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Home My WebLink About4785-zFOR~[ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at JJJJJ..JJ~J.l:t..JJO&~, ....................................... Street Map No. ~W~J..HOIliJjock No ....................... Lot No. 'J.i~j. ......... 8.~.~t.~.~.~.d......~...~..,. .................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................................... ~JJJJ..3 ............ , 19...~/J~ pursuant to which Building Permit No..~..~..~.~.. .... dated ......................... iJ'~' ......... ~ ......... , 19....~/~ was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ The certificate is issued to ..W.,J.~..&..R~a..~J~.~It:JIJ ......... 0Ml~,e~'J .......................................... (owner, lessee or tenant) of the aforesaid building. House f~ 62tt00 FOP,~ NO. ~: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 4785 Z Permission is hereby granted to: .......... L~leJ~.Zr~a ....... (..M,Z.~.a,Z,... at premises located at .............. ~ .......................~/~ll..~ .............................................. .................................................. ~....~.,~..I~II ................. ~ ......... I~,I, .................... pursuant to application dated ............................. ~ ......... .~. ......... , 19..~....., and approved by the Building Inspector. Fee $. ~.,~,.~,..0~... .......... FO~ NO. I TOWN OF SOUTHOM) BUILDING DEPARTMEHTc TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ^..roved P. rm,t ...... Disapproved a/c ................................................ ......................... ......................... Application No ........................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in 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 praperty must be drawn on the diagram which is part of thie application. c. The work covered by this application may not be commenced before 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 progress of the work. e. No building shall be occupied or used in whole or in part 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 pursuant 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 removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. Id're.& Hez~an Leible~ (Signature of applicant, or name, if a corporation) ............. ~muth~d. ...... ]L.T. ................................................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... .o...~...~..~, ........................................... 0~meza ......................................................................................................... 91..Z.& H.X. ~eiblei~ ,Z Name of owner of premises ........ ..~....:..~....:....L~.(..~...~....L...?.~..~....~......~...~..~...:...~..(...~...-~. ..(~'~?~'.....-A~... ....................................... If applicant is o 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.: .......~.....1~.~....~....~..e..~.....~..,Liot No.: ........................ Street and Number ........... ~A~....~Ia.:LG..B~&IL ........... a~t~l~ ....... 11~. ......................................... 2. ~te e~Ing u~ and ~cu~n~ of premiss and intended use and ~cu~ncy of pr~os~ const~ction: b. I~ u~ ~ ~cu~ncy ..... ~..,.,,..,.... .............................................. , ............ e ~ ................ 3. Nature of work (check which applicable): New Build og ~ Addition .................. Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ...~...~..y...~....O....~........~...~..O..t~ ............. Fee ....... ]~lel~O ....................................................................... (to be paid on filing thi~ application) 5. If dwelling, number of dwelling units ...... .~...'....~):..~.... ...... Number of dwelling units on each floor ............................ If garage, number of cars ....................................................................................................................,~J~ ........... 6. If bus,ness, commercial or mixed occupancy, specify n?ture and extent of each type of use 7. Dimensions of existing structures, if any: Front: ..........[~' ~V (.,,'~1t/"/~-~'~'/~r ................................ DePth Height ........................ Number of Stories ........................................................................... Dimensions of same structure with a. lterations or additions: Front .................................... Rear ............................ Depth ................................ Height ......................... i..Number of Stories ................................ 40O ~JO0 Rear ~.~¢:~)100,.. /, ,~10~ 8. Dimensions of entire new construction: Front ............................................. ~..~,. ........... uepth .......v. ...... : ....... f Height ...~.1.~$ ..... Number of Stories ........... /~1~ ........................ j ....... j ................................................... 9. Size of lot: Front ......... .1,~0:~. ......... Rear .................................... Depth ..... ..~.~.+.. ................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ~ iA -%/. 8,~ C~,~.~ .......... nj}Il II, tlr, ...................... 12. Does proposed cOnstruct!o~ violate any zoning law, ordinance or regulation? ....~...Q. ............. ~ ............................. 13. Name of Owner of premises ....... Addre ..... ................... Pho,e No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .~1.131~1 ......................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all 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 lot. NOTARY PUBLIC, State of New York No. 52;8125850, Suffolk Cou~t'L Term Expires March 30, 19~_4~ STATE OF NEV~,,yORK COUNTY Of ....~.~.~JL:..'..J~'~' ..............................]~w~"':~be~m~..r..' ...................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ................ ;. . .. ;. .. . ..(~. ..................................... ~ ................. j ......................................................... (Contractor, agent, corporate officer, etc.) of said owner o~ owners, and is duly authorized to .perform or have performed the said work and to make and file th s appl cat on;"that a statements Containec~ 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