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Home My WebLink About4257-zFOI~I NO. 4 TOWN OF SOUTttOLD BUILDING DEPARTMENT Town CleriCs Office Southold, N. Y. Certificste Of Occupnncy No. Z..3676. .... Date ..............D. ed...~ ...... , 19. THIS CERTIFIES that the building located at .I~eaehwood..la ............ Street Map No..Sout;hwoO~ Block No ........... Lot No..~.~ ...... ~.O~.~.h.q~.d' . .E. :.Y,.: ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... Apr.f~l. · · .21 ·.., 19. -69 pursuant to which Building Permit No. ~2~. ~. Z. dated ........ Ap~'il...2~ .... , 19.6~)., was issued, and conforms to all of ihe require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .P~l.vate..or~. £amil.y..d~e. lling ....................................... The certificate is issued to ...A,[t,S~ ...... 0~r~e~. ............................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .... .N,~, ........................... Building Inspector [ House # 320 ~O~Jl~ NO. ~- TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLI:RK'$ OF;lCI: $OUTHOLD, No ¥. BUILDING PERMIT ('THIS PERMIT MUST BE KEPT ON THE PREMIS£S UNTIL FULL COMPLETION OF THE WORK ^UTHORIZED) N? ~257 Z Permission is hereby granted to: .... s/..e.~..s.....o::~..e. ~...~.......~,.,.T~.~Jm~ .................. at premises located ot ...,~g.~....~ ....... ~.(il~.~l~..~Ot~, ........................................................................... ......................................... ~.~......~.e. ~ .e.~ ..~....~..x~, ............ .~ ....................................... pursuant to application dated ........................... .A.~.~..~ ....... ~,~.; ....... , 19....~, and approved by the Building Inspector. ~e, ~;..~.'.~ ............. · - Boilding InspL=~f6T - ~'J Approved .................... ,19 .... Permit No. /-/*~ ~ ? ~ TOWN OF SOUTHOLD' '! / BUILDING DI~PARTM~:~T~ l ~ ~,,/~/~ vows x's ovw ff ..... Disapproved a/c ....... ~ ............. ]AISTRUcr~ONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspectxyr. b. Plot plan showing location of lot and of buildings o n premises, relatkmship to adjoining premises or public streets or area~, and giving a detailed description of lay out of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not b e commenced before issuance of Building Permit. fl. Upon approval of this application, the Building In specter will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspectima throughout the progress of the work. e. No building shall be occupied or used in whole c~ in part f~r any purpose whatever until a Certificate of Occupancy shall have been grarrted by the Building Inspecl~r. APPLICATION IS ldr~Y MADE to the Building Department for the issuance of a Building Permit pursuant bo the Building Zone Ordinance of the Town of S~athold, Suffolk Ommty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of build ings, additions or alterations, or for removal or demo- lition, as herein described. The applicant agrees to corn ply with all applicable laws, ordinances, budding code, housing code, and regulations. Jess Ownes Greep. Dp~ ' (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ................... ¢ontrao to~ ................................................................... Name .of owner of premises ...... ~,~,~all~ ............................................................. If applicant is a corporate, signature of duly authorize d officer. (Name and title of corporate officer) 1. Location of land on which proposed work will b e done. M.ap No.. ~.oll:~a%ro~d... Lot No...1 ~. ........ Street and Num~er . .~. · .0. .... Beachhead. La ..... Sollthold .... It.Y .............................. Municipality 2. State existing use and occupancy of premises an d intended use and occupancy of proposed construction. a. Existing use and occupancy .... ~W~L].J~g ..................................................... b. Intended use .and ~ccupancy ...... Sa~ae..~it]~ .a. ~J.~;J.ola. ~. a~te~&t;LOla ....... , ............. 3. Nature of work (check which applicable): New Building ........ Addition . .:ICILY.. Alteration ~ .... Repair ......... Removal ........ Demolition ........ Other Work (Describe) ...................... 4. Estimated Cost . 3~0O0,.~. .................... Fee . ,~..00 .......................................... (to be paid on filing this application) 5. If dweiling, number of dwelling units ...0~... 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: Fr<mt .... 16 ........... Rear ....... 16 .... Depth ...18 ...... Height ............ Number of Stories ... ~ne ...................................................... 9. Size of lot: Front ................ Rear ............... Depth ............... 10. Date of Purchase ............................... Name of Former Owner ............................. 11. Zon~ or use district in which premises are situated ..... qA.~. .d.i~ ..................................... 12. Does proposed construction violate any ~oning law, ordinance or regulation? ... alO .................... 13. Name Of Ownerof premises ....A.~.R.,.S.$R~ ....... Address . J~OR~hO~.d .......... Phone No ............ Name of Architect ............................. -~ddress ...................... Phone No ............ Name of Contractor . .J.e..S.S....Og..~l~. ............. Address ...0~*.~Qr.~ ....... Phone No ............ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property Unes. Give s .%feet and block number or description acoording to deed, and show street names and indicate whether interior or corner lot. STAT~ OF NEW YORK, )S.S. COUNTY OF ~.u~.oM~ .... ) ................. ,Tess. l~el~, ....................... being duly sworn, deposes and says that he is the appli- (Name of individual signing application) cant above named. He is the .... ~.Olki;r&C.1;01'. .......................................................... (Oontraetor, agent, oorporate officer, etc.) of said owner or owners, and is .duJy authorized to perform or have perg~ed the said work and to make and file this application; that all statements oontained in this application ~ true to the best of his knowledge and belief; .and th.at the w~k will be performed in the mann er set fortl~ in the application filed therewith. Sworn to before me this Notary of No. 52-8125850, Suffolk C0un_t]~ .Term Expires ~arch 30,