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Home My WebLink About4864-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No. ~$'~.~9 ...... Date ........... Feb ..... 8 ...... , 19~.. THIS CERTIFIES that the building located at . ~,'e:t~ .AV~ ............. Street Map No. ~-~~lock No ........... Lot No. ~ .... G.~e~. · .N.~, ...... confoms substantially to the Application for Buil~ng Pemit heretofore filed in ~is office dated .......... J~.. ~.., 1970. p~u~t to whi~ B~ding Pe~it No. ~.. dated ........... g.~ .... ~0., 19 '7~', was issued, ~d confoms to ~1 of the requir~ ments of ~e applicable pro~sio~ of the law. The occup~cy for which ~ ce~fficate is issued ~ .... Pr.~te. aec~ee~. (sto~ge). ~ .............................. The certificate ~ ~sued to .. CarL..~eke~ ...... ~ ....................... (owner, lessee or ten,t) of the afores~d building. S~olk Cowry Dep~m~nt of He~th Approv~ . ~,B, .............................. Building I~pector [ FORM NO. :g 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) Permission is hereby granted to: ............... e~...'~t~a~aa"lla ..................... .................... Iltae~ .......... I~.~.~. ....................... to ............ ~t~4..aee,.. ~ee~...eee~,~e...st.~t.....CAee,~..~ ................................ at premises located at ................ ,[4~t...~....~lla~e~.l~lq~t ........................................................... ............................................. ae~te~..A~ .............. Gree~e~ .................................................... pursuan$ to application dated ............................ e~l~.~r ....... ~!~ ......... , 19..~, and approved by the Building Inspector. TOWN OF soUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Examined. ... ........., 19........?0 Approved ........................................ ,19 ........Permit No...~..~".....~...~.....~..... Disapproved a/c ........................................................ APFLIGATION FOR BUILDING FERMI1 / / Dote .............. .Z:...2.. ~/...../..0· ..................... ,19 ............ 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 bu.ildings on premises, relationship to adjoining premiee~ or plablic streets or areas, and giving a detailed description of layout at praparty must be drawn an 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 approval of this application, the Building Inspector will l~ue o Building Permit to the applicant. 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 port for any purpose whatever until a CerHflcate 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 pumuant to the Buildit~j Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Law~, Ordinances or Regulatlor~s, for the construction of buildings, additions or alterations, ~' for removal or demolition, as herein de~:rlbed. The applicant agrees to comply with all applicable laws, ordinanc Iding code, lng code, and regulations. ................................... (Address of applicant) - r . State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .~/~..~..~....~.--~.'.;.....~..q.C.~.~'...~'./~c'..~/~ ...................................................................................... If applicant is a corporate, signature of duly authorized officer. 1. Location of land on which proposed work will be done. Map No.: ..~.../...?...'~.. ....................... Lot No.: ..................... Street and Number '/~'""'~"~"~"~"'{ "~"~X~/'/~"~"~'"~"~':'""~"' '*C7"' '~//'~'/'~'~A'~"Municlpallty ...... ...~. ~.~...~.(4W...~.¢~ ..................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .~..~...~'.~,~.........~..~'.~.....~.~..~.q......~. ...................................................................... b. Intended use and occupancy ....-~/~...'~../~ .................. (,L4~..-~... ........................... .~.~.. ....................................... 3. Nature of work (check which applicable): New Building ~'~ '~ ~ ................. Addition . Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ............ ~.~..~.. ..................................... Fee ....... .~....o.,~.~. ......................................................................... (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 ....... ~ ............... Rear ................................ Depth .................... Height ........................ Number of Stories ........................................................................................................... iJ .... Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ..... /.~.....~. ................ ;;;. Rear ....... Z~'.~...;. ........... Depth ...~.....; ........... Height ......~.. ........... Number of Stories ...............~. ..................................................................................................... 9. Size of lot: Front .....A..<~..~, Rear ,~O Denth /5/7 ........................... ................................. , 10. Date of Purchase .............................................. Nome of Former Owner ~..~..:..~../.~,~.~.. ....................... ! 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law~ ordinance or regulation? .../~..~ .................................................... 13. Name of Owner of premises(`~.~?~L~.~g~-~e~ddress~.-~`/~~e~1~-6~ .~.65.~.~ Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGP~M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil 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. Is 4 u/fc STATE OF NEW YORK, COUNTY OF ................................ j' '~'~' ............... "t~"~'"'"~"':"tt'X~'"'~'~.~.-gt:-.8~ ............................ being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ..... ..~...e~....~..E~. ....... (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 that the work will be performed in the manner set forth in the application filed therewith. Swam to before me this ....................... day of .................... . ' ~l~.~}-~ee.~ .......... r/' .............. 'Y ~--~,.~K// t~ gnamre or applicant) ~OTARy PUBLIC, ,State of