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Home My WebLink About4889-z~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ~)~.108 ................ Dote .............................. ~T~,i~ ....... THIS CERTIFIES that the building located at .~.t~.~tl&..])~.It~ ................................. Street Map No.~.e...~l.~..J~l~l. Block No ....................... Lot No .........~.Jl, ......... O3~t,t..~aV. ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................................... · 1~ .......... ~1, ........ , 19.~1~. pursuant to which Building Permit No....~.~... dated ......................... ~ti~.....~1, ............... , 19...~., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ........... l'~l~te..~e..£ma~3,~'..4~ell~ ..................................................................................... The certificate is issued to ..~.t~I~II~J).~I(~B, II.t,I~D..J~..M~II.....g~R~B.~ .................................. (owner, lessee or teon~t) of the aforesaid building. ~oume f 170 Building Inspector FOI~I NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT i TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4889 Z Permission is hereby granted to: ; pursuar~ to application dated ........................ ~'~j~,~,...,l~..;...,.~,.., 19....~ ,and approved by the Building inspector. Buildin I~spector FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........................ , 19 ..... Approved ..................... '. ................ , " /'7/(~-~C- ~' 19 ........ Permit No ............................. Application No ............................ Disppproved a/c .............................................................. /\/ (Building In~tor) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. . b. Plot plan showing location of lot and of buildings on premises, re ationship 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 Buildin¢~ Inspector will issue a Bud ng Permit to the aonlicant Such n~rmit shall be kept on the premises available for ir~oection throughout the progress of the work. rr · r- e. No building shall 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 MADE to the Building Deportment 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 herein descr bed The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. (Signature~f applicant, or name, if a corporatior~')' "' (Address of applicant) State wheth~~er, lessee, agent, architect, engi'neer, 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 work2Kill be don~. J~Aap No.: ....................... Lot No ' ' "'" ...................... Street and Number ..... ...~..~ ....... !~.......~...~ ......................... ..~...~.~..~..,..... MuniciPality 2. State existfng use and occuPancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ~.! .............................................................................................................. b. Intended use and occupancy ...... ~ .......................................... ~ ................................................................ 3. Nature of work (check which applicable): New Building .................. Addition .....~ ....... Alteration ........... : ...... Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ...b.~....~....~.l...~...~.. ............................... Fee .......................................................................................... (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 ............................ Z.C..Y...':. 7. Dimensions of exiSting structures, if any: Front ...... ....... Rear ................. Depth~....~...'.~'...:.' .... Height .....,~....~..../ .......... Number of Stories ...... /. ......................................................................................................... · " 2~ '~" Dimensions of same structure with alterations or additions: Front ...... .~....~.....~... .............. Rear ............................ Depth ..... .~.?..;.~..'.; .......... Height ..... ~....O...'. .............. Number of Stor~es ....!. ......................... 8. Dimensions of entire new construction: Front ........... .~.. ..................... Rear ....... ~ ................. Depth ....'./../.. ............... Height / ~ * .................... Number of Stories ........... ~. ......................................................................................................... 9. S~ze of ~ot: Front ..... /....7...~.:;..~. Rear ..... ./..Z.~.:...~...4.. ....... Depth ...... (..~.~..~ ......... , 10. Date of Purchase ........................................................ Na.m~,,~of,~ Former Owner ..'~...~ .~.....~....*.~., 11. Zone or usedstrct nwhch premsesarestuated ~; .................................... 12.Does proposed construction violate~ ,~0~,- ,,~/~any zoning law, ordinance or re~u~~ ......................................................... Name of Owner of premises ............................................ Phone No ..................... Nome of Archit~:t .................................. .~ ................ Address ................... ~ ...................... Phone No ..................... Nome of ......... ^ ress .................................... Phane PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all setJoack dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether i,nterior or corner lot. STATE OF NEW_YORK. t S.S COUNTY ,OF .....~'..~..~...~'.~.Z.~.. ........ ~ · .................... i..~,~.~;'.......~....~.~../',['..~,~../~. ........................ '.'.:.:,;.:being duly'sworn, dePoses and says that he is the applicant (Name of individual signing application) above named. He is the ............................................... .~.~...L.Z..~...~...~. ..................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have berfofmed the said work and to meke 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 manne~ set forth in the applJcaHon/filed therewith. .S..w..°..I.n.~.t..Q..7.b.~....f°.r.7 dmaeyt~;s .......... .~..../-/...~. ........................ , 19...7...~.....~...~ o,o r ,, ,, u ,, , , , . . . ?. . ; . ; : ' ; i ; , " " ........................... No. 52-7267800 Suffolk Count~ Term Explr~ March 30,