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Home My WebLink About4377-zIoOF, a{ NO. 4 TOWN OF SOUTHOLD BU-~DING DEPARTMENT Town Clerk's Ottice $outhold, N. Y. Certificnte Of Occupnncy No.. z.~3~1 ..... Date .Ju~..27~ .................. ,19. THIS CERTIFIES that the building located at . ~1~.1.0. l~l~L].. ~O .......... Street Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated . .J~y .10 ............ , 19 ~9. pursuant to which Building Permit No. ~.7~.. dated . .J~l,~-~ .10 ............. , 19.69., 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~.lV&/;~ .Olxe..F~. l~el/I.~.~__~ .................................... The certificate is issued to ..... F~..&. 1~.~,. gh&r~,u. ~ ....................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ........ 1~..,.R., ........................ UNDERWRITERS CERTIFICATE No. Pe~ti~ HOUSE NUMBER ~810 Street l~t]J. Lane ...... ........ FOEI~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4377 Z Permission is hereby granted to: ............. 2~........rg..v..e...r..a. ~..a..e....~.~.v...e...., ................. ............... ~a~,~.e~,~ ....... ~.,~.,......~ ................. to ............. ]~.vAl¢l ...aa ..a.40,i~iag ..~.. ~ at premises located at ................. .14...~.~..]......~......&....~..~..~.~.a...~....A.....V~. ......................................................... Nattit~k N,~. ~ pursuan¢ to application dated ............................. ~1~. .......... ~.0. ...... , 19.~.., and approved by the Building Inspector. ~ee $..~,..0..0. ............. INSTRUCTIONS a. This application must be completely filled in by t3~ewriter 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is port 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 shall be occupied or used in whale or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. ,, APPLICATION IS H.EREBY MADE to the Building Department for, the issuance of a Building Permit p~, rsuant to the Building Zon· Ordinance of the Town of Southold, Suffolk County, New York, and~ other applicable .Lqws,~ Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant egrees to comply with all applicable laws, ordin, ances, building co~!.e, housing code, and regulations. (Name and title of corporate officer) 1. Location of land on ~hlch prapo~d work will ~..._ ............................. Lot No.: ........................ ¢ Street and Number ..~..~.~.~~.(~'~'~'~'~'~'~'~'~'~~..,..~.,..~ ........................... : / I /,21~.f_ :~<~-/ ~ '..~ / / Municipality 2. State existing use and occupancy of premlfl~ int~l'nd occupancy of proposed construction: a. [xisting use and occupono/ ........................................ b. Intended use and oecuponcy ......................................... 3. Nature of work (check which applicable): New Building .................. Addition ...,~. .......... Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ (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 entire new construction: Front =~.(~.~.1~)~. .................... Rear ............................ Depth ........................ Height .................... Number of Stories .................................................................................................................. 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 I. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation? ............................................................ 13. Name of Owner of premise__~'~iirC~'-oC"~'$~:tCfJ(.....Address ....................... Phone I~'ame of Architect ...................................................... Address ..f~. ........................ Phone No ..................... Locate clearly and distinctly all buildings, whether existing or proposed, or~J indicate all set-back dimensior~ from property lines. Give street and block number or description according to deed, and show street names and indicate STATE OF tS.S. COUNTY (I ind above named. He is the duly sworn, deposes that he is the applicant (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make crud file this application; that all statements contained 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 application filed therewith. Swam to before me this Notary ...... J/'~: ' '" ""~J~l"'" ' ~'/d~' ° f '~'~'~': ~':':i'~"~ ' ? l(~ou~'n~' ~ Pub, lc,~~ ........................... RIVERHEAD IILANI 303:, { 6LLPPLY CO. A¥,I~N:U£