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Home My WebLink About3953-zFOl/~M ~qO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE Of OCCUPANCY THIS CERTIFIES that the building located at ........... ~[l[~i}~....~...~....[ltii~t{..~[..,~.~;... Street Map No.~t.r~jl..]{li.l. ll~lock No ....................... Lot No .... 'J'6 ....... 1~il~[~iiji'Xl.-Jt ....... l~l'?l'~: .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................. ~':l~:":J'~ ............ ~ 19 ........ pursuant to which Building Permit No .... 39~3 z .... dated ....................................................... .~9 ......... was issued, Ond conforms to all of the requirements of the applicable prov~n]'t~'ofl&e law. The occupancy for wl~ich this certificate s issued is ........ T ..... P. rivate.~ne fancily dwelling . ne cerr,r,ca~e-,s ~ssuea~o-. ....................................................... : .................................................... (o~esi~,e Holf Bruvi~ -buil~e~ ~ ~o~ Marie Zaluc~i O~ners of the aforesaid building. August 3, 1970 by Ho Villa FORM NO. 2 TOWN OF SOUTH ~0LD BUILDING DEPARTMEN'I TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISEs UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3953 Z Permission is hereby granted to: ....... ~e~...~ ............................. ? .................. to ~t:t~ ..~r~...e~e..:~aa~t~r,.~.,... ................... ; .......................................................... at premises located at ...o~0.~,.]6 ....... ~..~[ ............ J .......................................................... ........................ ~ ........... ~..~..~.,m~,..~..~......,..~ ................................ pursuant to appli~:ation dated ............................... ~.~[~ ....... ~.i..,.., 19...~, and approved by the Building Inspector. .Fee $....~.~.~ ........ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date, Bldg. Permit No. TO WHOM IT MAY CONCERN: at The (Give Zaeed location) have been inspected by this sewage disposal facilities for a structure located department and fo:und to be satisfactory. BUILDING DEPARTMENT TOW~ CLERK'S OFFICE SOUTHOU), N.Y. ///~'- ~',,~/~-~ ,~ ~"/~ t~aplication ................ APPLICATION FOR BUILDING PERMIT 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 st.r~ts or areas, and giving a detailed description of layout of property must be drawn on the diagram which is p~t of this apphcation. 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_r_emoval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances,~,-~z~'~/~°us~nde' and regulations. (Signature o~//dpph'con, or name, it a corpora iota ....... ............. ..... '..-. ......................... ~i;;~ ~'g~'~,conti ................. ;~' State whether applicant is owner, lessee, agent, architect, engi.neer, general contractor, electrician, plumber or builder. ;81N C. H 'F'1 o P -,,E-1C I -T Name of owner of premises ............................................................................................... Y.. ................................................. 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.: ?.!..L...L.~. ....... ..~.?.~...~. ........ Lot No.: ....L~... .............. Street end Number ..,,I ............................................................................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ................ .V....A....c...~...kl....-[. ......... ~....N...D.. .................................................................... ~ ,.F.~.. M.~ ........... b, ..W., ~ ~ ',.H..~.. b. Intended use and occupancy ........... ~..~...~. ...................... ~ ........ ~. .............................................. 3. Nature of work (check which applicable): New Building f Addition Alteration Repair ............. ..... Removal .................. Demolition ................. .l~:)ther Work (Describe) ........................................ 4. Estimated Cost ........... L..~..t....~...~....0.. ........................... Fee .......... J[.....)....~..L.~..~.~. ........................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... .~....h..(...~.~ .......... Number of dwelling units on each floor ............................ C^T C-^ A6 A-rr AC H L: If garage, number of ~ ............. ~ ............................................................................................................................ 6. If business, commercial or mixed occupancy, sp~i~ nature and extent of each ~pe of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... ' Height ........................ Nu~er of Stori~ ................................................................................................................. ' Dimensions of same structure with ol~rations or additions: Front .................................... Rear ............................ ~pth ................................ Height .............. ~6 .......~ Stories. ............................... ~' 8. Dimension~ ~tire n~ construction: Front .... r '~ ............................. ~ c~<-( Rear ............................D~th ........................ Height .................... 1~l-soNu~er of Stories ................................ I~O,O : ................. '1"~'~'~''~ ...... ~'"'"~'~'~':"~7'"~"~'~ ........ 9. Size of lot: Front ............................ Rear .................................... ~pth ..................... ~.~.~. ~ L:LL ~ N 10. Date of Purchase r~ ~ ~t.Z. .......... Nome of. Former ~ner ........... ~ ~c7 11. Zone or use district in which premis~ are situated ............................................................ .~..~ ................................. 12. Does proposed construction violate any zoning law, ordinance or regulation.;> ............................................................ ~1K~ ~ H ) L L 13. Name of Owner of premises ........................................ Address ............................................ Phone No ..................... Name of Architect ......... ~ ......... ~ .................. .~.~ ....... Address ~ 0 I- - ~ ~ ~.~.~.~.~.j?..~.~.~ ........ Phone No. '~'~'D'~ Name of Contractor .................................................... Address ...~,p..f..N~ ........................ Phone No ..................... PLOT DIAG~M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-~ck dimensions from prope~ lines. Give strqet and bilk number or description according to deed, and show street nom~ and indicate whether interior or corner lot. STATE OF NEW YORK, ~ c ¢ COUNTY OF ................................ .f J"~' ................................................................................................. being duly sworn, deposes and soys that he is the opplk;ant (Name of individual signing application) above named. He is the ......................................................................................................................................................... (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 oil statements contained in this application ore.t,r~,xto,the best ~ef his knowledge and belief; and that the work will be performed in the manner set forth in the applicatj~'n~il~d/therel~4t~l[ Sworn to before me this ( 1,4/u~/l~ ....... ...... ................ .............. ....... /o-i I'VIA i:~ o,~' LO7- /.4. .4;'0'= I" ~reen?or'/~ Nev~ )4" k,