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Home My WebLink About4837-zNO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ZI~)~,~ ................ Date ................................ .DN......~O ...... , 19..~O.. THIS CERTIFIES that the building located at .eed:a,~...D~,[~e...(.La~t~) ......................... Street Map No.lJ.eJJ.]~ll.t~ ...... Block No ....................... Lot No. 'J6~'}66 ...... '~e~S¢'"lv~"~OIt ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ......................................... ~T.~J,~ ...... ~....., 19...~0. pursuant to which Building Permit No...J~8.~.~7~.. doted .......................... ~ ....... 6 .......... , 19...~O, was issued, end conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ .......... P.~[~t,,..eae...£a~a.~ ~l,~r..4~e1.].~i~ ....................................................................................... The certificate is issued to :Ri ~/~.1~ O'a~o~'~'~'r'[ i;';~';[ ................................or tenant) of the aforesaid building. House f Building Inspector FORI~ NO. 2: TOW~ OF $OUTHOLI~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE' $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIl FULL COMPLETION OF THE WORK AUTHORIZED) N? 4837 Z Permission is hereby granted to: ......... ~.,~.. ~.:tr~.L. ~ZR......~.,...~e",.I.~..,~ ............. to at premises located at ........ ~,~...~.~...~...J~....~.~!~b....J;~:~'..~$.~ ........................................... ............................................ ~.~ .~......~.~.. ~.~ .......... ~..,....~.~...~.,...~.,.~ .~ ................................ pursuan,t to application dated .............................. ~.....~ ....... i....., 19..~(~., and approved by the Building Inspector. Fee $.. ~.~..Q..0. ............ ^ppro~d ...................................... o I~ ........ TOWN CLERK'S SOUTHOLD, N. Y. Application No ................ Disapproved a/c .............................................................. APPLIC, ATIOH FOR BUILDING FIEP. MrT INSTRUCTIONS This application must be completely filled In by typewriter or in Ink und submitted In duplicate to the Building Inspector. b. Plot plan chowlng location of lot and of buildings on prem!ses~ mlatloni~lp to adjoining I~mmleee or public ,treats or areas, and giving a detailed description of layout of property must be drawn an the diagram wl'~ah lc part of fhle application. c. The work covered by this application may not be commenced before lssu~.~e of Building permit. d. Upon approval of this application, the Building Inspector will I#ue a Building permit to the applicant. Such permit shall be kept on the premises available for Ir~pectlon throughout the progress of the w~rk. e. No building shall be occupied or used In whole or In part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the Issuance of · Bud ng Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ,~nd other applicable Lawl, Ordinances or R.egulatl.o.n$, for the construction of bulldlngl, additions or alterations, or for remova ar demo It on, as herein deKrlbed. · ne ppphcant agrees to comply with all op~)llcable lows, ordinances, building code, hauslng cc, de, and regulatlofls. ..... ....................................... ', ........................ (Signature af applicant, or name, If a coq)oration) Green~o~t (Address of appllca~t) State whether applicant Is owner, leis#, agent, architect, engineer, general contractor, electrician, plumber of builder. iLO ......................................... ................................................................................................................................ Name of owner of premises ,..,J~,,...bre~l~ ........................................................................................................................ If applicant Is a corporate, signature of duly authorized afflcer. (Name and tltle 'of corporate officer) /~//-/~,~ 1. Location of land on which proposed work will be done. Map Na.: .,.G.~..,~...I.~'..~..t, ......... Lot No.: ........................ Street and Number ...... ~ed~r...D~e ......... ~.....~iLr~.mG ....... N.,Z., ..................................................... -~ / V'~ ~,~,/,L~ ~ Munlalpallty 2. State existing use and occupancy of Inte~W~dand use premlm and occupancy of proposed construction: a. Existing use and occupancy .......~Ive.1.]..~LBK ........................................................................................................ b. Intended use and occupant,, ........ ~&me..~;L.t~..&~..Id~l.d,t,~o~. ................ i ................................. 3. Nature of work (check which applicable): New Building ~ ................. Addition ...~1:~ ......... Alteration ~ ............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................. j ..................... 4. Estimated Cost ............ ~,,~O~...t-. ............................ Fee ...... ~.0~ .......................................................................... (to be paid on fi!lng this application) S. If dwelling, number of dwelling units ...~1~ ..................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 ............. 2~,..~...~. ........ Rear ........... 2~//.~ ....... Depth ..... ~2../.12 .... Height .................... Number of Stories ........ ~ ...................................................................................................... 9. Size of lot: Front ............................ Rear ................................. ~.. Depth ................................ 10. Date of Purchase ..................................... ~ .................. Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated .......... ~.~...~l.:LIIt~ ....................................................................... 12....Does proposed C°nst~:tio'n violate any zoning law, ordinance or regulation? ........ ~ ............................................... 13. Name of Owner of premisesTl',JJe3:~,~ ..................... Address ....~.l~l.l~.....~t.~.Q~ ............. Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ..~o..nl~,~ ................................. Address ..~eel~o~-t~ ....................Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, Whether existing or proposed, and indicate all set-back dimensions fram propen~ lines. Give street and block number or description according to deed, and show street names and Indicate whether interior or corner lot. STATE OF NEW~_YDJ[I~,_ ! ee COUNTY Of ..?...~....z..9...Jr~... ,. ................. ;':;~ ........ :~e~h....~l.e~l...; .................................. being duly sworn, deposes and says that he Is the applicant tr~ me at ma~vlaua~ signing appllc.atl.on) above named. He is the .................. ~,el~..t~J~4~, .......................................... "; ......... '~:~ ....................................................... (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-am true,t~ the best of h s knowledge and belief; and that the work will be performed in the manner set forth in the appl'lcatlon filed therewith. Swam to before me this ................. .Ldoyo, ............... /2 _ Nota Publlc~..~ Z )__ '/)~ .... ~'~v.~,"'~..~....~ ...... ry ~(¢7,~,&~..~,,.~.'.J'.(cf/~...f..~Countya/,,~T'/_aj;l~e (SJ~'natur~ of applicant) ~ / ...... (.,/ ELIZABETR ANN NEVLI:.J~ HOTARY pUBLiC State o! l~w ~1o. 52.81~§8§0, Suffolk ~rrn Expires .t.~'ch 30, lg~/_~,,