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Home My WebLink About4984-zFORM NO. 4 TOWN 017 SOUTHOLD' BUILDING DEPA.R~. MENT Town Clerk's Office Southold, N. Y. Certificate O cupancy No. Z~063 ...... Date, ............. Apl'~l..& ..... , 19. ~'.3 THIS CERTIFIES that the building located at . ~/8. l~$n. P, oad ........... Street Map No.. ~ ........ Block No .... w,z .... Lot 1~o]~ ...m. · .0r~.ent · · N.,Y, .......... conforms substantially to the Application for Buildidg Permit heretofore filed in thiS office dated ............ 0c.t;.. · .~., 19.70. pursuant to which Building Permit No. dated ........... 0ct;... ~ .... , 19.70, was issued, and conforms to ail of the require- ments of the applicable provisions of the law. T~e occupancy for which this certificate is issued is . .. Aariaultural. bu/ldSn$... (p~tate..storage) ..................... The certificate is issued to .HsKo~emar..est. ~ .~ona .... Owner ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approva~ ....... N,Iko. ........................ UNDERWRITERS CERTIFICATE No ...... NeR.~ 'i ...................................... HOUSE NUMBER.. ~(~. .... Street... Ma..:I~IRO~ .................................... Building Inspector FOl~I NO. ~ TOWN OF sOuTHOLD ! BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT 6N THE PREMISE~S UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? zl§8z] Z V~e ............ ~ ...... ~te~z, ......... .~ ....... , ~...:?o Permission 'is hereby granted to: pursuan,t to application dated ........................ ~.1~, ......... .~ .......... ...... Building Inspector. }=ee $...~(~ ........... 19~...~'~ and approved by the Building' IhSpector · row o, sou'moLD BUILDIHG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOU), N. Y. Approved ........................................ , 19 ........ Permit. . ..................... Disapproved a/c ............................................................ APPLICATION FOR BUILDING FERMrT ' . k.~~- INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building~' Inspector.onth~diagn~n Ml]d~ I~ pair M~Jla~aa~'~(" ~! b. Plot plan showing location of lot and of buildings on premises, mlationshil~ to adialnina ~)remi#l arm areas, and giving a detailed description of layout of proparty must be drown 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 Issue a Building Permit to the al~lcaM Such permit shall be kept on the premises available for inspection throughout the progrm of the work. e. No building shall be occupied or used in Whole or in port for any purpese-Whotev~r until a Certificate of Occupancy shall have been granted by the Building Inspector. RB .A,~P. PLI~CATION !S. HEREBY MADE tothe Building Department for~ the issuance of a Building Permit punment to the ~ uilaln~.' z. on~. u?. mance of ~ T,o~. of Southold, Suffolk Count, New Y, ork, and other al:)plic~:lble ~ OMtn~nc# o~ .~l~U a,,.om, tar me construction at buildings, additions or alterations, or tar removal or demolition, al herein d#crtbed · pppl,cant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulMImtl. It.l~.I)emarest & Sons (Signature cf applicant, or name, if a cM1)(mat1~n) ~ ......... 0~.im.~, ......................................................................... (A'~dreu of applicant) State Whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder;~ ............................................................ .............................................................................................. i.] Name of owner of premises 13sli- Denmtest & Sons If applicant Is a corporate, signature of duly authorized officer. (Name and title 'of corporate officer) I. Location of land on Which proposed work will be done. Map No.: ............. ~ .................... Lot No.: ...................... Street and Number ........ ~[~I.:JJ:I.,.~.CI~.~ ....... O~.l.e. IL~, ......... ~1.~.t ............................................................................... "-~..~ ~ ~ _~ .3 El 0 Municipality 2. State existing use and occupancy of premises and Intended use and occupancy of pmpaeed comtmctlon: a. Existing use and occupancy ......~g~..~..e,..,~..~...L~....~,~...~..I~.~..C];.~...~.~ ............................................................................ b. Intended use and occupanc,. ............. ~tI),me...~t.t:~..SJ~...~LCI. cI.~,~:LQI3. .................................................. 3~ Nature of wo[k (check which applicable): New Building ................. Addition ....,:~r,:... ......... Alteration ~ ..... Repair .................. Remova~ .................. Demolition .................. Other Work (Describe) .................................... .................. · 1.,o,~o..~.,: ...................... Fee .......... ~.... ~ ................................................................... 4. Estimated Cost (to be paid on fi!lng this application) 5. If dwelling, number of' dwelling units ...,1~3Z~ ..............Number of dwelling units on each floor ....................... ~f garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..~.g.?..~..~....t~....~...t~....e.. 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: Front ........... ~.6. ................... Rear ....... 36 ................ Depth ....J~ ............... Height .................... Number of Stories ......................... OD. el ...................................................................................... 9. Size o{: lot: Front ............................ Rear ................................... Depth ................................ 10. Date of Purchase ........................................................ Nome of Former Owner ....................................................... # II 11. Zone or use district in which premises are situated ...... ;....~.....~..~ ......................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation.;) ......... ~ .............................................. 13. Name of Owner of premises ..~...*..~...*.?..e....~....~.e.s..~.....~.....~.Address ..... .0Z't~D.~; ........................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No .................... Name of Contractor ...... ~ .................................... Address ............................................ Phone No .................... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer Jot. - · STATE OF NEW YORK, COUNTY OF .... ~I~'~3~, .......... ~ · ......................... ~ .......... ,~,~113,'Lffi..~J~ii~l,~'.~lffi.~, ......................... being duly sworn, deposes and says that he is the appJicant · · (Non~ of individual signing application) above namec~ He is the ............................ ]~..~.?..~e...~. ................................................... ~ ........................................................ (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 all statements contained in this application are true to the best ~ knowledge and belief; and tha~ the work witl be perfOrmed in the manner set forth in the application ~.iled ther~ewitl~. ~'~ Swam to before me this ,~_...~ ..................... ~. day of ........ ~...;...~qg.~ ............... . 19..~t~ ~ I__-~ f ~. '~ ./~ ~'~,~--c.~.../(......:.?-,.,-~-... ..... ~ ..... Natant Public~~Q/J~L~M~C,~. ...... Couq~.~ll~ (Signature of applicant) ~/ [LIZABETH IANN NEVILLE NOTARY PUBLIC, State of New Yerl~ Ne. ~2,11125~80, Suffolk Cogg~.~