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Home My WebLink About4999-zTOWN OF SOUTHOLD BUH.i~ING DEPARTMI~N-T Town Clerk's Office Southold, N. Y. Certificnte Of Occupancy No.~ .1~..1.7. ....... Date .............. .0.c.~ .... 12 .... ,19. ?.~. THIS CERTIFIES that the building located at .. C~.eseent. ~.v.e ........... Street Map No...x~. ......... Block No .... ~ ..... Lot No....x~..F~[.s. hcr~..~[~z~hd ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ 0et .... 12 ..... , 1970. pursuant to which Building Permit No... dated ........... .0.e.t....~.~...., 19.~.0.., 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 l~.$va.t,a .one..Saintly. d~e~ ~[.~ng ........................................ The certificate is issued to J,. ~ez~,~. ~;a~.sons. ...... ~w~er ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...N.:~ ............................. l~OEl~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Yo BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NV 4999 Z Permission is hereby granted to: · .&~T.,~,~:~ u.....'..~-~ :+.+~.~.+..~ ...~o.. ~ r~...,~,, ..3,o-..s t ~ ~ P~' J~l~l .............. P~t:~z"~'"t's' '~ ................................ ..................... ~:-~y¥. ................................................ to .......... ~i:'~-'~' ~-~.~.~C'~'~ .('.~'-~ ~.~i,.~.~'~ ~.~-e3.~ ~.~ · · · at premises located at ............. ~.~..e(,~e~,.~..~:v~. ................................................................................. .................................................... ~'4 eJ'~e.~ ~..-~. e.:J:~r~ ........... 31.,,T.~ ..................................................... pursuan¢ to application dated ............................ Qe~ ......... .Jg .......... , 19...~.(~, and approved by the Building Inspector. Fee $..~,,/aO ............. Building Inspector/ FOBM NO, 1 TOWN OF soUTHOLD BUILDING DEPARTMENY ,: ~ TOWN CLERK'S OFFICE · SOUTHOLD, N, Y. Examined ~.)'C~. - F ,~ fi ~) , ,. ..................... ................. : ......... Application No...L.!.?..?..? ............. APPLICATION FOR BUILDING PERMIT Date ..iDc.tober...l~ ................................ , 19..~.Q ..... INSTRUCTIONS a. This application must be completely filled in by t~,pewriter ~r in ink und submitted irt 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 a detailed description of layout of property must be drown an the diagram which is part of this application. c. The work covered by this application may nat be commenced b,~fo~e 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 progcess of the work. e. No building shall be occupied or used in whole or in port for any pgrpose 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 pur,~uant 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 remove or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buil~ling code, housing code, and regulations. (Address of a~pllcant) State whether applicant is owner, lessee, agent, architect, enoin~r, generol contractor, electrician, plumber or builder. ......................................................... ................ ................. ......................................................... Name of owner of premises ....~..~...~..e.~%..e..%*...?.;%.~..~..°...~.E.,~....~...~..*. ................ i ........................................................................... ' If <rapid'ant is a corporate, s~gnature of duly authorized officer, .... .......... Vice (Name al~ title'of corporate officer) Pre sident Location of land on which proposed work will be done. Map No.; ..., .................................... Lot No.: ........................ Street and Number ............... .~.r...e.~.~...e..n..,t:.....A..v,.e...D:.~...e, ................ ~.~:[1~,1:1{S...~.3,,~,~...]~.~.~....~..o...~..~. ....................... Municipality State existing use and occupancy of premises and intended use and occupan~ of proposed construction: a. Existing use and occupancy ............ ;~.~;L.~g.~. ..................... i ........................................................................... b. Intended use and occupan::, . ........ ~.~.~..~..e...~.g~. ............................................................................... 3, Nature of walk (check which applicable): New Building .................. Addition .,.,~ ........... Alteration ' ~ Repair .................. Removal .................. Demolition .................. Other Work (Describe) ...................................... 4. Estimated Cost ...... $.'/.,.D. Q0...0.0. ................................ Fee .......~.~.~.0.Q ....................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...Dtle.; ............... 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 ............................ 7. Dimensions of existing structures, if any: Front ....~.0..~. ................. Rear ..... .'~.~..~ .................... Depth .....5..0...~ .......... Height ),.~...0. .............. Number of Stories ............. .1..~ ............................................................................................... Dimensions of same structure with alterations or additions: Front ....... ~0.! ....................... Rear ..... .5.0?. ................ Depth ...... 5.Q.~. ................... Height ...... ~.~ .................. Number of Stories ..... .1..~ ...................... 8. Dimensions of entire new construction: Front ....~,.0..~. ......................... Rear .......~.0..e. .............. Depth .....~..6...~ .............. Height ...].4.! ........... Number of Stories ...... .'...QT).~ ..................................................................................................... 9. Size of Jot: Front .~.f~...~.~,~C~Reor .................................... Depth ................................ 10. Date of Purchase ........................................................Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ...... P~e~;J,~[ ..................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ........ ~O ............................................... 13. Name of Owner of premises ~T..~.,,...gaz:s~on~t~..A~'.~ddress ~L~ZleZ'.e..Ts/.atl~ .......... Phone No. ~.~J.-..'/.~.3.1~.. Name of Architect .......... ~Qr/~. .................................. Address ............................................ Phone No ..................... Name of Contractor .A.*.~.°...~..~.....G...~.~.a'...-G..9..~.~....C..°..~.~..~dress ~.:1:..~..~..e..~.B.....Z.~.~.~.~.~ .......... Phone No. 788-723]. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil 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 corner lot. STATE OF NEM/~Ot~,,4,./~, COUNTY OF ~],¢{¢9/,'~'/~....~.. ......... }'~"~' ................. ~~.~ ....................... being duly sworn, deposes and says that he is the applicant (Name of individba~ign~ above named. He is the ......'-t~.. ~.~.%..*~..~.~.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 of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn tq before me this .... ....... ...... ,,__°' ....... ................... ............... ......................., (Signature of Co~mission Expires Marc~ 30,