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Home My WebLink About4620-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No ~5B,~.8 ................ Date ....................... ~.1~.~.....1.0 .............. , 19.7.0.... THIS CERTIFIES that the building located at ...~/~. ~.~],~...~.ft~.~.~...~.q~.....~., ............... Street Map No ....... ~1~ ........... Block No ......~,~ ............ Lot No ...... = ......... J, Le, t.~i.~ttCk.....~{4[~ ............ conforms substantially to the Apphcahon for Building Permit heretofore filed in this office dated .......................... ~e~ ............ ~9 ............... , 19..~.O. pursuant to which Building Permit No..~.~,O~ ..... doted ................... ~ ......... .~ ............... , 19...~0, was issued, and conforms to all of the requirements of the applicable prows~ons of the law The occupancy for whmh this certificate is issued is ........ ..... ~.i.vaf~e..one...£~ ....l~r,..c~, g~ ............................................................................................. The certificate is issued to .........l:..'[G~d....t~..i.'J-t,o~ ............... 0~.~l¢.]P ................................................ (owner, lessee or ten~t~t) of the aforesaid building. Gz'oup house # lt+O0 ...... ,.~..~ ..................................... .~. ........................... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NY 4620 Z Permission Is hereby granted to: at premiss I~ated at ' pursua~ to application ~t~ / ~ .. F~ ]~ 7~ and approv~ by the Building Inspector. J:ee $ ........................ Building Inspector FORM NO. I TOWN OF SOUTHOLD BUILDING DEPART/V~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined 7o Applicahon No ~d'~. ~. ....... ~ Disapproved a/c ...... ~............--..................................... .............. ............................................................ ........ .............. (Budding Inspector) APPLICATION FOR BUILDING PERMI'I' Date ........... INSTRUCTIONS a This apphcat~on must be completely filled m by typewriter or mmk and submitted ~n duplicate to the Budding_ Inspector. b Plot plan showing location of lot and of buddings on premises, relat,onship to adjoining premises or pubhc streets o areas, and gMng a detailed description of layout of property must be drawn on the diagram which ~s part of this application c The work covered by th~s application may not be commenced before issuance of Budding Permit d Upon approval of this application, the Budding Inspector will issue a Budding Permit to the applicant. Such perm~ shall be kept on the premises available for inspection throughout the pragress of the work. e No building shall be occupied or used ,n whole or m part for any purpose whatever untd a Certificate of Occupanc, shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building Department for the ~ssuonce of a Budding Permit pursuant to th~ Budd:ng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other opphcoble Laws, Ordinances o Regulations, for the construction of buddings, ad&tions or alterations, or for removal or demolition, as harem described The opphcant agrees to comply with all applicable lows, ordinances, budding code housing code, and regulations - (Signatt~re of apphcant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budder ................ ...................... YD /4 3/v//L N' Name of of owner premises 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 ................ ~.z~/! /- ~'- .~. ..... ...~...~..~..?...~. ....... ..~. ~..~...~. .......... ~. //}. .?'/. ................. Mumc~pality / ' 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction a Existing use and occupancy ........... ..~..~'../~.T..~...L. ........ ..~....~...'~..~. ~:/--~' "~ b Intended use and occupancy 5~/~/'~/'"- ////'/ ~ ,~ ~)/)/ t-1~/~7 q x~. ~xlature of work (check which applicable) New Budding ................. Addition .... . ..Z;~.. Alteration .......... Repair .................. Removal .................Demohtion ................. Other Work (Describe) ............................... ................ ~... ~..,,~.~=... ....................................................... 4 Estimated Cost ............................. .~...3~6~...1~. .............. Fee ~' ~' (tc,-b'e pa~d on filing thru apphcation) 5 If dwelhng, number of dwelhng units ........ ~r~A~'.£,.'T.....Number of dwelhng umts on each floor ........................... If garage, number of cars ............................................................................................................................................ 6. If business, commercial or m~xed occupancy, specify nature and extent of each type of use ....................... 7 Dimensions of existing structures, if any' Front ............. X"~. ...... Rear ......... 7" '~ ............... Depth ....~.2..~ ...... Height ........................ Number of Stones .......................... : ....................................................................... : ........ D~mens~ons of same structure with alterations or addmons Front .................................. Rear ..................... Depth ................................ Height ....................... Number of Stones ........................ 8 D~mensions of entire new construction' Front ....................... '/'C ....... Rear .............. ~ ......... Depth ...../..~ Height .................... Number of Stories ............................................................................................ 9. S~ze of lot: Front ............................ Rear ......................... Depth ................. 10 Date of Purchase ....................................................... Name of Former Owner ..................................................... 11. Zone or use d~strict in which premises are situated .............. ~ ............... ',~'~.~v.-~.¥z-.~?.'~.y)~.~:z ............... 12 Does proposed construction violate any zoning law, ordinance or regulation:) ................................................... 13 Name of Owner of premises .y_. ...... '/-l'~"~"~'~.z..'~.~-/,'/Address ',l.~t ........ 'z':'z~.*/''z:. ........... I~"~'No..~.J....5.~. ..... Name of Architect .............................................. Address .......... ..~.~..~....-~/../....~.X-.~../.~:... Phone No ................. Name of Contractor ............. ~'~"~'Z~ ............. Address .............................. Phone No . PLOT DIAGRAM Locate clearly and d~st~nctly all buddings, whether ex~stmg or proposed, and ind,cate all set-back d~mens~ons flor property hnes. Gwe street and block number or descnpt~on according to deed, and show street names and ind~cat whether interior or corner lot. '""'-. g'/ 4oN STATE OF NE~)YOJ?,J(, , / /'SS '~'"--'"'-- ~{2A ~ COUNTY OF~ ........... I ' ' ~ above named He ~s the ............................ ~q.~..~.F.~...~. ............................................................................................... (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and is duly authorized to perform or have performed the said work and to ~ke and fH this application; that all statements contained m th~s apphcation are true to the best of his knowledge and behef; ar that the work will be performed m the manner set forth m the application filed therewith Sworn to before me this ................. y~ day of ...................... ~..~.;~.., 19~e ~ ~' ,/ ~ ~~ Notary Pub,,c ~ , [, Count .......... ": ,:,"~',:;L~'"'~'~'~'~r~,'g~'"Z'~"~'~ ..... ~~ ~ "/~~ No 52-8125850, Suffolk Cot~ ~ Term Expires March 30, ~9~