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Home My WebLink About4072-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOt~-~-tlOLD, N. Y. OE:RTIIrlCATE: OIr OCCUPANCY No. ~. ~.383.... Date ......... ~)~cemi:~z...17., ..... 19~8. THIS CER'I'LFIES that the building located at .~dl~Oi~. ~t~t, ........... Street Map No ............. Block No ............. Lot No.. G~eOnpOZ:t,. N~..YO~k ......... conforms substantially to the Application for Building Permit heretofore fried in this office dated ....... 0CI:~M:. 1, ....... 19 ~. pursuant to which Building Permit No. 4072. ~. dated ...... .Q~t.4:~h~:..~, ....... 19~8.., was issued, and conforms to all of the require- merits of the .applicable provisions of the la w. The occupancy f. or which this certificate is issued is .. ~rAvaf:e. ~araqe. &. ~.orage.. (ae~eas~ry. build~ng ) ................. The certificate is issued to ... ~Oh~ .Zfi].oMSk.:L ....................................... (owner, lessee or tenant) of the aforesaid building. ~f Suffolk County Department of Health Approval .... ~ .~.~..' ......................... -.. PO~ 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) N? ~072 Z Date ..................... J~.....I ..................... , 19..~. Permission is hereby grented to: to ...~4....~..~.~.e.$~..ea..~.. m~ta~tar,..e~e, amaz~.., i~t~ ........................... at premises located at ............ ~(~.~JJ~lJ...~.lj..~..~Jl'.t~..JJlll~t[ ........................................................ pursuant to application dated .......................... J~t~ ....... J ................. , 19...~, and approved by the Building Inspector. Fee $... ~.. ~.(~ ........... vuilding ~nspector J TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, Disapproved o/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 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 whale 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 oil applicable laws, ordinances, building code, housing code, and regulations. (Signature of applicant, or name, if a corporation) ...... (Address of applicant) State whetherapplicantisowner, lessae, agent, architect, engineer, gJeneral contractor, electrician, plumber or builder. ............... ......................................................................................................................................................... Name of owner of premises ..... ,.~'T.~l..~3.....~-~..(~..~/~..~...~.(~..i ................................................................................... 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.: ........................................Lot No.: ........................ reet and Number ....,,~.~....J..~....~.....~...i.~.O./~.....~..~...) ........... ~..i..'~..!.~.~.]~.~,~.~....~....~,~.l..i .................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .....(~..¥...~..~...L~.£-L.[d..C-~......~..O....~......-~...~...~..../~....,,~../..'J:...~.~. ............................. 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 ..... .~..!.....: .......................................... Fee ..~.......-~c... ............................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... i .................... 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 ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of some 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 ~ · 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 ..~.?.~.~..~...~..~....S..~.l.....Address ..~.....~.....r).~...~.~.../..... ....... Phone No ..................... Name of Architect .............................................. ........ Address ............................................ Phone No ..................... S -L F- Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oll set-bock dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF N~ YORI COUN~f ~-- ~OF ................................ f~'~' · .......... .~.....~ .............................. being duly sworn, d~oses and says t~t he is the applicant //(Name of ~ividual signing application) a~ve flamed. He is the ......................................................................................................................................................... (Contractor, agent, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke 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 t~ ma~er set fo~h in the application filed therewith. Sworn ~fore me this I ....... No. 52-3233~20 Suffolk 6ou~t~ FORM ~0, 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES COMPLETION OF THE WORK AUTHORIZED) N? 4072 Z UNTIL FULL Permission is hereby granted to: ................. ~.s~a..5.t ................... : .................. ...................... .~.een~c~t~ ................ i .................. to ....~...~..~,1 .~....~...~..~..~. ~ .I~Q~...~:~J~ ..~&l~...1~A351~ .~g~..~,.~.~.S ~Q~ .. ~ld ~ ........................... at premises located at .~..~..~.~.~. ~ .~. ~ ~.~]/~ ' .................................................... :G~.ee~p~ ........................... ' .......................................................... pursuon,t to application dated .......................... ~l~.t~:......J ........... i...-., 19...~I~, and approved by the Building Inspector. Fee ~...5..~.9.~ ...........