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Home My WebLink About5033-zTov, rN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupancy No. ~1'~6~ ...... Date ............... ,1'~9'...1.~'..., 19 THIS CERTIFIES that the building located at .W~. fl~ .l~ .......... Street Map No .... ~ ....... Block No.. ~ ...... Lot No..~... $~th®l~... ]~.,.Y., ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... 0~t' · ~' ', 19. ~ pursuant to which Building Permit No.. dated ........... 0~t-- - -27- -, 19.70., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is . .l~r~,~l'.ate. ela. e. fa~t.].~..(I, woX].:L~I ...................................... The certificate is issued to .. Jaamil .Fx'~ak. · - ~ .............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..... JTI~S. 9, · 197. ·. 2.. BUILDING PERMIT i (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 5033 Z Permission is hereby granted to: ' . , ........... ,~3 ....... ~t~.~ ..................................... to ............ ~t4..1~.~...~1~t:~. 4~tI~.~:-....- ..--!~ ........... i:...~,. .................... : ................. at premises located at .......... .~,/~;.'~t~1..~..~,.~;.:~, ...... ii...~ ........ ~'.,*..-~i ...................................... pursuan¢ to application dated., .......... ~ ................ .~,~...,:;~,ii~.;,, i9., i~' and approved by the Building Inspector. ' , ~ $-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH TO WHOM IT MAY CONCERN: at Date '~.~C'~ ~ 7 Bldg. P~rmit No. The sewage disposal (give deed location) 7 o faciliti,~s for a structure located have been inspected by this department and fdund to be satisfactory. Chio£ of Oe~ora% E~gi2eering Services JIjNg Ig7'~ INSTRUCTIONS (~ This application must be completely filled in by typewriter or in ink und submitted in duplicate to the BuildingTT) Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premilal or public itmets or areas, and giving a detailed description of layeut of properly must be drown an the diagram whlch It pprt ef ~hJl application. c. The work covered by this application may not be commenced before issuance of Building Peemit. d. Upon approval of this application, the Building Inspector will Ir~ue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. 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 pureuont to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lav~, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, al herein dalcrlbed. The applicant agrees to comply with all applicable laws, ordinances, building code, housing cnde, and regulations. (Signature of applicant, or name, If a coq~mtlon) (Address of applicant) State whether applicant is owner, lessee, agent, arChitect, engineer° general contractor, electrician, plumber or builder. Name of owner of premises ...~T~.~..~.~a~LI[ .......................................... ............................................................................ 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. Mop No.: .......... ~3; ......................... tot No.: ..... Street and Number .......... W~.~...Pa~'.Q¥&..Roa~ ......... ~o~t;baa~d:~ ......... ?~,~ .......................................................... ~- .~e 0 ~ MunicipallY/ 2. State existing use and occupancy of premises and intended use and occupancy of propoeed cor4tru~tlon: Existing use and occupancy ....Ta~a~t;...'J. li,~l. ..................................................................................................... Intend~l use and occupan? .......Oll.~..l'l~.'l.'l~...rl~fe'l-l.&ll~ ............................................................................. 3. Nature of work (check which applicable): New Building ..~.....~. ....... Addition .................. Alteration ............. Repair .................. Remova~ .................. Demolition .................. Other Work (Describe) ..................................... 4. Estimated Cost ............. ~J~...QO0......~...1. ..................... Fee .....1.0,,~0." ...................................................................... (to be paid on fi~ing this application) 5. If dwelling, number of dwelling units ....~)~i3~ .................. Number of dwelling units on each floor .......................... If garage, number of cars ....2 ........ tmcl. e~. ................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, Jf 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 ........ ~,~ ....................... Rear ........... ..bra ............ Depth ...... ~.LI... ............. Height .................... Number of Stories ..O=e ............................................................................................................. 9. Size o~: lot: Front ...... ~F~ ................. Rear .............. 7~. ................. Depth ..... .1. J;).0 .................... 10. Date of Purchase ......... .1.~,6.~. ..................................... Name of Former Owner .~,.~,,~4¢G.~3~e ............................ 11. Zone or use district in which premises are situated #A,~ (~,I-~.~ . . . 12. Does proposed construction violate any zoning law, ordinance or regulation? ..... .t~. ................................................. ]3. Name of Owner of premises ~T&~$..~.;~&z'=il; ............. Address ....... ]~,~.o~;;kl~q3. .................. Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor 1~.~...~)~9. ................................ Address ....... ]~l~..t;.~.~.lz¢l~ ............... Phone No .................... PLOT DIAGRAM Locate clearly and distinctly oll 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 corner tot. STATE OF NEW YORK, te¢ COUNTY OF ..P'~.£c~ ............ ~'"'~' ........... ~.-..~ ................. ~Ta~ae~..~'.~ta~ ...................... : ............ being duty sworn, deposes and says that he is the applicant (Name of individual signing'application) above named. He is the ..................... (~Z~ ............................................................... ~' ....................................................... (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 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. Swam to before me this .................. ........ ..... :..:.:....,,.....?.o. ...... cou .f ....................... No. 52-8125850, Suffolk Cou~nty_ Term Expires Ml~h 30, 19,,~