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Home My WebLink About4582-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, CERTIFICATE OF OCCUPANCY No. Z .~8~2 Date .1'u.13, 21 I9 70 THIS CERTIFIES that the building located at ..~;Lt,~...[,a~te ....................................... Street Mop No..~..O...~....t~...~...O...O~... Block No ....................... Lot No. ~[ ................. ~.~.~.~,f~,~,4.g...~..~.~..v. ............. conforms substantially to the ^pplicotion for Building Permit heretofore filed in this office doted ................................ D~e~ ....... ~ .............. , 19...6.~ pursuant to which Building Permit No..lf..~.... doted ........................... D.e~ .......... .1~) ....... , 19.~9.., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ........ ~.~,.v~e..m~..£~a~..~hee3,~,~g ......................................................................................... The certificate is issued to ..~T~.~..~.~.~ .................... QI~Z~Z'. ....................................... (owner, lessee or tenant) of the aforesaid building. TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT frills PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK ^UTHORIZED) 'N? 4582 Z Dee 10 Permission is hereby granted to: .... pur~sucm~ to application dated ..................................... .~....J~.........~. ........ , 19.,..~..., and approved by the BuildinO Inspector. Fee $..~t~ ............ INSTRUCTIONS in by typewriter'or in ink and -~Ubmitted a. This application must be completely filled in duplicate to the Building _~ Inspector. ' b. Plot plan showing location of lot and of buildings on 'premises, relationship to adjoining pm. miees or public streets or areas, and giving o detailed description of layout of property must be drawn on the diagram which ,s port of th~s application, r'~ 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 whate~r-in.port for any purposewhatever ~until a Certificate of Occupancy shall have been granted by the Building Inspector. , , ,I,; ,! I: ': ,11 APPLICATION IS HEREBY MADE to the Building Department for the issuance of a BiJilding Per'nit pumUant to the Building Zone Ordinance of the Town of Southold, .Suffolk County, New York, and other iappllcable Laws, Ordinances or Regulations, for the comtruction of buildings, addit,ons or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housi,hg code, and regulations. (Signature of appl!cant : ,.. ,.~,.., ,,... ~,~.~~-~eO~.. ~ .............................. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ........ ................................... ............................. ................................................. Name of owner of premises .....%,~,~ ......... :~.~ .............. ~ ........ ; ......................................................................... If applicant is a corporate, .~ignature of duly authorized officer. ' .......... ~/- (Name and title of corporate officer) . . 1. Location of land an which proposed work will be done. Map No.: ...................... ~. ............. Lot No.: ........................ St~ 'and' Ni~mbe, .~...~"./21.C~........~.~..,,;,.~Z~ '~.~.,~~..:.'~..:~'..:..:..:.!i ..... ~) I -- ~ ~ 0 ' Municipality 2. State existing use and occupancy of premises an8 int~ use and)[x~dpan'~'y of prOPosed construction: Ex' ting use nd ' ' a. IS a occupancy ......... ,...,.,, ........................... .......................................................... b. ,htended use and occupancy ...~...q.~"~m~.~....: ....................... 3. Nature of work (check which applicable): New~ Building .: ................ Addition .~ ............ Alter~ion .................. Repair ................. , ,R~,noval .................. Demolition....~ .........Other Work (Describe) ........................... ~ ............ 4. Estimated Cost ....... .~...~./..~..~..~...~?.. ...... ; .......... i .......... 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 ....... ./~'.~.~,~..'T ................................................................................................................. 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 ..... ~..~1~.... ................. Depth ....~..~.. ........... Height .....~..2~.~ ..... Number of Stories ...J.....'. ..................................................................................................... Dimensions of same structure with alterations or additions: Front ......... .~....O. ..................... Rear ...~....O. ................... Depth ......~...~.. ................... Height ...... ~-d~.....~.~.~ ....... Number of Stories ..... /. ......................... 8. Dimensions of entire new construction: Front ..~.}...'~. .......................... Rear ..... ~ ............. Depth ~. .............. Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ..... /.~.~ ............... Rear ...... ~...O..~ .................... Depth .../.'~4D ................... 10. Date of Purchase ~46~'~a~'~.~.~., ............................ Name of Former Owner .~4~ai~-/,~.~,~,.(~ ...................... 1 I. Zone or use district in which premises ore situated ..~e~!II~/.~_.~I.,~/~'/:C....-C.. .................................................. 12, · Does proposecl construction :v~otate a~ny zomng law, ordinance or regulatmn? ..~..~,-~ ................ ~;:~ .............. 13. Nome of Owner of premises ~'~IF~/~...4~,X~::I~ ...... Address ............................................ P hone .J~... ~..4~.(, ..... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ~.~o..r~..~....~.....~.. ...... Address ~~¢~.....~... .......... Phone No~7~....~..2.~.-.-~.. PLOT DIAGRAM Locate clearly and 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 comer lot. STATE OF NEW YORK, I ¢ c COUNTy OF ................................ ............ ~ ........ ~..,..~.. ~,.. ............... ;.'~...., .............. , ...... ,. being duly sworn,~ deposes, g.n says that he s the oppl cant (Narr~ of individual~.- __....signing c~li~:ati°n) ' .. above named. He is the ....~:~:~.~l~.~l~......~..~-L~.~_~_....., .......................... : ..................................................... -- (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform ar; have performed the said work and to make and file this application; that all statements contoJned 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 appliqation filed therewith. Swo_m to before me this ~ ^ .... .......... ............ ~1o. 52.8125850, Suffolk ;[erm Expires March 30,