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Home My WebLink About3160-zFOR~ N~O. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICB SOUTHOLD, N. Y. iiIEI~TIFICATI= OF' C]SCUPANCY No. Z Date THIS CERTIFIES that the building located at . .~ .~. 9t~..~[~ .~$.%~. ~treet Map No...~ ....... Block No ............. Lot No. ~ .... ~0~$0.~ .~.*~, ..... ' conforms substantially ~o the Application for Building Permit hereto~e filed in this office dated ........... ~ .... ~.., 19.~ pursuant to whi~ Building Permit No..~. dated ............ ~...~.., 19~., ~vas issued, and conforms to all of the require- ments ~of the .applicable provisions of the law. The .occupancy for which this certificate issued is~$~..O~. $.~$~. 4~;%~g ..................... ...................... The certificate is issued %o . ~gg. ~ .~g$~..~¢9.hU¢D ........ ~ ............ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...... ~.. ~ ............................ FOI~I 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? 3160 Z Date .................................. ~U.Z.~:....~ ...... , Permission' is hereby granted to: ~t~-~..~..;~=.~l..C~,~ ..................... ' :.... ~o~.. ~o~:~.. ~ ............................... ..... · ~al!~n~'o~.d.....P.a.. ................................... at premises [ocated at ..~.~..~2:.,.,,Fi,,,O.,~.~,...~.~.~I~..P~a~,.,~i/~g..~.~.Z...~a,~ ............................... .......................................... t~ccm~.~.....~ ~ ~. ....................................................................................... pursuant to application dated ................................... ~;j:~......~)+ ...... 19..~>, and approved by the Building Inspector Fee $...~"~D. ........... FOI~M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........... 19 ........ Approved ~ ~t 19 ........ Permit No ~./ (~C) ~ (Building Inspector) Application No..i-.~.-'~.~.C...C~.. .......... 'FUC, 'rION FOR BU LDIN 'ERMrr Date .......... .................................... , ............ 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 port 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, as herein described. The applicant agrees to comply with all applicable laws, ordinan~e ,sT-bsdldjng code ~d regulations. if ocarporat on> 109. Stratford Road~ Wallingford- Pa. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi.neer, general contractor, electrician, plumber or builder. Nome of owner of premises ................~g~,~g~...~hr~..~n~..~id..(3,~,..~h~,~ ........................................................ If applicant is ~ corporate, signature of duly authorized officer. (Nome and title of corporate officer) 1. Location of land on which proposed work will be done. ~op No.: ........................................Lot No.: ........................ Street and Number "~r'~"~'y"~,~e~oy"~own"o~"~ou%hotd)'"Oo~'t~'DT':B.=D~OT~;"~'Zy; ........................ ~unmcl~/mty - 2. Store existing use and occupancy of premises end intended use end ~cuponcy of proposed construction: a. Existing use and occupancy .......... ~g.i~e~ ...................................................................................................... b. Intended use and occupancy ........ ~&de~ ...................................................................................................... 3. Not~re of work (check which applicable): New Building .................. Addition .................. Alteration Repc ir .................. Removal .................. Demolition .................. Other Work (Describe) ..0~..~Uoreh .............. 4. Esti,~ated Cost .~.ZgJ2Q ............................................. Fee..~,..0 ................ '. ~ ............................................ ..... ' ............ ~o be pa~d on fihng th:s apphcat~on) 5. If d~)elling, number of dwelling units ............................ Number of dwelling units on each floor ......................... If gqrage, number of cars .......................................................................................................................................... 6. If b~siness, commercial or mixed occupancy, specify:nature and extent of each type of use ......................... 7. Dimensions of existing structures, Jf any: Front ..~¢...~e~¢ ............ Rear ..... ~'.Eee¢ ............. Depth "~O"~ee¢ .... Height ~L$.~I/E6~... Number of Stories ....O~e .................................................................................................... Dimensions of some structure with alterations or additions: Front ..~4~ ............................ Rear 3~ ................... Depth ..~.[ ........................ Height ....8..Eee¢ ............ Number of Stories .~e ........................ 8. Dim ~nsJons of entire new construction: Front .................... ................ Rear ............................ Depth .................... He~, ht .................... Number of Stories ................................................................................................................. 9. Size of lot: Front .."~..~ee~ .......... Rear '"'80"~e¢' ................. Depth ..... ~9~'T~ ........... 10. Dat~ of Purchase ...... ~5/5] .................................... Name of Former Owner .~.~en ........................... 11. Zon~ or use district in which premises are situated .................... ~,~z~.t,~$ ...................................................... 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? ........... ~ ......................................... H~iltu~ ~ochr~ & ~nid G.D. GQ~}~ , 13. Na~e of Owner or prem;ses ........................................ aaaress ..~Qg..~;.~.6~f.,2.~..~.,.. . ¢ ,. ........ Phone No...~%~ ....... Nmhe of Architect ...................................................... Address Wallznz.~o~d, Pa. Phone ~ 6-3646 Na~e of Contractor .4~tm..i~ae ............................ Address "G~Zfhoguey'~'~'Y'~ ............ Phone No .................. PLOT DIAGRAM Locat( clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions ftc property li,~es. Give street and block number or description according to deed, and show street names and indice whether iht ~rior or corner lot .ro, n/ of county of sufYolk and Ltabe of llew Zork~ buind more ]iobe~-t ~u ~i;~ie ~ctlroy a~ which point is on ~te north~,r~y lin~: of ,~ 33 priv~b~ driveway; N.~2° ~1 ~. lO0 ft. l'rum tile intors~)ction of ~iu line with the l'~n~ng thenc~ in a ~uner~ north~rlj, ~;r,~ction along i~nd?~ of said l(obcrt ~ ~,lcii~oy N. 31° 20~W. a eist~:ce o~ 291 ft. more or lc~;s to the .~ean high wat~z' iiue ~f t~]e Long I:~l~d [~o~d; ~'~i~ th~ce ~ a gcncr~ c~. ;teriy ~ir~ctlon along the lm~d~ heretofore uonveyed by tho p~ty of the first part to Joim t~mahan$ running thence ~ a 6~ural ~outho~ly direction along the l~nd~ of John B~mah~ S.31° 20~ E. a di~t~nce of ~95 ft. more o~ less~ to ~he No~therly lin~ of ~,id pt.,rate ri~ht of way$~, ruzming thence in a general.we,~terly di~-uction along th~ northerly line of )riv~to .ci[~ht of way~ S. 820 Y~9' ~. a ~ist~,ce of ~0 ft. to the point or pl~c~ of b~ginn~. SZAT~ aFl--K, t ~ S COUNTY 0~.~'~. ........ ..~' ' / [Name ~f individua~ signing application) above ~a ed. He is the (Contractor,''''''' agent,''''''''' 'corporate''''''''' "'"' 'officer,' "'"'"'" 'etc.)'''''' md~ and and bfHef; / of said owner or owners, and is duly authorized to perform or have performed the said work and to this applicgtion; that all statements contained in this application ore true to the best of his knowledge that the w<~.'k will be perfor,~d in the manner set forth in the applica~ Ied therewith. Sworn to b~f~ore me this _ ' -- 1- ' ................. ?......: aay or .................. z. ........ ; .............. , , ........ /~_~,/~. (, ~ Notary Pu,blic~~.../_.~ ........... County (S,gnature of apr r N%ec~ia I~rough, Delnware Counl:y ' '}1{ ~,¥/. ~%a ~J{'.~ ½~e~a, Pa.