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Home My WebLink About4802-zFOKM NO, 4 TOWN OF $OUTHOLD! BUILDING DEPARTMENT TOWN GLERK'S OFFIGE $OUTHOLD, N.Y. CERTIFICATE OF OCCUPANCY No. ~'3.98~ ................ Date .......... : ......... ~LlaLa.t; ......... ~.~, ........... , 19_.~7Ct THIS CERTIFIES that the building located at .{~./~.....0.].4]i..~.J~..R~{,~ ....................... Street Map No....;Iii .............. Block No...]r~ ............... Lot No. ~..! ...... ~;OB~O'I~ ......... .}L~.~'~ ............... conforms substantially to the Application for Building Permit:heretofore filed in this office dated .................................... ~.tiiq. e......~j.2 ........... , 19..,~0.. pursuant tolwhich Building Permit No......~0~ dated ............................... ~1~1e ........ :J~..., 19...~,0, was issued, and conforms to all of the requirements of the applicable provisions of the iow. The occupancy for which this certificate is issued is ........ ......... f~iva~e...§a~.'age'"'"(A~'O'e ~.o:~... ~:l.~g) ................ ............................................................ The certificate is issued to ..... {~...~.~.m/OJ~J{ ............... OWY/~. ............................................................ (owner, lessee or tenant) of the aforesaid building. House # I+,O00 Building I~/~ector FORWl NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENI~ TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT fi.HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 802 z Permission is hereby granted to: .............. ~uek ............................................ to ..... I~u;t,;L([. ~e~...p z~&~a[e...t~a~e ................................ t .......................................................... at premises located ct ........................ ~./43-..-.fA~O.-.J~o~.tb.-]~ ...................................................... ................................................ ~=the~d. ......... ~-..~, .......................................................................... pursuon~t to application doted ............................. ~.'~/~. ......... -$~'b"", 19....~0, and approved by the Building Inspector. Fee $....~.,0~ .......... IPOB~ NO. I 'TOWN OF soUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........~ ( ~ 19 ~ O Approved ..................... '..! ................ , 19..~..!... Permit No.....~.....~....~....~...~ Disapproved a/c ............................................................ ~ APPLICATION FOR BUILDING PERMI'r Date ~T~u~.e 1~ 19 70 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und 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 property must be drawn on the diagram wl'dch is part of this 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 wurk. 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, hous!ng code, and regulations. (Signature cf applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....A,~...8~.~L.~..eIZ'JI ....................................................................................................................... If applicant is a corporate, s!gnoture 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 .............. ..~..~....g.~....~..9..~..~..~...~.O..~...~. ......... ..~..O...G..~...~..O...~..~. ....... ..~.....~...*. ............................................. /'/~ O~ ~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ...... C~e~,~-~J~ .......................................................................................................... b. Intended use and occupant, .............. me..~j.l~..pT:Lva~e...gaz~e ......................................................... 3. Nature of work (check whici~ applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Remova~ .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .........~..~..~.......O...O....._~.... ........................... Fee ~' (to be paid on fi!ing 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 ..; ..................... 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 ............ L.~. ................. Rear ....... /..~. ............... Depth )'- ~ Height Number of Stories ~ 9. Size of lot: Front ............................ Rear .................................... Depth ................................ ]0. Dote of Purchase ........................................................ Name of Former Owner ........................................................ ] ]. Zone or use district in which premises are situated Ax.~l .......... , ............ 12. Does proposed construction violate any zoning low, ordinance or regu at on? . ]3. Name of Owner of premises .~...~ ............ Address ~ ........................... Phone No ..................... Nome of Architect ...................................................... Address .............. Phone No ..................... Name of Contractor ......... ~ ........... Address ....... Phone No ..................... PLOT DIAG.O, AhA Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and b~ock number or description according to deed, and show street names and indica~'e whether interior or corner lot. STATE OF m~ YORK, lee COUN~ OF ................................ ~'~' ................................................................................................. being duly sworn, d~oses and says t~* he is the applican (Name of individual~igping ~pplication). ' ' obove n~med. He is the .............................................. . (Contractor, ag~t, co~orote officer, etc.) of said owner or owners, end is duly authorized to perform or hove performed the said work and to ~ke and file this applicotion; that all stoternents contained in this application ar~ t~e to the best of his knowledge and belief; and that tee work will be Performed in the manner set fo~h in the application filed ther~ith. Sworn to ~fore me this ~ . / f C ~ . .......... ,.~ ....... a~o ............. ~ ............... , ]gZ.....~ , ~ . 2~,,~.~. ~f ~g -- .Z~/~.~.~:,... ~ ......... NOT~Y PUBLIC, State of N~Yo~ N!~-0618100 Suffolk~ou~