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Home My WebLink About4826-zll~)~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE: OF' OCCUPANCY THIS CERTIFIES that the building located at ~..~:~t~..&~ ........................................ Street Map No~F~&t41~r~ I~l~k No ..... ~ ............ Lot No...3~. .........JJ&~t~tlt~ ....... ~. ............ conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................. ~'.13~....,~ ............. , 19..~.O.. pursuant to which Building Permit No.~k~ ..... dated ....................... ~e ....... ~. .......... , 19...~[1~, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ The certificate is issued to ~ll~...~..~J~t~l~..~.~ ......... ...~e~'J~ .............................................. (owner, les~e or te~t) of the aforesaid building. ~l ~ ~ kXtehen faoX1itXel ~ ~ ~ ~ Building Insp~tor FOK~I NO. f~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 4826 Z Permission is hereby granted to: ............ Jl~..~ai...aeJ%=~..Ce ...... .te~. ,TmJe~ C~a,l,e ............... ..................... ...................... 6eJ4elm ....... tlv~ .......................... to ............. ~t-Za..em. aid~iel~'""ea" e~l:scl~ts~-' dye t-~t~ ............................................... at premises located at ................. jJ,i/ItJj.....J~l~..&~ ............................................................................ ...................................................................... Iiat. t StJdl~ ....11 ,~., ...................................................... pursuan,t to application dated ............................... ~J.....~ ......... , 19.~1~.., and approved by the Building Inspector. Fee $'J~e~)' ............ ........ r -" ~7"~""~uilding Inspector c7 ...... Examined .. y../........... ................ , 19.~ ...... Approved ......................................... , 19 ........ Permit No ............................. ~ Disapproved a/c .................................................. v/ ............................................................................. o (Building Inspector) APPLICATION FOR BUILDING PERMIT ~ Date ~Tl~e 25 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. Plat plan showing location of lot and of buildings on premises, relatlonshio ~o adiolnlna premises or public ~tr~t~ n, areas, and giving a detailed description of layout of property must be drawn on th~dlagr~m whl'c~ Is part of t~h-J~'~-p~'l'lc%~i'o~ 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 pppllcant. 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 hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bud ng Permit pureuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other app Icable Low~, Ordinances or Regulations, for the construction of buildings, additions or al.terafions or for remora or demol tlon, al herein described. The applicant agrees to comply with all appl cable laws, ordinances, bul ding code, hOusing code, and regulations. Du Aa.1. Contract nK Co (Signature cf applicant, or name, If a corporation) D Se den .............. ..................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, eleatrlclan, plumber ar builder. .............................................. ,.. ontrac. r. ....................................................................................................................... Name of owner of premises .....~T~.l~e.~..~a~"! e= .................................................................................................... '~, 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. Mop No.: ...~.~.~.~.°..°.~.~.....~..a..,~..k. ..... Lot No.: ........................ Street and NUmb~l} '...:....~,.,..~,...~.....~,3.....~aZ'k..,~,l~ ............ ,,~ti1,~.1~.,~,13g~,.,..,.,,~., ............................................. Munlclpallfy 2. State existing use a.nd occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... &V~.3.~J~13~ ......................................................................................................... b. Intended use and occupanc~/ ............ sa~&..~L~F.J~..ILCl. ClJ,~I. OZ~ ................ 3. Nature of walk (check which applicable): New Building .................. Addition ......... ~'~... Alteration ........ Z~ .... Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................. ~ ..................... 4. Estimated Cost .............. ~g.O~O .................................. Fee ...~eO0 ............................................................................. (to be paid on fi!lng 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 ....... 2.~' ................ Rear ....~. ....................... Depth ...l~. ............. Height ........................ Number of Stories ......... ~ ................................................................................................ Dimensions of sarne structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ............ ~,.b¢.. .................. .Rear .~.~. ...................... Depth ....... ..~..~.. ........... Height .................... Number of Stories ...4~ ........................................................................................................... 9. Size at: lot: Front ....... ~..Q ................ Rear ........... ~.0.. .................... Depth .............. ...~.....~. ..... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ! 1. Zone or use district in which premises are situated ..m~.~ (J~,l. Bt, 12. Does proposed construct;on violate any zoning law, ordinance or regulation? ....... ~ ............................................... 13. Name of Owner of premises ....~T~.~el~..(~&.z,-].e~ ...... Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ....,~13,.~1i~1~...~.O~1;J .................. Address ....... ~.e,~,~l,.~l~, ....................... 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. OF NEW Y~RK, Y OF ..... ~.1~.~ ff'o~ir .......... ~' '""' STATE, COUNTY .................................... ~T.c~,~.~.pb,..~.~3,~J,y~.lJ9. ........................ being duly sworn, deposes and says that he is the applicant (Name of individual.signing application) .. above named. He is the ....................~...O..~....~..~..~...O..~...O..Z'..!.~....~.~..~...~..~. ...... i ................ ] ......... .: ....................................................... (Contractor, 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 ~rue to,the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed thereMlith. Swam to before me this ................ of ................. ................. , MARION A. REGENI~ v NOTARY PUBLIC, State al New No. 52-3233120 Suffolk Count!, Yerm Expires March 30. 19_'7~