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Home My WebLink About2977-z FORM NO. A TOWN OF SOUTHOLD 6UILDINC+ DEPARTPAENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. Z~...$Ii:QEf........... Date .........................."~~F~.~......~~.~'........., 19.~~.. THIS CERTIFIES that the building located at N~~.....~~~~?..~<?~.~..~X.'.~......~..~...~.l~~Q~?.~?,,, Street Map No.3G~ Block No...~CK............... Lot No. .~4.........tt$~t1SS1Ct...N~,Y.................. conforms substantially to the Application for Building Permit heretofore filed in this office darted .......................................~~Y1Lt€tt'.',1:..,.~.~.., 19..~.~. pursuant to which Building Permit No...Ir~.tgr~..f...~ dated ...............................~.~n...... 19 F?~?.., 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 .......Px~,vat~...AZa~..,faan~.~.. dca.~~~.~ The certificate is issued to ....~Q~18x'.4i...~l.b".L~tl";f ...........................~WT1G~,~`................................................ (owner, lessee or tenant) of the aforesaid building. H.D.ApPr4va1 ~'eb 9, ~.96~, 'hy fit. ~'tlla Bw mg. s eL/toF~ FORM NO. 2 TOWN OF SOUTFIOLD BUILDING DEPeARTMENT TOWN CLERIL'S OFFICE SOUT9iOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZEDI i\1~ 2 9'7'7 Z Date A~RI'f~A~`~....... ~i~:........., 19 Permission is hereby grunted to: to . ~u~.~:~.. ~'.~al~~~~:: at premises located at ......~1~~:X.~,~y3.,pit$~.2a~.~.y~"•~'1~~gT}}.rr..::... pursuant: to app4ication dated :.s~{'BSEY Y9..~I~r.,~and approved by the' Building Inspector Fee $.....~~x~~....... Building Insp~ttor S-9 SCHD $tk'FCI,K CCUNTJC D~Pk~S'N1ENT OF HEALTH Date Duiading Permit No.2 ~ ~ ~ - Z. "'.'G WHOM IT MAY CONCERN: The sewage disposal facilities ?or a structu-^e lo4ated at (Give deed location) v~ have been inspected by this Department and found to be satisfactory. Dis Pr ~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE t.. SOUTHOLD, N. Y. 'y p Examined /`~,~'s....„.,,,' / i i/.' t~ ~ r7 / 19........ Application No................... Approved Disapproved a/cJ.'y~.........I~,,.,-~....~~.~:r.~;,,:,...r.^.'"~.-. 1'.................../ 2/ ...t (Building Insp~tor) APPLICATION FOR BUILDING PERMIT Date ../•~,~f 19.C~ 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 moy 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 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 Yorl<, 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. (Signature of applicant, or name, if a corporation) h'oXS^/S~~f#~ ...ter. ~s=~J...~,~:~..~1-~ iAddress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. o.WN.~....: ~....~vi.~~ Name of owner of premises I/f~a~pplicant is a c/o/;r~porate~,/signature /of'd/u,~l1y au~t~horized officer. /..`:.!li..~~~'•.~.~••~r~'~..;cif..~-::Q::......1..:^~Y':P°.~~..J (Nam and title of corporate officer) 1. Location of land on which proposed work will be done. Map No~~.~r*'./7aL~.C,E?E~.~'~j~~:~. Lot No:..Q Street and Number .~.~~p....~~~~.....~/~~~~ :...............~~.~G.~r.............................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy ....~!v.~:....~II~C.L~........G~J/'r'4~".~..C:/~'„~r 3. Nature of work (check which applicable): New Building ..i.~........... Addition Alteration Repair Removal Demolition.................... Other Work (Describe) 4. Estimated Cost .................l:Z.~l..Q~....................Fee (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 G. If business, commercial or mixed occupancy, specify nature .and extent of egch 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 ~ Sri / ~ 8. Dimensions of entire new construction: Front.......~f ~ Rear Depth Height .~?..~i~.. ~ Number of Stories...l. 9. Size of lot: Front .......~../.........f........ Rear ~ Depth ....r~................................ 10. Date of Purchase .....I.,1.~I„/.6,,~ Ngmepof Former Owner ~k~~!~'!~...!~9.1~;T/.~!................... 11. Zone or use district in which premises are situated....../t...LC.^~1 12. Does proposed construction yv+iolgte any,,~~yyzoning law, ordinance or regulation? .....1.~~ 13. Name of Owner of premises/....~AG~. ~.lif1,(!lG~' /~'r~,S'ff. ~i7/a;G~~7~~QG~: phone No ~6~p ............Address 7.. Name of Architect ................~J.............~~.................Address ......y.................~............... Phone No..~~................ Name of Contractor .....................Address ~~.................~r................ Phone No.. 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. ~ _ ~~U ,N r`1 I ~ ~i \ k~ ~ ~ ~J~ ~ ~N w ~ ~ ~ , i oZO ~ o o k. STATE OF NEW YORK, ) COUNTY OF ...........................J S.S. ................................................................................................being duly sworn, deposes and says that he is the applicant {Name of individual signing application) above named. He is the ....f ' (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 in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this day of 19........ Notary Public . County (Signature of applicant) A DEEP Np~F E-842.39' TO SOUTH LINE R=278:25. 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