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Home My WebLink About4499-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ~...~.~O~ ............. Date .......................... ~1'~.1~ ....... ~..~. .......... , 19..~..0.. THiS CERTIFIES that the building located at .... JJ&.~t..~ ............................................... Street Map No..,X~. ............... Block No ..2 ............ Lot No .~r,....O~.~r~1~t..~,Y~, ............................ conforms substantially to the Apphcation for Building Permit heretofore filed in this office dated ................................ ~}e.l~ ...... 8 ....... , 19..~ pursuant to which Bu,ldmg Perm,t No.....~.l+.c~.c)7.. dated ....................... ~)e.t~ ....... 8 .............. , 19.. ~o~ was issued, and conforms to all of the requirements of the applicable prows~ons of the law. The occupancy for which th~s certificate ~s issued is ........ · ..Aeces ~.ox'y..{.etorage'}"~u~'tc~'£~l~ ......................................................................................... The cemf,cate ~s issued to .Ga~...L,,~..Tabor ....... Owrter. ................................................................ (owner, lessee or tenant) of the aforesaid building ~ouse ~ 680 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4499 Z .............................................. ~.~L.c.-...Z.r... ....... ot premises locoted o, ...................................................... ..~....~....~.....~........~.....'~....~....~.~.~C..~... .................... ............... = ........................................................................................ ~...~.L..c:...~...T... .......................... # pursucm¢ to application doted ...................................................... 19_ and approved by the Building Inspector. Building Inspector NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .................... .................... Na ..... ~ro~ a/~ ............ ~ ................... ~i ........................ (Building Inmeator) APPLICATION FOR BUILDING PEP, Mr/ 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~ets or areas, and giving a detailed description of layout of praperty must be drown 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 shell be occupied or used Jn 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, ordinances,.building code, housing code, and regulations. (Sig~6ture of applicant, or name, if a corporation) ............................ ...~...~.~..~.....~'.-.~..-C... ............. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................................ .~..u...~.~ .................................................................................................................. Name of owner of premises .............. ...~....~....T~_.....~. ......... ...~.. ........ ...T....A~.....'~....0....~. ...................................................................... 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.: ........................ Street and Number .............................................................................................................................. ~,, ................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing (lee ond occ.lpancy ...................... .,~,..~J~..~..,~...~....T'... ..................................................................................... b. Intended us~ and occupancy .,~'7'07-~ 3. Nature of work (check which applicable): New Bu{Iding .................. Addition .................. Alteration .................. Repair .................. Removal ................ :. Demolition .................. Other Work (Describe) ........................................ aa 4. EStimated Cost ................................. ./...~.. ................... Fee ........ ~... ...................... ; ................................................... (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 .................................................................................................................................... ......... 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 enti~ new construct on Front ../...~....~.. Rear/' Number of Stores O .~..~ 9. Size of lot: Front ............. ./.,7...~ ...... Rear ! '7 ~ Depth 17~ - / 10. Date of Purchase .................... ./..~.....~........./.~...~...~ome of Former C)w?~er ......~..~....~...:.~...,~....O....~. e / ~;~': ~' I Z~ ............... 11. Zone or us d'str'ct in which premises are situated .................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............ ~ ......................... 13. Name of Owner of premises ..~...~....~..~......~......~...~..~.~ldress .~....~...~...~...~....?....._'~..~ .......... Phone No.~..~..-...~..'..~..7.~7 Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ............ ..~....~...)~......~.. ...................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly ond distinctly all buildings, whether existing or proposed, and indicate 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. /?I STATE OF NEW YORK,eI,,~ lee COUNTY OF ..................T. ............ / .............................................................................. ~ ................ ~e~ng duly sworn, d~es and says t~t he is t~ applicant (Name of individual signing application) named He s the ~ ~_._.. . ' above (Contractor, agar, co,orate officer, etc.) of said owner or owners, and is duly authorized to pe~orm or have perfo~ed the said work and to ~e and file this application; that all statements contoJned in this application are t~ to the best of his knowledge and belief; and thaz the work will be performed in the manner set fo~h in the application fil~ therein. Sworn to bef~ me this .-, .................... ..... .... - Nota~ Public,n'~'~~E~'~' '~~""~[[~'~; ................................ ~ .... ~ .............. ~ ' ~ (S'gnature of applicant) ~..~ ELI~ETH ANN ~-. u='a~5850, Suffolk C0u , erin ~psres March 30,