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Home My WebLink About4863-zl~OP~f NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...ii/~..,Teeke~..Gl, eek..g~ .................... Street Mop No..~1~ ................ Block No..~, ...............Lot No...~IX .......JJ~l.t~l~,iJ.....J~.~ ................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................... ~11~.~'. ....... ~J(~ ........ , 19_70. pursuant to which Building Permit No....JJ~,,~.. dated ............................ ~t.....~.7 ........, 19...7. Q, 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 ........ ......... ~Lv~t,e...JwAJ~...p~l..~m~l~..(awess~)...s~,~a6e..l~ldj ............................... The certificate is issued to ...~l~t,J~.JJ,...~l~J~r ............J~t~. ....................................................... (owner, lessee or tenant) of the aforesaid building. lt~use tt 375 Bui ding Inspector / 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? ]863 Z Permission is hereby granted to: .... .~...~...t~..!.e.....~Z.. ................................................. ............. ~m~r...~..~z~ ....................... to .... Z~..?.~.~...~.~..........~..~...~..~ ~.~.~ ~u~tes~e at premises located at ........~..~.Off..~(~...~.~D~k.,~*~,~Fl~ ............................................................... pursuord' to ~ppli¢otion a~ted ............................... ~ ....... ,~ ....... , ]¢.....~..., ~r~:l ~pproYed by the Building Inspector. Fee $.~'.s...r~... ............. TOWN OF SOUTHOLD "~74~' BUILDING DEPARTMENT Exam,n ........ f......° Approved 19 Disapproved a/c ................. ~... Appli~otion No ............... ~. APPLICATION FOR BUILDING PERMIT ~ Date ..... ~.7...~:./...10 ....................................... , , 9.'~.....?....L11 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 bUildir~ls on premises, relationship to adjoining premises or Dubl c streets or areas, and giving a detailed description of layout of p~perty must be drawn on the diagram which is part of t'his application. c. The work covered by this application may not be commenced b~fore issuance of Building Permit. d. Upon approval of this application, the Building Inspec,R~r will issue a Building Permit to the applicant. Such Permit~ shall be kept on the premises available for inspection through6ut 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 have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit parauant to the Building Zone Ordinance of the Town of Southold, Suffo k County, New York, and other app cable 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, ordinonci~i, ho~i:~,?. ~ulations. .........'. ........ ........ ....... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, p~lumber or builder. Name of owner of premises .....~..~..~ ....... ~......../.'~-. ~(/..~..~ ......... ..' .............................................................................. If applicant is a corporate, s!gnature of duly authorized officer. , · (Nome and title'of corporate officer) 1. LocatiOn of land on Which proposed work will be done. Map No.: ............... ..~:.....i .............. Lot No.: .....~. ............. Street and Number .~...Z.-~'.."..-~....~.C,~C~6/.......C,~.(~.,~....'~../..~/.~. ........ .~'.~..¢J,~tz~'..~.. ........... ~...~ ......... -- Municipality , 2.State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... ~..~..'~..(.~..~.../.d....~.~....,:-~:~ ....... ,~.4~..~.~. J ............................. b. Intended useandoccupan:, ~r~ta~.~/.x~.~`~.~d.~C~.~..~..~.~:~`t~'~.~f~.~ / 3. Nature of work (check which applicable): New Building ~ ................. Addition .................. Alteration .................. Repa,r ................ .~//Removal .................. Demolition .................. Other Work (Descr be)~;~lt.~,~-~..~,~.~...~...~/~ 4. Estimated Cost .~..~..~.'.~... Fe- ~?-~ ...... (to be paid on fJ!Jng this application) 5. If dwelling, number of dwelling units ....... ..~-.,.~.'?.."::.L-.......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 .~.f,-:~wT ........ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth ............. L ..... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ N/u~ber of Stories ................................ 8. DNnensions of entire new construction: Front .................................... Rear .......... .~..~. ............. Depth Height .................... Number of Stories ................................................................................... 9. Size of lot: Frant ............................ Rear .................................... Depth ................................ 10. Date of Purchase ................................... Name of Former Owner 11. Zone or use district in which premises are situated .. .~ ..~..~.C 7' 12. Does proposed construction violate any zon nn aw ordnance or re u at on> ./..(~..0 13. Name of Owner of premises .D.!.~.~....' .... .to../~. .... Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .................................................... Address ............................................ 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. STATE OF NE~YJD~./~' COUN*, ................. · ,.,~~...;......Z.? ....... ~.:~ ........... being duly sworn, d~es and says t~t he is the app cant t~ame or ma~iauat signing ap~tion) / above named· He is the ................ ~~...1~....~ .............. : ....................... <Co t,oc r, off.=.,, of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke ~d file this application; that all statements confined in this application are tree to the best of his ~owledge and belief; and that the work will be performe~' ~ the ~nner set fo~h in the applic~filed therewith. Swam to be~re ~ this I I // ~ . / I ................ .............. botoe/Pub c, · -- Court ....... ~'1~ ...... ' · ................ .......................... ..........................