e,:''''''~'''': Notary Public, ..F~./,/,{,W;~...~.._~4...../'C~.'r~¢,,;:,,,,.~'. ,,C?u,n~ _ (S~gnature of apphcant)