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Home My WebLink About5085-zFORM TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z~-)~2 .... Date ............. DzO. ~13 .... , 197.i. THIS CERTIFIES that the building located at .. Eas~woo~l. Dy &. ]~ol~len 4f~treet Map No..b~210 .. . Block No ........ Lot No.. 2~... C. uteh~gue...N,Y., ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... Dec 1 , 19 .70 pursuant to which Building Permit No...~08~ dated ....... Dec.. ~ .., 19 70, 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~iva-te,gwrage · (aec~essory- -~IClg)- ........................... The certificate is issued to . .~.~o~d..KO.b.e~ ...... .~.~e~ ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Eastwood Dr Building Inspectdr TOWN OF SOUTHOLD ,BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISF_.5 UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5085 Z Permission is hereby granted to: ............... .~.~,.*..~.L.,'~ ....... ~/.~.~.~:¥ ............ ........ .-...~... ......................................................... f....~. ........ .(...~:.,..~.....~..:~..,.~ ..... .~..e.r.~.~ ................................... .¢.~.r~..~..~.~.:. .............. pursuant to application dated ..................................... ,/. ...... ,.~...,.AT..~,.~.;,., 19.Z~.., and approved by the Building Inspector. .Fee $....~..~ ..... Building Inspector I- 0 I'rl Z llrO~i ' NO. I TOWN OIr SOUTHOLD BUILDING DEPARTMINT TOWN CLERK'S OFPIC! SOUTHOLD, N. Y. Approved / /"~'-- 19.ZqPermlt No. "~' ~'~ Disapproved o/c .................. ~ ................................... Application No ............................. (Building Inspector) APPLICATION FOR IUILDING PllLMrl ~u, .%. .................................. ....... , ,9 7o........ .... INSTRUCTIONS ..~ a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building ~ iml~.tor, c~ b. Plat plan Wing location of lot and of bu_lldingl on premlm, mlatlor~hlp to adjainl _r~ pmmile or I~lic Itreet$ or ~ area~, and giving a deealled descrlp¢lon of layout of property must be drawn on the diagram ~ b part of ~HM al~llcaflon. c. The work covered by this application may not be commenced before i~uance of Building Permit. ~ d. Upon approval of this application, the Building Inspector will I#ue a Building Permit to the applicant. Such permit x~ shall be kept on the premises available for inspection throughout the pragre~ of the work. e. No building shall be occuj~led or used In whole or in part for any purpose whatever until o Certificate of Occupancy-< shall have been grarrl~d by the Building Inspector. APPLICATION IS HEREBY MADEto the Building Department for the issuance of a Building Permit pumuant to the~'~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other al~llcable Lmm, Ordinancel or. Regulations, for the construction of buildings, acldltlons or alterations, or for removal or demolition, al heroin dmcrlbecl. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. / ~' (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. O / ...................................................... Nome of owner of premim ............................................................... If al~plicant is o corporate, signature of duly authorized officer. 1. Location of lend on which propo~ed work will be done, Map No.: ........... ..'~...,.c~,.,../.,..O. ............ l~' No.: .,..c~,...~... ............ 2.State existing use and occupancy of premises and intended use and occupancy of prapmed comtrtmtlon: o. Existing USe and occupancy .~....~.~.*~ ..~...~...~..~../..4. ~ .~.....~..,,~,:.L,..~.../, .~..~......~... ................ b. ,ntend. u,o,do cu on:, ........ ............ ...... 3. Nature of walk (check which applicable): New Building .............. Add,t,on .............. Alterahon . . Repair ................. Removal .................. Demolmon .................. Other Work (Describe) ........................ 4 Estimated Cost .................... f:~./....O....O....~.. ................... Fee .... ~...~ ...................................................... (to be pa~d on fi'.lng this application) 5 If dwelling, number of dwelhng umts ...........................Number of dwelhng umts on each flor ................ If garage, number of cars .................................................................................................................................... 6. If business, commercial or mtxeO ~cupancy, speci~ nature ~nd extent of each type of use ..................... 7 D~mens~ons of e>.~st,ng structures, if any: F~ont .......................... Rear ............................. Depth Height ....................... Number of Ston~ ........................................................................................ Dimensions of same structure with alterations or addmoqs' Front .................................. Rear ....... Depth ................................ Height .......................... Number of Stones .......................... ~.2 of~,~ ,~, ~o,~o,: ~o,t ........... ................. R,~ ...... ............. ~h .... ~ .. 8. Dimensions He,ght .....Z~'~ ..... Number of Stories ......................... .~.~ ............................ ~.~..~. 9. Size of lot' Front ........... .... Rear ............ ¢..~ ...... Depth ........................... 10 Date of Purchase ................ ~.~ ......... ~.~..Name of Former ~ner .... ~....~..~Z .................. 11. Zone ar use district in which premises are situated .................... ~....'~....~.~.~.~. ................................. 12 Does proposed construct,on ~olate any zoning law, ordinance or regulahon? ...... ~.-~ ........................ 13 Name of Owner of premises .~..~.~ ........ ~.~s .............. ~.~.~.~.~.~.~. Phon~.....~..~/ Name of Architect ................................................... Address ....................................... Phone No ............... Nome of Contractor .................................................... ~ress ......... .~.j.~.~.~.~.~ ..... Phone No ................ PLOT DIAG~M Locate clearly and d~stinctly all buddings, whether ex~st~ng or proposed, and red,cate ~11 set~ck d~mensions fro prope~ lines. Gwe street and b~ock numbe~ or de~cript~o~ccordmg to deed, and show street nom~ ond indico ................. ~.~..~ ................ ........... ~.~...~..~.~ ........... being duly sworn, d~oses and says that he ,s the appJica (Name of individual s~gnmg apphcat~on) above named. He ,s the ....................... ~.~.~.~.~.~Z~ .............................................................................................. -- (Contractor, agent, comorate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and fi this application; that all statements contained in th~s apphcation are true tha~ the work will be performed ~n the manner set fo~h in the apphcation filed ther~h.~/ Swam to before me th~s ~_ . / / / // .................. .... o, .............................. ~ ~ ~ ............... ~. ~.~ .................................................. Nato, Public,. ...................................................... ~Counh ~":~f-~Signature of applicant)