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Home My WebLink About4565-zFORM NO. 4 TOWN OF SOUTHOLD BUH.BING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at · ~S·/.S.. ,M.a.%ri., R.o.a.d. .......... Street Map No,:~X ......... Block No...Y,~-~: ..... Lot No, . XX~...0~i..e.n,~.....E.:Y... .......... conforms substantially to the Application for Building Permit heretofore fried in .this office dated ......... l~alr . 19 19.69. pursuant to which Building Permit No. dated ........ N. gy..' .2~.., 19..6.9., was issued, and conforms to ali of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .Re~.5.do..n.c.e...w.~.t.h...a.d.d.5..~.tg.n...&. n..eK .p.V.~v.a.t.e. ga.~..ag.e. .................. The certificate is issued to ... ¢~.],. &..J. ane..galp:tn~ .... . .o~olel~ .................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .~ :.R.: ............................ UNDERWRITERS CERTIFICATE No. .pg.n.d.~.n.g ................................... HOUSE NUMBER ..2.82.80 .... Street ....~.a..5.n..R.o.~.d ..... p.r.~..e.n.~. ............... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4565 Z Permission is hereby granted to: ............... g~..&..,~esm.a~lala~ .................... to .: ...... ~'-ea" ~Mea..ae.. ax~te.td.~, ..ee~J. MC...~.. ~.. ~.te~ ............. at premises located at .................... ~....~...~...~......~ ..................................................................... .......... : ................................. : ........... ~;Le~.....li~.. ......................................................................... pursuan) to application dated ........................... ~i.~.~..~.~. ............... , 19....~, and approved by the Building Inspector. Fee $......~.~...~.. .......... .......... ~' Building lnsp~cfor ~,- ~ £ FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 4566 Z Date ..........................1"I.M J.®........� ..... .. 19... �? � Permission is hereby granted to: ...... :..a,?an..bzr.btne...................... ................................................................................ ................................................................................ to .........................................................uilthnew two car nrlva to)...EC00350?� .................................... ,. ................................................................................................................................................................ atpremises located at ....................?i/`a......$ Jai..;?t447arh...................................................................... .........................................................(:;V.Z C.n ?a.d?r�. ......................................................................... ................................................................................................................................................................ pursuant to application dated .........................K,-��r......... r�..........•••. 19.<,",., and approved by the Building Inspector. Fee $... .5.f'O.......... ............................ Building Inspe or -:, . · _ _ ~"";Y'~ ~,~ ........ ~...~.~.....,,.~ ,~'~ ,~,,~,,~.,o. ~.~ ............... ..................................................... .................. ...~., ............ ~ .......... ~.~.......~....~_'..? a. Thi, *pplicati~ m~ be completely fill~ In ~ ,w~o~C,~ ~ic~t~ ~ Buildi, In~r. b. PI~ ~17 s~in~ I~ation o~ Im ~ of bu~ldin~ ~ premiss( mlation~ip ~ adjoini~ ~i~ a~s, a~ glw~ a ~a.ed ~riHl~ o~ ~t 0tP~ must ~ dr~n ~the d~agmm ~h is ~ of ~ ~. c. ~e work c~ by this a~li~ion m~ ~t ~ comm~c~ ~u~ce of Buildi~ Pe~it.. d. Up~ ~proval of ~ls applic~i~, t~ Build~ In~ctor will I~ a Buildi~ Pe~it ~ the ~plicant. ~h ~all ~ kept on the premises avall~le for i~tion theft the p~r~ of the wo~. e. No building s~ll ~ ~c~i~ or u~ in w~le or In pa~ for any pu~ what,er until a Ce~ifi~ ef shall h~ ~n gmnt~ by ~e Bulldi~ I~tor. APPLI~TION IS ~REBY ~DE to the Bulldl~ '~ent fo} ~e i~uance of a Buildi~ Pe~it Building Zone O~i~nce of ~e T~ of ~thold, Suf~lk C~n~, N~ York, and ~her a~llcable R~ulations, for the c~ruction of build ngs, a~ tions ~ alterations, or for mm~al or demoliti~, as ~n ~r ~e applicant agrees to ~ply with all applicable I~, ~inan~, buiidin~e, housing c~e, ~d ~ulotions. ' /~.~-...~....: .................................................................. / ~ (SJgn~ure of applicant, or ~ame, if a co~mti~) ' r. (Addr~'of applicant) ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder, i;i 0 ~/,V ;--' mis 4~ ,~/4~ /_ v.. J/'~/~,~ ...~....~..8 //V~'- _ Nome of owner of pre es ................................................................................................................................................... ~;' If applicant is a cof~.rOte~ signature of du y ,author zed, officer. (Name and title of corporate officer) 1. Location of laqd .on_which proposed work will be done. Map No.: ........................................ Lot No.: ......... ~ .............. Street and Number ...................................................................................................................................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy . 'J'~>~9~'~'~- .4~..~'..~."~C..~.. .... .~;.., ,.~'....~..~ ~1-...6:..~-" Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .................... ./...?.....~...~....~...o..; ................ Fee .......................................................................................... ~ ~'Q R ~¢,~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... .~..x~5.~.~(~....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 ~.~..~..~/..~..~...~..~f. ~' 7. Dimensions 9f existing structures, if any: Front .....~..~./...~-~.. ........ Rear. ........ ~/..:...~'.. ......... Depth ..~.~...~./...-fi~... He ght /.~.....~..~ ........ Number of Stories ........ ./. ....................................................................................................... Dimensions ~Lsg.me stj~ct~re with alterations or additions: Front ...... ...-~../..~./.,~, .............. Rear .....~'..~..'./...~... .......... Depth .....~Ll~.......~..~...~/~-Ieight ....... ./..~....~..?.: ...... 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 ......~.....D...x../. ...... ../..?. ......... /.~'.~..-..'~..7...Nome of Former Owner ..~....'~.....~q~'.....,~/.~.~.~...~..~-../....~/~.9.. ! 1. Zone or usa district in which premJsas are situated ............................................................. ~ .................................... 12. Does proposed construction violate any zoning aw, ord nonce Or regu at on.;> ......................................... 1'3. "~ame of Owner of' prem ses ..~...~...~..~....%~..~....~. ~.~....~'.. Address~..~..~...~...o. ..~...4../..~..?:.~ ......... Phone No~..~.~- a~ .~.~/.~ i~- ~' _ · ~.~ ~'~ ,. ~ .................. Name of Contractor .,.~...~..?.....~...~..~.. ............................ Address .....i~./.~...~....'~....%~.~/~....'~.... Phone No ..................... ~, . . pLOT DIAGRAM ' Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil sat-back dimensions from · property lines. Give street and block nuttier or description accordina to deed, and show street names and indicate ~. whether interior or comer lot. STATE OF NEW' YORK.. ~ lee · ~ / (Name of indiv~ual signing a~lication) deposes and says that he is the applicant above named. He is the ............ ~ .......................................................................................................... (Contractor, agent, corporate officer, etc.) o.f said ~wner or .OWners, and is du!y:authorized to perform 9r ha~e performed the said work 'and to make and file this application; ,that all statements contained in this applicdtion are true to ~the best of his knowledge and belief; and that the work will ~e performed in the manner set forth in the application' filed therewith.// Nato. ry Public, . ......... ~.../f ............. .;~../~:. ~./'..~ .~.......~. ...... County /' ~ ( S,~'~-t~'~ ' ~pplica n t ) ........ '~ ~T~iq ~'~ I