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Home My WebLink About2994-zFORM NO. 4, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF ODI-t. UPANDY No..Z. 2~,~,~ .... Date .............. &U~St.. ,~3' ', 19. THIS CERTIFIES that the building located a~/S. ~bO:~ ' '~rle ............ Street Map No.. ~ ...... Block No ..... ~ .... Lot No..~ .... ~;~hogllS~ '~',Yi ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ ~'Sb ..... 28. ' , 19 .~. pursuant to which Building Permit No..~1~ dated ............ F~b.. ~ .... 19.6~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . P~'$vat® .one. £~mi'3.7' 4,~e2.1ing ...................................... The certificate is issued to .(~ho~tel~. (l;~l~i · · (~I~®~ ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .~1'~':~.. ~3~. ~..~7.. Buildin~ InspeCtor FOI~M NO. 2 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) N? 299~ z Permission is hereby granted to: Chester Orlowski .................... E~ho~u~+... ~N., Y., .................... Build new one fa,.~il w ~1~ to .................................................. Y....~ ~.~, $~.E . .............~.....~ ...... ~....~ ......... at premises located at W/S'Harbor~ Lane i ' ~ ...................................... ...~~...:.~..~;~.L...~.......L.:..~..~....~Z~ ~.~ ~..~..:...:..: .... Buildin~ Inspoctor ~ SUFFOLK COUNT~ DEPA~V~ENT OF HEALTH ~t~ ..... JU~ 2 3 ~96~ TO ~0~ IT ~AY CONCE~.. The sewage disposal facilities for a structure located at deed locati~) have been inspeoted by this Depar~raent and foulld to be satisfactory. .... ~i~l~Engines~ FORM NO.I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .....~...~ ...... :.~.....~. ............ ,19.~...~.. Approved ........................................ , ]9 ..... Permit No ............................. Application No....'~.,;~..,~...~ ........... Disapproved a/c .............................................................................................. (Building Inspec~r) APPLICATION FOR BUILDING PERMIT Dote ..... ............................. 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 adioining 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 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 demolition, os herein described. The app icant agrees to comply with all applicable laws, ordinances, byilding code and re_gulations. (Signature of applicant, or name, if a corporation) .................. ................. (Addres§~of applicant) State whether applicant is owner, lessee, agent, architect, engi'neer, general' contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~ ~(/~v-Cf( .¢1~''j~'(/f)~..~.~.~.:. .~.. ~ 1. Location of land on which proposed work will be done..MaR,,i~o.: . ~ .............. at .: . Street and Number .~~...~:~..~.~....2-..~:~..~..~L..~..~ ............. Munici~ty 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 ....~...~.¢~....~..~...~:;..~ .............................. 3. Nat~ re of work (check which applicable): New Buil~in~ ...' ........ Addition .................. Alteration .....j ............ Rep~ ..................Removal .................. Demolitian .................. Other Work (Describe) ........................... ~ ............ 4. Estir~ated Cost ...... ./. ....~......~.. · .............................. Fee ................ ..Ol.../...~ ........................................... I ............ (to be paid on filing this application) j 5. tf rivalling, number of dwelling units .......... ~ ................ Number of dwelling units on each floor ............... I ............. If g~rage, number of cars ............................................................................................................................................. 6. If I:usiness, commercial or mixed occupancy, specify nature and extent of each type of use ............... j ............. 7. Dim msions of existing structures, if any: Front ............................ Rear ................................ Depth ........... J ......... Height ........................ Number of Stories .................................................................................................... j ............. Dimbns ons of same structure wtth alterations or additions: Front ....................................Rear ............... , ............. Depth ................................ Height ............................ Number of Stories ................................ J 8. Dimensions of ~ntire new construction: Front.. ......... ~..~...~ .............. Rear ...... ~....~..~ .......... Depth ...~...~. ............ He (Iht ...~ ...........Number of Stories ....... ~...~.,~..: ....................................................... ; ............. 9. Siz~ of lot: Front .....~..~....; ........Rear ........... /.~-...' ........... D~th .......... ~..Y..~...f ...... ~ j 10. Dat~ of Purchase .......... ~..~...~...~ ......................... Name of Former Owner ..~.~...Z~ ............. 11. Zon 12. Doe~ 13. Nan Nan of Architect ...................................................... Address ~~~;~] Phone No ....... ~, ............. Na~e of Contractor ....... ~ .................. Address Pkone No .......j'.i ............ PLOT DIAGRAM L.ocot~clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-back dimensions from property lihes. Give street and block number or description according to deed, and show street names and indicate whether i'nleri°r °r c°rner I°t' ~ ~ NEW YORK, } S S COUNT~-OF ........................ ~ ...... ~ ' ' ....... ......... , ~ ~ .............................. being duty sworn, deposes and says that he is the ~pplicant Name of individuql sianing application) n ~bove ,~, ~. H~ ~ ~h~ ....... ~....~...~..~ ............................................................................. ~ .............. (Contractor, agent, corporate officer, etc.)j of said o~ner or owners, and is duly authorized to perform or have performed the said work and to makeJ and file this application; that all statements contained in this application are true to the best of his knowledge and b~lief; and that the w ),rk will be performed in the manner set forth in the application filed therewith. Sworn to ~ ~fore me this ~ ~ ........ o, ........................ , [ '~Z~ -'"~ '~2;;Z~' . ...~...~~r ...................... ~o~ p.~i~/~~~~~ co..~y~ (s~g.~,.~ of or use d'strict in which premises are situated ~...~......~..: .................... j ............ ~roposed construction violate any zo~ir~, law, ordnance or reau at onP ~..~~~..~,dd tess of Owner of pram,sas