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Home My WebLink About4800-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...E~/~..Bo.l. de~.A~ra ................................ Street Map No....31~ .............Block No .......... ~ ....... Lot No....31~ ......I~l~tltJJ~l~.....~.e.~.e. ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................................... ~13J~.,.,..~O ........ , 19..~). pursuant to which Building Permit No....~'.~.. dated ............................ .~TxIIJlB......~.0 ........ , 19...~.0, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate Js issued is ........ .......... l~.t~ata ..one...£a~L3.y...d¥~ l],Lu~ ...... .... The certificate is issued to ...~,f~'d....~~ ....... Ole'ZlO~. .................................................. (owner, lessee or terra, t) of the aforesaid building. ltov~e I~ Bui d~ng Insp//~tor FOEM 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? 800 Z Dote ................ ~ .............. .J~J .......... , 19...~Jl~J Permission is hereby granted to: ......... I~'t.. ~or~...&. JLt. W.. II~JeZtl. ln .......... ........... ~.~-,. n..A,~ ............................................ to ......... ~13.i ]~... e.~,,~.. D.~,.~.~..'k~ O'll. · I~J...~'$~,11 .t,..~ · .tIMI~, ~J~. .................................................... at premises located at .................... ]J~....]JG~Jell~..~,~ll ................................................................... ............................................ ~t~..l[eek~,....~"uJei~lgJ ....... li.!~, ........................................... pursuon¢ to application dated .......................... ~ ........ ~JJ~ ............ , 19...~l., and approved by the Building Inspector. Fee $.~.,.'9.~ .............. / Building inspector BUILDING* DEPARTMENT TOWN CLERK'S OFFICE ~OUTHOLD, N. ¥. "~,~f~O ~am,.~ ..... ~..!....°. ........ .,~.2..0. ,.__ __ ~ ~"~ · ~,,~,~.. ,.. .. ............. ...... ~.. A ~isopp~ ~/= ...................................................... ......................................................................................................... ~ .......................... ............ ........................ (Suildi~ . APPLICATION FOR BUILDING PE~i~ ~ ,~,~,o~' ~ .......... ~'"('P ............... *. Thi~ opplicotion mu~t b* completely {ill~ in by ~writer or in ink ~nd ~ubmi~ted in ~plic~t~ to th~ Buildiag In~ctor. b. ~lot plan ~howin~ I~tion of lot ~nd o{ buildinfl~ on premix**, relationship to ~d~oinino pmmi~ or ~re~*, ~nd ~vin~ a ~iled ~ri~i~ of I~ou~ o{ pm~ mu~t ~ dr~wn on th~ diagram which c. ~* Work cowred b~ thi* opplicotion ma~ not b~ corem*need b~fore i~uonc~ of Buildin~ ~rmit. ' d. Upon ~prowl o{ thi~ ~pplic~tion, t~ Buildln~ In~ctor will i*~u* ~ Buildin~ ~rmit to th~ opplic~nt. Such ~rmit ~h~ll b~ k~pt on the premi~*~ ~v~ilobl~ {or in~ction throuohout th~ pr~re~ o{ th~ work. ~. ~o buildin~ ~1 ~ ~cupi~d or u~d in whol* or in p~rt {or ~ny pu~os~ whatever until ~ ~holl hov~ been oront~d by th* Buildin~ In~p~tor. 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. ..................... ~-X~i~.;;;;..;;~..~-~.;ii~;;;;i.~ .................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... ~.~.~ ~ ...................................................................................................... If ~licant is'a co~omte, signature of duly authorized officer. (Name and title of corporate officer) ,. 1..Location of land on which proposed work will bedone. MapNo.: ................ .~: .........LotNo.:.~ ........ Street and Number ...~....~..~....--.....~..°..k~..~..YX.......~..~....~....t.......~....~....~....~...~L..°....~.~.i~i~_ 2. State existing use and occupanCy of premises and intended use and occupancy of proposed construction: o. Exstng use and occ"pancy ......~..~...~./ de ~ ~' ...~-~... . ntend~ use and occu "~'/'/~ ~ ~'~"~ C..~. '~'~'"~"~'i'"; ........ ,'"':"":" b. pa cy .~ ....... .':r. .............. "t ................................... :'"'='"~' .......... ;'~ ...... :'":'*': ......... 3. Nature of work (check which applicable): New Building .................. Addition ....../~.. .......... Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ............ ..._~....,....~......c~.......,~.. ...................... Fee ....~....~ ......................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ 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 ....... .~.~..: ............. Rear ........ ................Depth .....~...~...:. ...... Height ....... .,/..v~../. ...... Number of Stories .................. ./. ............................................................................................. Dimensions of same structure with alterations or additions: Front ............ .~.-.~.....~ ............ Rear ....... .5.].~].~ ......... Depth ~'-~ I Height ............................ Number of Stories ...........~. ................... 8. Dimensions of entire new construction: Front ............ /...~..~../. ................ Rear ........ ./..~.-..~. .......... Depth ......~'~...,,~X'.../. ........ Height ....../.'.~..~ ....... Number of Stories .............,/. ....................................................................................................... 9. Size of lot: Front ..... /.d...0. ............... Rear ........ /...o...o. .................... Depth ......... ./...~'...5..-...~ ........... 10. Date of Purchase ............../...?....'¢.~..~.. .......................... Name of Former Owner .....~...~...~....~..,.'~. ............................... 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ......... ..d/..°. .............................................. 13. Name of Owner of premises ...... /v,~..~...~...e...~./.~..~. ........... Address ./~..~./..~..~...~...~..~..~.,.~..~T..~..~c.~.HCnone No. ~..~..~..T...~...d...&..~ Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .'~..q..~t~....~....~.Jn~...~....~..,~ ............... ^ddress/.~.~l}.~../~...C..~{.]."' L2..~..°~...~... Phone No~.~.7..~..~'...~...~ 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 shoo street names and indicate whether interior or corner lot. ;q D^T, o , STATE OF NE'W(~OR~,,~.,,~// t ¢ c: COUNTY OF ....~-'..,~/.,?~t..'.~..,f-,.,-,-('X}. ' /7 ...............................(Name of-~'"'-~'~"~" .~.~..individual signing applicat~.,,,, .................... being duly sworn, deposes and says that he is the applicant above named· He is the .............................. ~~- ' ...... ~ ................. ~ ................ i ................................................ (C~.ntractor, 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 j~I the manner set forth in the application filed therewith. Sworn to before me this / I ................. da,, of ........ ............. . .... 4'7/...:., -/L,., . ,.nn .... ............................... Notary Public~..~,~Ir'~'~./..~ ...... Count~~ (Signore of applicant) · v ELIZABETH ANN N~VILLE NOTARY PUBLIC, State o! New york Co 52-8125850, Suffolk ~~tt~4 Term Expires March 30,