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Home My WebLink About4898-zFOIt~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERKS OFFICE SOUTHOLD, N.Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ..... ~ll~l~'..l.S...]~a, ........................................ Street Map NoP.~.~.,.....~ ..... Block No ....................... Lot No....8 .............. ~.ft.~.~.~ ....... ..~..*..~...*. ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................................. ,1~......~2....., 19.~.0.. pursuant to which Building Permit No...~...8.~...8~..... dated ................................... ~,~ ........ .~J~., 19...~.0., 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 ........ ......... la.~./.v~.te · · {ia~&e .............. . ......................................................................................................... The certificate is issued to ..~,,~],UI~....Me..I~t1~t.~e .......... ~e~. .............................................. (owner, lessee or ter~nt) of the aforesaid building. House ~ 87~ FORM NO. 2 TOWN OF $OOTHOLO BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Iq. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISI~S UNTIL EULL COMPLETION OF THE WORK AUTHORIZED) 4898 Z Permission is hereby granted to: ........... ZC..Z./...~...m/ .¥ ~ ......... ~ /.......~..~.~t~...~...~- to ~,~ ~ ~ ~r..~.~..~.~.~ ........ ~:,:~.~:4~..~.~:: ........................................... at premises located at ................................. ~?.?'.~ ...... ~;!.{~..i~..~.:~C.,~ ........... ~.J.~,L'; ....................... ........................................................................... ~/5..~c~.~.~ e~_., ,~,..Y. .................... ~ . :~ i.'/~- 19.~*~,~.., and approved by the pursuan¢ to application dated ................................. ~'~ . .. ¥. ' ,., Building Inspector. Fee $ ........................ Building Inspector Examined ................. ./...~.. ............... ,19 ........ ^ roved ....... : ........... r...'./. .......... ....... Disapproved a/c ..~...........~.......~ .... " (Building Inspector) /OBi(NO, ~N OF SOUTHOLD TOWN CLERK'S ~TH~, N. Y. APPLICATION FOR BUILDING PERMIT ~ ~t.....Zg,...~..-...~..e.~..~ ................. ,9...~..o...~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted tn duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving o deeailed description of layout of property must be drawn on the diagram whlch Is part of ~hle 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 inspection throughout the pragre~ of the work. ' e. No building shall be occupied or used In whole or In part for any purpese whatever until a Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to 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 applicable Lawi~ 0rdlnance~ or Regulations, for the construction of buildings, additions or al!erotion% or for removal or demolition, ee herein described. The applicant agrees to comply with all apl~licable laws, ordinance% building code, hou~lng code, and ragulatlonl. (Signature of applicant, or name, If a corporation) ............................................~ ?~-//~a/~,~ ...'.x,~,'.~...~..5..o...-.:i.%:..5:....,, ~,- , 5, (Address of aapllcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 65) ~V'e- r~ ............................................... Name of owner of premises ...~/.~..~.....~..~.~.....~.L...~.~-...`~.....~.....`~......`~...~7-....7.-..~``~.. ..................................................... 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.: Street and Number ~"~'~"- N~--/L/R ~/~ ~Z..~,/~:' ,,~'c~/t..' Municipality 2. ~tote existing use and occupancy of premises and intended use and occupancy of prapesed construction: a. Existing use and occupancy .................................. .~..., . . / .............................. b. Intended use and occupan:-, . .......................................... F .................. ~..~, ................... 3 Nature of wo~k {check which applicable): New Budding ................. Addition .... ~ ....... Alteration ............. :epo~r ......... ~R, emova! ................. Demolition ........... ~ ..... Other Work (Describe) ...................... (to be paid on fi:lng this application) 5. I~ dwelling, number of dwelling umts ........................... Number of dwelling units on each flor ............................ If garage, number of cars .....~.~..~ ...... ~2 ...................................................................................................... 6. If business, commercial or mixed ~cugancy, speci~ nature and extent of each ~De of use 7. D,mens,ons of existing s~ructures, f any: Front......~. ............. Rear ...Z.~. ...................... Depth ..~.~..( ...... Height ..Z.~.~ .......... Number of Stori~ ....... / ........................................................................................................ Dimensions of same structure with alterations or additions: Front .... ~.~..~ ........... Rear ..... ~.~...( .......... Depth ..... ~..~ ............ Height ........ /.~..( ........ Number of Stories ........ Z ..................... 8. Dimensions of entiru new construction: Front ....... ~.~.~ ................ Rear....~.~.~ .............. D~th ...~..&..~. ....... Height ...~.~. ..... Number of Stories ................. ~. ................................................................................................. 9. Size of lot: Front ...Z~..~.~..~..~ Rear ...... Z~..~....~ ........... Depth ....... Z.Z~...~ ......... ~0. D~t~ of P,~h~s~ /.~ ~ZE.,...,.Z.~.2~ ........ Nome of For~r 11. Zone or use district in ~hich premises are situated ................. ~. ............................................................................. 12. Does proposed construction ~iol~te any zoning law, ordinance . . _ _ _ ................................. : ............. :....:....~ 13. Name of ~eer of prem:ses ~.-~.~.~.~..~.x.~.~~C~.~Z.~.~ ~o. Name of Architect ...................................................... A~ress ............................................Phone No .................... Name of Contractor .................................................... A~ress ............................................Phone No .................... PLOT DIAGRAM Locate cleorly ond distinctly all buildings, whether existing or proposed, ond indicate all set-back dimensians from property lines. Give street and block, number or description according to deed, and sba, street names and indica?e whether ;nterior or corner Jot. ~¢~p q gl ~TATE OF N~ YORK, ISS ~OUN~ OF ................................ ~" (Name of individual signing application) above named. He is t~e ................................................................................................ ..................................... (Contractor, agent, co,orate officer, ~tc.) of said owner or owners, and is duly authorized to per~orm or have performed the said work and to ~ke and fil~ this application; that alt statements contained in t~is application are true to t~e best o¢ ~is ~nowledge and bel that tko work will be performed in the manner s~t fo~h in f~e application filed t~r~with. Swam to before me this ~ _ ~o. 52'8125850, ~uffolk Coo