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Home My WebLink About4317-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z.%37.2 ...... Date ............. A~gust...13..., 19.75 THIS CERTIFIES that the building located at N/S./~.a~lrAlxlg. Road ......... Street Map No. ~ ......... Block No.. ;g3g ...... Lot No..:g:l~ ....~.e.~. ~.~.f.f. 9.M~.....N.,.~.~ .... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... a'lzl~e...] .... , 19 [~.9. pursuant to which Building Permit No.. ~317Z. dated ............. J.v~e. 2..., 19.6c)., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is P.~lYa.~:e.. ~.e,~.~.o.x*.y..~.~.~g ............................................. The certificate is issued to .. ~;tCh~e~. ~1~ ...... (~t~. ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...~ ,g,. ............................ UNDERWRITERS CERTIFICATE No..N.:R.: ....................................... HOUSE NUMBER ...$~)+~ ....... Street .... l~.ar~l~[. R~4 ....................... Building Inspector FO~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 317 Z Permission is hereby granted to: ............ ~,~.: .~.~ ~. ~.. ~,~,]~ ~U0t~ · -~'; --~0 ................. ................... ~ ~; .. ~.~:~*. ¢~k .................................. pursuanit to application dated .................................. ~-1+t~!~ ....... ,~..~:...., 19....~., and approved by the Building Inspector. Fee $ ...... .~C~ .......... Building Inspector APPLICATION FOR BU~ILDING PERMrI' INS'rRUCTIONS ~ a. This application must be completely filled in by t~pewriter or in ink and submitted in duplicate to the Building ~' Inspector. :{~ ' _'~ b. Plot,plan showing location of lot and of buildings on pre.mises, relationship to adjoining premiees or public stree~ or areas, and giving a detailed description of layout of prof~ty must be drawn on the diagram which is port of thks appllcat,on. c. The work covered by this application may nat be commenced before issuance of Building Permit. d. Upon opf~rey~l ¢~l~thJs application, the Builcl~ Inspector will issue a Building Permit to the applicant. Such permit ~ shall be kept on the premises available for inspection throughout the pragress 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 Buildi.ng Permit pursu.a, nt 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 alteratic~ns, or. for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, budding code, housing code, and regulations. Mar Jory Mallory New Suffolk (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which pmpaeed work will be done. Map No.: .................. ~ ................. Lot No.: ....~, .................. Street and Number .~../..~..~...&...X~...~.~..l~ ~.o..a...~. ............ : .... Munlclpol.lty 2. State existing use and occupancy of premises and intended use and occupancy of prpposed construction: a. Existing uee and occupancy ......... l~].W'.~..~].~kl~g .................... :~. ............................................................................. b. Intended use and occupancy sae with a detae~ec~ p~ivate: gar&~e 3. Nature of work (check which applicable): New B~ildipg :'~..~,,~G:.., Addition .................. Alteration .................. Repair .................. Removal ' Demol:ition~.....~;~...~;.." Other Work (Describe) ........................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ zlo~e .......... 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 s~me structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ..: ......................... Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... 20 ........................ Rear ........... 2,0. ........... Depth ...... 2.~. ............. Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ........... .1~,.~ .......... Rear .............. -1.2~ .............. Depth ..... .1~(~..~ ............... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated .............. ~La~.~ ................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ............... ..~..O. ........................................ 13. Name of Owner of premises ...~J..~IL~.~LO3~. ...............Address ....~e.~..~.l;L~t'o~ir ............ Phone No ..................... Name of ^rchitect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ..... ~.&T~e ..................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensio~ from proper~y lines. Gi,/e: street and block number or description according to deed, and show street names and indicate whether interior or corner I ~t. STATE OF NEW YORK, lee · COUNTY OF ............................. ..~...:R.,1.~:J~.....~. ~g~. ................................ being duly ~om, d~ a~ s~ ~ he is ~ ~plicant (Name of individual signing ~lic~i~) a~ve name. He is the ........................~e~ ..... ~ ........ ~ ...................................................................................... : (C~t~r, ~t, co~e o~oer, ~c.) of said ~ner or ~ne~, a~ is ~y aut~riz~ to ~orm or h~e ~o~ ~ .~id wo~ a~ to ~ ~ file this a~lication; that all ~atements contoin~ in this ~plic~i~ am'tree ~ ~e b~t of his ~1~ a~ ~lief; a~ ~at the ~rk will ~ peHo~d in t~ ~n~r ~ fo~h in the ~llc~i~ fll~ ~i~. Swam to ~m ~ ~is No. ~-8125850, Suffolk C~ T~m Expires March 30, 1~