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Home My WebLink About4088-zFORM NO. ~ TOWN OF SOUTHOLD BUHDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at .~.~.s.t.l~.h.a.l.~.a.. ~ ........... Street Map No. ~ ......... Block No..~. ........ Lot No....x~......~..t.t..t..t.u.~.k...N.: .~., ....... conforms substantiallYoet ¶6t° the Application65 for Building Permit heretofore filed in th~0o~,e dated ...... (lot ....... L~.., 19..7.2 pursuant to which Building Permit No.. dated ..... .~.~.~.¢k:~;°.... 20..., 19.~.~., was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Pr~.vate accessory bulld~.ng The certificate is issued to . l~o. ber.t .ttea.e.k$. 6; .~/~f.e... mm~r.~ ..................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .... N. :.R.. ........................... UNDERWRITERS CERTIFICATE No..P.~..n~..ip..~ ................................... HOUSE NUMBER ..... 3..8.~.~. .... Street .... .lg.e.s..tp.h.a.1. ~.a...Bd ...................... Building Inspe~t~ ~OEM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? ~088 Z Permission is hereby granted to: '~ E~-/ Z..g...~ ...... ~..5...~..~.~..~..L~ ....... ~ ~ ............................................................................. ~..~..~.~....~..~..'. ................................................... at premises I<ated at ..................................................................................................................... ............................................................... ~.C~...~..~..7..e.<:.~ ................ ~.....E ...................... Building Inspector. Fee $ ........................ Building Inspector ~ (Budding Insp~'~;) ............................. lhi, applicotion mu~t b~ compl~t~l~ fill~d in by ~pewrit~r or Plot plan ~howin~ I~tion o{ lot ~nd of buildino, on pr~mi~, r~lotion~h ~ ~ivin~ ~ d~*il~d ~rlption o{ I~out o{ pm~ mu~t ~ Work eo~r*d bg thi~ applic~ion m~y not b~ commenced b~for~ i~c~ o~ Buildinfl ~ermit. Upon opprowl o~ thi~ ~pplicotion, ~h~ Buildin~ Ins~ctor will ~?t on th~ pr~mi~, ~voiloble for inspection throuo~out Ih~ pr~r~ o{ th~ wo~. ~uildin~ ~ll b~ ~cupi~d or u~*d in whol~ or in p~ {or ~n~ *hoH~* ~ ~n ~mnt~d b~ ~h~ Buildin~ Inspector. APPLIC~' 'ION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zo~ ~ Ordinance of fhe Town of Southold, Suffolk County, New York, and other applicable Lmvs, Ordlr~nces or Regulations, For the co~lstr~uction of buildings, additions or alterations, or for removal or demo t on, os herein d~cri~ ~e opplico~ ~ ~rees ~ply with oil applicable laws, ordinances, building c~e, housing c~e, and regulations. ~ddress of applicant) ~ ~; > ~'~ State whet er applicant is owner, lessee, agent, architect, engi.n~r, general contractor, electrician, plumber or builder. A L= ............... . N.~ ~ ~.~. ~ pr.~is~s .............................. If ~plicant is a corpo~fe, signature o~ duly outkorized ................................................................................................ ~ ~ ~ ~Lot o 1. k~otion o{ I~ on which pmpo~d work will ~ don~. ~op ~o.: ....................................... ~ .: .......... ,~ ....... ~.~ st~,~ ~,~ N.~ ............................................................................................................... ~~... 2. Sta~ ~xisti~g us~ and ~cu~ncy o~ pr~m seS and intended us~ and ~cu~n~ of pr~os~ connectix: o. Existing use and ~cu~nw b. Intend~ use and ~cupanW 3. Nature of work (check which applicable): New Building ..... ~... Addition .................. Alteration .................. Repair .................. Removal .................. Demolitian .................. Other Work (Describe) ........................................ 4. Estimated Cost .................. /..~.~.O...~'~. ................... Fee ....~T..~ .......................................................................... ' (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 ........................ ~./~/..L~ ....................................................................................................... 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 same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................Height ............................Number of Stories ................................ 8. Dimensions of entire new construction: Front ........... -~..~/. ................ Rear ...... ~...L..~ ............ Depth ..... ~..~ ......... Height ...... J..~.. ....... Number of Stories .................. ~h~- ..,~. ...................................................................................... 9. Size of lot: Front ......... /......~...0 ........ Rear .................... : ............... Depth ............................... 10. Date of Purchase .............................. /~,--.~....~. ....... Name of Former Owner ~,. , ] 1. Zone or use district in which premises are situated ............ 7~ ...... '~'~'~"~"; .............................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ............ ...-~'------------~..~> .................................... 13. Name of Owner of premises b~/~.~.......~.JI,~.C'TJ~...~..Address ..-~..~.~..~?~9.'~.j-'/-'~-.'~z~J~' Phone No~_~.~..-..~.~,~.7 Name of Architect ............................... ~/. .................... Address ............................... ;/ ........... Phone No ........... /. ........ ., Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly ond distinctly oil buildings, whether existing or proposed, and indicote all set~back 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 NEW YORK, tee j,//~ ~/-IA/_ / J~, (~. L~ COUNTY Of ................................ J ~"~' ................ .~.~...~ ...... .~;~.~../~'.~..~......-J~.~.~.C~.~.]Z:..being duly sworn, deposes and says that he is the applicant (Name of in~Tvidual signing application) above named. He is the ............................................................ O.~.4~.i.--~...q'?~-~ ................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove 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 o, ....................... 4_, Noto~ Public,. ............ ..~...~...i.-Z..~...~.A..~. ............. Cou~t~"7"~-~ ~ · ~'~~PPii~'~:r'i-- ~ ~-"