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Home My WebLink About4441-zl{'O~Wi I",TO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. 2'~9.1.~, ............... Date ............................... JLI~'I~..~[....., 19.....~ THIS CERTIFIES thor the building Iocoted ot .... O~I;..AV~.&.,~I)~I~¥&{;~,~S..,D~. ....... Street Mop NOl ..MIJltB.~J. ....... Block No ...... ,~[ ...........Lot No. JlClC....JJ:g, Jf, iJJl,OJ'l~O....JJ...~., ..................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..................................... 8Opt, ......... ~, ....... , 19..6l~ pursuant to which Building Permit No ...... Jl~l~;~ dated ........................... jj~p~ ....... ~ ......... , 19...~ was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate Js issued is ........ ............. l~.i.vit~.. ~,~Ji~,s ...(Aoae-,,s o~...~1~ ) .......................................................................... The certificate is issued to ..J)~,..~OJiJt..JJ~-j.~JJ~J{, ................... OiJll~ .......................................... (owner, lessee or tempt) of the aforesaid building. House d~ 8~80~k 260 Bz'oad, w~er Building ]~r~specto~" TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTNOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4441 Z Permission is hereby granted to: .......... J~....~o~e~e~ ................................... ...~l~.~e..& .:~,-~t,e~..~ .................. to .................. ]t~A..e~..aeeesee~,g~..l~,~-].& ~-- ~.~.G~.~e~e.) ........................................ at premises located at ..... 8~....0J~.~..d;..~¥&~'S.-.~Iz ................................................. ................................................... gllt~ .......... I1.,.~, ..................................................................... pursuant to application dated ............................. ..'~ll~r ...... '~ ......... , 19...~9, and approved by the Building Inspector. ?OWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Examined .....~...: .......... , 19 ........ Approved ..................................... :.., 19 ........ Permit No.....~.....?....L'!.../..~ ............................ ........................... Application No......L~.....L/....~...t. ......... APPLICATION FOR BUILDING PERMrr Date INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plat 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 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 ir-.spection throughout the progress of the work. e. No building sh~tl 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 h/LADE 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 here n des~r bed. The applicant agrees to comply with all applicable laws, ordinancesy~ilding code, housing code, o~d regulations. · .......... ........... ~(~ignature of applicant, or name, if a corporation) ............. ...... ................. (Address of applicant) - 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, 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.: ,..;..~..../~.. a r~ m r ...................... '"'r ................................................... ..~. .............................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .~/~)~ b. Intended use and occupa~x~..~.~:.~: ................ ,.......,..;..:....;; ......................................... : ......... 3. Nature of work (check which applicable): New Building: ........... ~ ..... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition ......... ~ ...... Other Work (Describe) ..... ~.,~..~./~.~.z~. ........... ~ ~.....(~. (~ Fee O~ 4. Estimated Cost ................................................................................................................................................ (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 c. ors .................. ~ ....................................................................................................................... 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 ar additions: Front ....... ,~...°....~.. ................. Rear ...~,..C?....~ .............. ,~ , Depth .......... ~. .................... Height ............................ Number of Stories I 8. Dimensions of entire new construction: Front ...... ,~.?...~ .................. Rear ...... ..~.....°...i ........... Depth ......~.....~. ............ Height ....~.~.f./..~.f.... Number of Stories .............. J ..................................................... ~ ................................................ 9. Size of lot: Front ..... /...f?.-...°...:.;......,,..R~.ar ........... ~/...~...~.,e..~..'. ...... Depth .....~..~.,..o...~. .............. 10. Date of Purchase ........... ~..../....7./?.~..~i .......................... Nome of Former Owner ~./.I/../..~...~....~......~....//~. ~..Y..~'.../~.J~$.(~/ 11. Zone or use district in which premises are situated ....~7......~...~.~....?.. .................... ,.....~.., ........................................ 12. Does proposed construction violo~te any zoning law, ordinance or regulation? ...~...~...'~.....~.. ................................ 13. Name of Owner of premises .~..~ff...~....~.....~..a./.~..r?.~.~...~....Address ...~/...~'~/,~......°.P..P...'~...~.~'~t~hone No./~...~.....~...~..~''~ Name of Architect ...................... ~.~.~ ................. Address ............................................ Phone No ..................... Name of Contractor .................... ~.~.(.~....~'.. ................ Address Phone No ..................... PLOT DIAGPu~A 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 shaw street names and indicate whether interior or corner lot. C~A~e~ COUNTY OF ................... t . ~ Yl ................ ~.D~/~......~..;......~...O.~/~c~.~.~J.Z .......................... being duly swam, deposes and soys that he is the applicant (Name of individual signing applic, e, tLon) above named. He is the ..' ...............i ........ ~...~ ............................................................................................... (Contractor, agent, corporate officer, etc.) ~f ~ni_cl ~,-~r or o~-o,%-~qd ls duly authorized to perform or have performed the said work and to rnc~e and 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 foYch in the application filed therewith. SwOrn to befo~ me this ~ /t- /~ .............. .................. ................................ o oyof ~.. /'t.~ (S gnature of app cant} Noto Pub,c,. ...................................... ...... ' ' ~W~o. ~-0~0~ ~.*. ~. ~ino. Co.., .. Commission Expires Mnrch 30, 1971 . THE NEW YORK BOAI D OF FIRE UNDERWRITERS B,W BUREAU OF' ELECTRICITY ~ 85 JOHN STREET, NEW YORK. NEW YORK 10038 THIS CE~IFIES THAT D~. ~ohn Wolleben~ n~ eorne~ Oak S~&Broadwa~e~a Rd.~ ~ehogue~ L.I. in thefoHowing ~et~n; ~ B~e~nt ~ l*t F]. ~ 2nd FL O~d~ ~ction BIlk m exami~ on AU~U$ ~ 1 $ 1 ~ 7 ~ andfo~ to be in compliance with the requirements of this RXTURE RXTURES ~NGES ~INO ~CKS OVENS DISH WA~ERS EXHAUST FANS OUTLETS Z~AC~S SWITCH~ N~E~ FL~E~E~ ~ ~T, K, W. MT, K.W. ~T. K.W, ~T, K.W. MT. H.P. SYSTSMS 1-~on AC Matt ltuck, L.I. / COPY FOR BUILDING DEPARTMENT. THIS COPY OF CER.,T;~FICATE ,MUST NOT BE A~TERED IN ANY MANNER.