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Home My WebLink About2778-zFOR~ NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No..,~..~6.~. ........... Dote ................................... ~lp~,~......~,...., THIS CERTIFIES that the building located at lt/./.~].....B~.~/~.t:;e~..~d....(~l~.t~e,~.~..~.~treet Map No..~,~C ............. Block No ........ ~ ........ Lot No. ~ ......... [~.~.t~$.~.~O~e.....~.~., ............... conforms substantially to the Application for Buiiding Permit heretofore filed in this office dated .................................... ~1,1~e ........ ~. .......... , 19~',,,, pursuant to which Building Permit No...~.~.~....~. dated ............................. .~.~......~[. .......... , 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 ........ ..... ~.l.Yat~e... one...f~l.~7.....d~,e ~6~i~ ............................................................................................ The certificate is issued to .~],3,[attt..G1)~l;O~..&..~;~ .............................O~e~.s ...................... (owner, lessee or tenant) of the aforesaid building. FOKM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 2778 Z Date ............................ Permission is hereby granted to: ¥~1,3~1,1m~.. ~ez~ · &.. ~/~.£e .............................. .... lim~l.ter~..&ve ............................................... ......... l~t t.t,f,t.uok r .... ~,. ~..,. ................................ to .~l/~..~.d-..~..~ld.~.t~..o~..ml..ex~..s~4.ng'..d~.]..~,~tzg~ ........................................................ et premises located at ...Jl~.~....]~/tlaJgwa.te]'...~...],~lth~l~l..P~J.) ..................................................... ................................................ ~t;t:Ltuck,.....~. ~., ............................................................................ pursuant to application dated ........................... ~]/' .......... 2~' ............ 19.6~.., and approved by the Building Inspector Fee $.....~.0~3 .......... ~(~.~b, ^i,-. ~ .t' /..t/'-~-' I "'~ ~:'~"~'~'"";'"'"?':'"'"~ ...................................... '1' ' Budding Inspector / ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19....f...Permit No ........................ Disapproved a/c . ......................................................................... ........ ................................. ................................. Application No....?...J....{.....C,..' .... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o, 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 o detailed description of layout of propertymust 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 shah 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 po rt For any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment 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 demolition, as herein described. The applicant agrees to comply with oll applicable lows, ording_nges, building cache and r,~guJotions. '-'=-, 0__-, ( / / . 'i~/~/~..~, " .......... 1./,.~.~ ....... ~ ......... ~ ....................................................... ~ignature of oppl~ant, or name, if a corporation) ...... ..... ~., .............. (Add ess of appl cant) ~''t r'"'"-""r"'"i'"'"" .............................. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder, ~?-~, ~.~L.~ ................................................................................. ................................................. 2'~ ..................... : .................................. '~ Name of owner of premises ........ ~ ........... 7. ................................................................. If applicant is a corporate, signature of duty authorized officer. ~p, / i /. ~ .................... ::.'. ............. :'"':'"m .................. : ............... (~.~A~/~,~ SA) ~ ~/~.~.~/ l~ : ~r,-l~ ~ (Name and title at corporate officer) ~,~ ~ ~.~ ~ ~ ~,~.~-~ ]. Location of land on which ~ropasea work wlu oe done. ~ap mo: ............................................ Lot No:: ................... :z. ................ ........ .................... Stre~ ~.d Number r-' ..................... ":'" Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................. ;~~.~z... ~:~:~ ............................................ b. ntended use and occupancy ...... ~,~.~{:~-' ~.~{~/~d~ 3. Nature~ of work (check which applicable): New Building .................. Addition .................. Alteration .....~%,.'. ......... R~,pair ..................... Removal Demolition .................... Other Work (Describe) 4. Estimated Cost .................................................... Fee .......................................................................................... (to be paid on filing this application) 5. If dwe!ling, number of dwelling units ................./. ......... Number of dwelling units on each floor ............................ If gar6ge, number of cars ........................................................................................................................................... 6, If business, commercial or mixed occupancy, specify nature and extent of each type of use ................................ 7. Dimenbions of existing structures, if any: Front ....~.."/~...~.2..,.~T.... Rear ...~..~:~...~C: Depth ...~.~.~ .... Heigh~ ...b.~ ...... ~be~ of S,o~i~s ........ ~ ................................................................................................... Dimensions~--''of same structure with alterations or additions: Front .~'" ~ Rear Depth ............... -~.~;~ ........... Height .......... ~. ...........Number of Stories ...... ~ ............................... 8. Dimensions of entire new construction: Front ............ ................ Rear ............................ Depth ........................... Height ............................ Number of Stories ............................ s,~ of ~ot. F~o,t ....Z.¢.Z,..~...L.. ~ ............................ D,p h ...L.~ .................. ~ ]o. D~t~ of ~ch~ ...~ ............. ~.f .............................. N~ o~ ~o~, ~ ~ ~ ............................................ ~... . /~ ( ~2. ~. ~ ~ ~,~ ~, ~,~,~ ~..~.~....~,,~,- .~,z~.. ..................................... ~- ~, ~,~- ~-~ ................... Nam~ ~ Ar~kit~ct ............. ~ .................................. ~ ,...Addr~ ............................ , ............. ~ ~ ............ ~ _(~ ...... ~ ...... - ........... ~ ~ . , . Nam~ ~{ C~tractar .......... ~...,,.~,, ......................... ~ ................... ~-'~, ............... / PLOT D1AG~M Locate clearly and distinctly all buildings whether existing or proposed, and indicate all set-back dimensions fro~ property lin~s. Give street and block numbers or description according to deed, and show street names and ndJca whether interior or corner lot. I STATE OFINEWJgOP-~,_ ?~ ~, t¢c COUNTY ,OF ~;,:~.....~'~...":~...;-.'~........f ""'" /./~.~r/([,~¢~, /.~.~...(....~...~(.~ .................................... being duly sworn, deposes and says that he is the ..... ~' ........ i~l';'~'~"c~f i~dividual/signiog application) above non'ed, He is the (~'~,t ~ ~ e~-~ (Contractor, agent, corporate officer, etc,) of s~id owner or owners, and is duly authorized to perform or have performed the said work and to m~ke and this application; that afl statements ~ontained in this appHcatJon are true to the best of his knowledge and be~ and that t~he work will be p~rmed m the manner set forth in the application filed therewith, Sworn to ~efore me this ~ .~ ~- ~ / ... ~.M ..... d~ o~ ....... ~Z~ ............ ~.,,n.C..~.. '-L-~, ./%, ' ~ ~1 ~ ~ I ~., ........ JJJ/~ ....... ~.~%~.~......~....,.~ ~.~..~.:.~ .................. ~ /¢ No. 52.3~9685 y Tour FORM TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 4 C- SOUT.OLD, N. Examined .... i ........... ~ ..... 19. ....... Approved t~, ~' c~ '~ '~ (~"'- ......................................... 19 ........ Permit 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 propertymust 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 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 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 demo)trion, as herein described. The applicant agrees to comply with all applicable laws, or, dinances,_ O..~ ,7~/~uilding cod~ and regal'arians. (&ignature of applicant, or name, if a corporation) ......... ~-/~.~/ ..... :l..e ~.~ ............ .:/ ................. ~ ......... '1~ ....... ~ (Address of applicant) ~ ~,~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of ow er of p ................................................................. ..~. ............................................................................ / If applicant is a corporate, signature of duly authorized officer. .................... [~":'~'~'Ti~i:'~f':~;;~;~¢~'~r::;)' ............... ~-~'r~,~:,~" ~ of ,o.a o. Municipo~W ........... 2. St~to existin~ use ~nd occupancy o{ p?~i)es ~nd intended ~ ~nd oecuponey of proposed construcHon: a. Existing use on, occupancy <:D'~ ~'~ b. Intended use and occupancy ................................................................................................................................. 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost ................... ,,m.~ ................................. t-ee ......................................................................................... (to be paid on filing this application} 5. If dwe!ling, number of dwelling units .............. ,~. ........... Number of dwelling units on each floor ............................ If garqge, number of cars ........................................................................................................................................... 6. If business, commercial or mixed occupancy, sp,e.cify nature and extent of aa, ch type of use ............................... 7. Dimension[_of existincl structures, if any: Front ..~./..~...~fif,.~..~... Recur ...... ~,,,'./,.,¢~_,,i,.,c._,-t~Depth Height '..'z~:'.. Number of Stories ................ ./'.: ................................................................. >,*, ......... ~, .......... Dimensions of same structure with alterations or additions: Front ......... ~'~..Z....~..i.. Rear ..,,~.~...¢.~ ........... ~'- '~'J~- ~ . Nh.tuber of Stories ................. (.. .................... Depth, ......~.. :~...r..:.: ......... Height ....... ,... .......... ,~ ...... 8. Dimenbions of entire new construction: Front ............................Rear ............................ Depth ........................... Heigh~ ............................ Number of Stories ............................ 9. Size of lot: Front ............................ Rear ............................ Depth ........................ ¢r_v /z.~ ,, 10. Date Of Purchase ........................................................ Name of Former Owner ../../.~,...,~..../..(...z~.~..~:.....~...~..(;~./(..~?..././. 11. Zone or use district in which premises are situated ................. 12. Does proposed construction violate any zoning Imy, ordinance or regulation? ....... · :,/~-,,~,,/~ ,L/,4--,~,. '' .~....~...':? ../...'~..~:...:'/'~:'"- 'Phone Nameiof Owner pram,see ............... 13. ~ Phone Name~ of Architect ...................................................... Address ............................ . ................ No. Name]of Contractor ...................... ~...(.J........~.. ............ Address Phone No. PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, end indicate all set-bock dimensions property line~. Give street and block numbers or description according to deed, and show street names and whether interior or corner lot. STATE OF NEW ,i~.bR~,// ~£ 1 S S COUNTY OJ:,,~;~¢x~././..-~.... ·. ·//; ' ' ....... ' {/D t J-~ / ~ ~H. ('~/-r~l/Lzr~ .. ~ beina du v .............. (N'~m'~ of 'i~di'~idual";i~;i;~";l~l~'ii~o~'J'~n)(Z-- ' ' " ' sworn, deposes 7-,1 above named. He is the (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 th s application that all statements contained Jn this application are true to the best of his knowledge and and that the work will be portaged in the manner set forth in the application file~t therewith. Sworn ~o before me this L / .~7~}'.7;/,'~/'/,"J[~ VAL W./~TYPE [~/'//~, ./... /..~.~..f/../..~.~:~.~'.~-~ ...... .~/.../..~.....1. ................................... ~'~,~ .u~/~U~../~,/,~) . laO~~ Public,(~al~e of New .Y..o. rk. ~ Count,." .......... '~ .... (S gnatu~ of app cant) Notary T~l/bl]~c, .; ............. H0...52,~889~8~ ..........~ .... · 7- f I I~lallfled in Suffolk County '1 ] ~eltlmlsslolt Expires March 30, ,196~