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Home My WebLink About4597-zFO~I~ NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMI~.NT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ...$.ti],lWa~e~'. Av.~, i ...... Street Map No. ].280 Block No. XX .Lot No. ~ 88 ~l;ahog~ conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... J.~t,. 2t ...... , 19.~.. pursuant to which Building ]Permit No....~.~.~..~ d~ted ....... ~.~,2.! ......... , 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~..v.a~;$. 0~$. f~.~.Y..~e~,l~ .................................... The certificate is issued to ... ~.c~. B.o..{~1.~%11~ ..................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..... I~,IR., ........................... UNDERWRITERS CERTIFICATE No. PENDING HOUSE NUMBER ... 2.6.?~. ...... Street ...S.t;.i.l.~.W..a.l;.~.~...A.~..,. ..................... Building Inspector FOR~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE $OUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4597 Z Permission is hereby granted to: ............. :....~..e.~ ..~..~...~.t~ .............................. pursuczn~ to application dated ......................... ~...~.~l~t....~ .............. , 19...~, and approved by the Building Ihspector. TOWN OIr SOUTHOLD BUILDING D~ARTMEN'r TOWN CKARK"S OFFICE sOtrTHOLD, N. Y~ Examined ........... '..., 19 ........ ^pp~.~ ..~ ............... '.:~. .......... . ,,...7..~ Perm,t No....~Z.~.Z..~ Dimpproved a/c .............................................................................................. APPLICATION FOR BUILDING PEI~I~.,~. ~,.~.~ '~1 · ~'- Jg.~..~_.. ~'~' not. .......... ~..~..~ ............................ , ~ INSTRUCTIONS _-'1 a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building ~ Inspector. b. Plat 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 drawn on the diagram which is part of this application."i,~ c. The work covered by this application may not be commenced before issuance of Building Permit. d. ~aa-epp~wal of this application, the Building Inspector will Issue a Building Permit to the applicant. Such permit ~k~ll~ c~ the premises available for inspection throughout the progress of the work. · ~.~,,.Jge,t~dlng shall be occupied or used in whole or in part for any purpose whatever until a Certificate of c~,.- -- ' ~JJ~"&ll have been g~anted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pumuan'J"~to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and ather applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for ramoval or demolition, as herein described. The applicant c~jrees to comply with all applicable laws, ordinances, ~,~ode, ho~.~sing codA on~ ,reg, ulatlor//I. . ~ ' "'~i'~J~J~tu'~;~'~licont, or nam~i!o~'~l'~ ...... ~_ !' (Address of alSplicont) State wheth*r applicant is o~ner, I~0 ag~'fl', aKhlt~', ~'m~r, ~'~r~l contractor, el~ctriclon, plumier or builder. If applicant is a corporate, sigr~(ure///of duly authorized officer. ' ........................................... (Name and title of corporate officer) 1. Location of land on which/~ropasll~[ work will be done. Map No.: ..../..~...~...~.. .................. Lot No.: .~g~... ........... ~'~ f ~ c~ ~ 7~-- Manicipq~(y 2. State existing use and occupancy of premises and Intended use and occupancy of proposed ¢omtm~lon: i .....~u~- a. ......... , .................. ....... ............................ b. ~nmeed u-- and o~up~-y ...... ...~-=~.,..,...~.~.,....~.,.'.,..:....,~_.:~"'~ Ul/°'~'-~- ........................................ .. t. 3. Nature of work (check which applicable): New Bu Iding ~ ................. Addition .................. Alterotion .................. Repair .................. -.~ A,~~em°val ...; .............. Demolitior.; ...... ; ........ r~ Other Work (Describe) ........................................ 4. timated ca .... ............. ........................................................................... (to be paid on filing this application) 5. If dwelling humber of dwelling units ......... ~ ........ Number of dwelling units on each floor ............................ If garage, number of cors ........................... ; ............................................................................................... ;.~ ............. ~. If business, commercial or mixed occupancy, speci~ nature and extent o_f ~a/ch type of use ......~../~.: ........ 7. Dimensions of e~isting structures, if any: Front ....~,, .................... Rear ..... ~.~. ................. Depth .............. ~ ..... Height ..L~Number of Stories ........ .(. ........................................ ......;...). .............................. .~.. ....... 7 ...... " Dimensions of same structure with alterations or additions: Front ............ ~.~:~:...~./ ......... Rear ...... ~,~. ............ Depth ..... ~ ...................Height ...~..~...~...~.~. ....... Number of Stories ........ ../....'./.~. .......... 8. Dimensions of entire new construction: Front .................................. Rear ............................ Depth ........................ Height .................... .--____~ · ,,Number of Stories ...................................................................................................................... 9. Size of lot: Front .....~..A./~l.~...../-~br ..~..~.1.~ ................. Depth ................................ 10. Date of Purchase ......... ;...~...~.ZI~ ................................ Nome~.~er C~,e~r i~..~...~ ...................................... 11. Zone or use district in which premises are situated ............ ./~.~.../.J..: ............. /~..d~. ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation.;) ...... .~.....~.. ......................................... 13. Name of Owner of prernises-~'.....O...~/..,~ .~......C~...~....(.~.[.~..(~.~Acldress----~'~ --" ----'~ .,~..~../..~,~....~....~...~.~..~..~ 'P~ hTo~ ..'".'"'"".'"" Name of Architect ................. · .~...L....-~... ...................... Address ............................................ Phone No ..................... Name of Contractor ................. ~..l...~.. ..................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicat~:all set-back dimensions from property lines. Give street and block number or description according to deed, and sh°w street names and indicate · ~ether t~terior or corner lot. STATE OF NB/O01~. ~.~_ cOU.TY o~ .~= ......~'"' n ........... ~ ....... ~.;....Z~.C....~~.....~ing duly swam, d~s and s~s t~ he is t~ applicant (~f i~i~d~J sign~J,E~ __ a~ve named.~e is the ............... ~..~...~ ..................................................................................................................... (~tmctor, ~t, co~r~e officer, ~c.) of said ~ner or owners, and is duly a~horized to pe~orm or h~e pe~orm~ the ~ work a~ to ~e ~ file · s a~ati0n; that all Statements confoin~ in this applic~ion am tree t0 the be~ of his ~l~ge a~ belief; and that the~rk will ~ performe~ in the manor ~ foffh in the ~plJc~i~ ~ ~r~i~. Swam to ~om me this I 1 0 // ' ~ ' ............... ..... ........ ........ .................... N~a~ _ T~rm Ex~res~rch 30,