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Home My WebLink About4844-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. '~3~78 .............. Date ........................... S~I~i~ ....... 2~ ....... , 19..7.0, THIS CERTIFIES that the building located at ~[a. ,~13..~d..&..~)lk~,].~,~..~,~l~ ................... Street /V~op No....3~& .............. Block No..~QI; ................ Lot No...~131; ....... ~ett~r~lo,14,,.,.N~.~. .................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................... ~ ......... ~ ......... , 19.~Q.. pursuant to which Building Permit No...~.8.~... dated ....................... ~.tt~.~ ....... .~. ............. , 19...~O., 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 ...Z~,I~.F.Z~r .......... (~F ....................................................................... (owner, lessee or tenant) of the aforesaid building. House f Y, ta Building Inspector FOB~ NO. ~ TOWN OF $OUTHOLD 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) Permission is hereby granted to: .................. ........................................ at premises located at ................. .}~JJ~..J]~..&..DS,~]~..Jk'~ ....................................................... ............................................................... .~.~1~ ............................................................................. pursucu~t to application dated ................................... ~3~,~. ...... ~I......, 19....~ and approved by the Building Inspector. FOBM NO, I TOWH OF SOUTHOLD BUILDIHG DEPARTMEH? TOWH CLERK'S OFFICE ...~. SOUTHOLD, N. Y. .x,,m,,,., .......... Z Approved ..... /..~... ................ C7 ......................... ' ........ ~ermlt No ............................. Disapproved o/C ........................................................................... Application No ............................. a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Buildil~a Inspector. b. Plot plan showing location of lot and of buildings on premises, r~lationship to adjolnlna premises or pub c streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which Is part of thle application. c. The work covered by this application may not be commenced before issuance of Building Permit. ~' d. Upon c~oproval of this application, the Building Inspector will issue a Building Permit to the applicant. Such per~t shall be kept on the premises available for inspection tt~mughout the progress of the work. e. No building shall be occupied or used in whole or Jn 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 Bul d ng Permit Imreuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other app Icable Laws, Ord nantes or Regulations, for the construction of buildings, additions or alterations or for remova or demo t on, as herein described. The aPPlicant agrees to comply w th all applicab eaws, ordinances, building code, housing code, and regulations. Z np=e,v. ene t,., .............................. (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 .................~...*..P...*.?..e...~...Z~. .............................................................................................................. If applicant Is a corporate, signature of duly authorized officer. ' (Name and title 'of corporate officer) I. Location of land on Which propased work will be done. Map No.: X3~ . . . Lot No . .. - l~a~n & Oaklawn Souyhold Street and ~lumoer ....... ~ ........................ 2. Store e×i~'lng use and occupancy o{ premises and intendod uss and occupancy of praposed con~'mcflon: a. E~lstlng use ond ~upancv ............. ~ ................................................................................................... b. Int,nded u~ ond ~cuponcy. .............. ~..~.~ .............................................................. 3. Nature of walk (check whici~ applicable): New Building .................. Addition ...... ~ ....... Alteration ~ ............. Repair .................. Rernova~ .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost 1 - 1.0.0 - ~.,?.00 (to be paid on fi'.ing this application) 5. If dwelling, number of dwelling units .......... ..o..~..e.. .......... 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 ....... 1..)4. ......................... Rear ....... 1.~. ................ Depth ...... .1.c~ ............. Height .................... Number of Stories ............I)=e ...... . 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date uf Purchase ........................................................ Name of Former Owner ........................................................ ! 1. Zone or use district in which premises are situated ............. .A.....~.~....'~.. .... 12. Does proposed construction violate any zoning law, ordinance or regulation? ......... X/O .............................................. 13. Name of Owner of premises .:[..,~..,~e~.l~: ................. Address...............................S°U'~cho'ld' ....... ...... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .....~.~..o.~...t,..e.x'....~..?.~.t..C..o.. .............. Address ........ .G..~.e...e..~.]~.o.z*...~. .............. Phone No ..................... PLOT DIAGRAM Locate clearly ond distinctly all buildings, whether existing or proposed, and indicote all set-back dimensions fram property lines. Give street and block number or description according to deed, and show street names and indical'e whether interior or corner Jot. STATE OF NEW YORK, [ S.$ COUNTY OF ....... ~.l~f'j~olle ........ J' · ........................................ A~'.t,~..,~;J~.eZ'. ...................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ................................. .~.g~'~.e..~..o.~ .................... ;: ....................................................... (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 true to the best of his knowledge and belief; and ti.at the work will be performed in the manner set forth in the application filed therewith. · S..:.: · .:..t..: · · .bT..f~:r.: _dmaey t ho ;'/~ ,../~ ~'% -~ .............. ~'.t~]~..: ...... ......... , 19...~.~. ~ounty(j~9~.gj~i~l/ (Signature of applicant) ........ ELIZABETH ANN NEVI ~o. ~2'8~25850 Suffol'* ,,.~w ~ork · ' march 30,