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Home My WebLink About4885-zFOEM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...... Map No ........... .~. ......... Block No. ~' Lot No. ~ ~?..~ ~'~'~ ~ ..,,~......~.. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................. ~ ........ ...~.. ......... ,19 70 pursuant to which Building Permit No. dated .......................... :.) ........................... , 19 ......... was issued, and conforms to all of the requirements of the a_~olicable provisions of the law. The occupancy for which this certificate is issued is ........ ..~.~...-_~., ...... ~...-~..~ ....................... t ......... C~' ...... ~ ......................... ~ ........... ......... rtfficate is issued to ..,.(, J~'b'.-,~,'"'~ ~1~.'~1' The certificate is issue o ............ ~' ......... :,: .................. r .......................................................... (owner, lessee or tenant) of the aforesaid building. Building Inspector FOI~[ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPbETION OF THE WORK AUTHORIZED) N9 4885 Z P~rrnission is hereby granted to: ........... ~.~,~.~..~ ......................... i ................ to pursuant to application dated ...................... ~..I~..~..~.' ....... '~"""'":',i-.., 19..~.:, ond approved by the Building Inspector. Fee $..~'.,..~.. ............ FOB~ NO. I 19..-~.....~. Examined Approved ........................................ , 19....!.~. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Permit No. /.`/% J ~' ~ Application No ............................ Disapproved ........................................................ ~ ... ~ a/c ............................................. ~.. ....................... ;g;i ................................. APPLICATION FOR BUILDING FERMI~' INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted Jr1 duplicate to the BuildingS. Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship t.o adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the d.agram which is part of this application.~. c. The work covered by this application may not be commenced bsfore issuance of Bulldi,g 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 wurk. e. No building shall be occupied or used in whole or in port 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 Building Permit puntuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ~.nd other applicable Laws, Ordinances or Regulations for the construction of buildings additions or alterations or for removal or demolition, as herein described.~, The applicant agrees to comply with all aaplicable laws, ordinances, building code, housing code, and ragu atlons. Helmut Hass (Signature cf applicant, or name, if a corporation) ............ S ou.t~o.l¢~ .................................................................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buJlder/-~ .................................... O~'~e.~:...-....hu:L~d.e.r. ........................................................................................................................ Name of owner of mr, mi,m, He]nut Hass ,. If applicant is a corporate, s~gnature of duly authorized officer. (Name and title 'of corporate officer) I. Location of land on which proposed work will be done. Map No.: ........... ~ ........................ Lot N ..o~.. ...................... Street and Number .... ..~/.i~..~;L0,~],e..~...[(~,2~.). ....... ~.~.q.~.D~.O. ....... ~.*..~...*. ................................................. Municipality 2, State existing use and occupancy of premises and intended use ,and occupancy of proposed construction: a. Existing use and occupancy ..~.v.,e..~.Z.,..l~.,~...&....b.,.u..s....lg...e...s,.s....~.l..Z.~./,~.s. ........................................................... b. Intended use and occu~,~an:', ~1~e~1~`~(~e~8~g~t~Z~~~ ..... 3 Nature of walk (check whicl~ applicable): New Building ................. Addition ................ Alteration ............. Repair ................. Remora! .................Demolition .................. Other Work (De, scribe) ................................. 4. Estimated Cost .........1.t250.,.. ............................... Fee ..~..~..0..0. ........................................................................ (to be paid on fi!lng this application) 5. If dwelling, number of dwelling umts ...,l~Pl:l~ ............... 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 .~.g.~.eS..~l:>~ ...... 7. Dimensions of exist!ng structures, if any: Front. ........................... Rear ........... ~ ................... Depth ................... Height ...................... Number of Stori~ ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ......................... Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... .~JL.-2 .................. Rear ...... .~(>,~. ............ Depth ..... ~..I-~l-. ........ Height ................... Number of Stories ....~zle ................................................................................... 9. Size of lot: Front ........ ~1:10 ............ r~ear ................................... Depth .......... ~0.1 ................ 10. Date of Purchase ........................................................ Name of Former Owner ....................................................... 1 1. Zone or use district in which premises are situated "~ ........ B.....clis.t ............................................................................ )2. Does proposed construction ~iolcte any zoning law, ordinance or regulation? ............... ~ ........................................ 13. Name of Owner of premises ....H........H..a....s..s. ..................... Address .....$.o...~..t..h...O..1...d: .................... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No .................... Name of Contractor .......... J~.~ ................................. Address ............................................ Phone No .................... PLOT DIAGRAM Locate clearly and distinctly oll buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give ~treet and bJock number or description according to deed, and show street names and indicate whether ~nterior or carnet Jot. STATE OF NEW YORK, JSS COUNTY OF ...~:13~f.O11r ............ ~' · · ..................................... · H~]rJ~t~.JJ~,~Jl ................................ being duly sworn, deposes and says that he is the appJicant (Name of individual signing application) above named. He is the ........................ ~.~....e..l~lL'LlrleZ': ................................. ...................................... (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 and file this application; that alt stoternents contained in this application are true to the best of his knowledge and bel el' and that the work will be performed in the manner set forth in the application filed therewith. Swam to before//~,.~_j~, ~;~'~:me this .............. ' ~.~-. ~ ................... of ............. ' Notar'/ Public,~,~,,;j~..,~.,.,.'.~,~. .... Cou,~tv~'~ (Signature of ~/ ELIZABETH ANN NEVILLE ~' NOTARY PUBLIC, State of New York No. 52-8125850, Suffolk County, Term Expires March 30, 19