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Home My WebLink About4877-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No. ~.~.0.~~, ................ Date ............................ D.ec......1.1 ........... , {9..7.0.. THIS CERTIFIES that the building located at .~/~..{*{~l.d~-].e..~o&~ ................................ Street Map No....,X]i ............. Block No. ~ .............. Lot No..:~i~r~ ......... (]=tC.h.O~l~.....~,~. .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ......................................... J.U~..~ ......... ~J~, 1~0... pursuant to which Building P~rmit No..I+~'~.~Z .... dated .................................. ~:u'l ]r.....~.J~..., 19.~.1~.., wes issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ....... l~, &v~te...~.t~r~ge..~a~e~s~r.y.)... ~u~id.£n~ ................................................................... The certificate is issued to ...J~O.]~e,?.t,..~J[lJ~J~a:E~ .......... O.~' .......................................................... (owner, lessee or tenant) of the aforesaid building. House # 16300 FOII, M NO. ~ TOWN OF $OUTHOLD BUILDING DEFARTMENT 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? ~$77 Z Permission is hereby granted to: to ............ ll~g~,...~..~e~...(,e~ra~e)...lml~ .................................................... at premises located at ............. ~..~l~..~Bl~..ll..~l~t,..~.~l,~ll~..~l. ......................... .............................................................. ~ ........... ,.~.,.~.,. ....................................................... pursuant to application dated ............................ ~1~ .........~ ......., 19.......~., and approved by the Building Inspector. Building Inspector FOB~ NO. ! TOWN OF soUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, ................................. Permit No. -~ ~'-, ApplicoHon No..~.,..,<~,..,,7..,..~.. ........... ~ m Disapproved a/c ....;.,~.:~....~ ..~.....~.....~._~_...~ (Building InspeCtor) APPLICATION FOR BUILDING PERMIT .Tul 28 19.2...O. ....... Date ................................... .~. ...................... , INSTRUCTIONS ".t a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building~t Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drown on the diagram wl',ich is part of this 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 Inspector will issue a 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 sh~ll be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancyk" shall have been granted by the Building Inspector. APPLICATION IS HEREBY/V~DE to the Building Department for the issuance of a Building Permit pur4uant to the.{. Building Zone Ordinance of the Town of Southold, Suffolk County, New York, end other applicable 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, ordinances, building code, housing code, and regulations. (Signature cf applicant, or name, if a corporation) ............. Cutchogue ............................................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.~. Name of owner of premises ....~3be.~..:t,...~,bb~,;~r~ .............................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title 'of corporate officer) 1. Locat~n of and on Which proposed work will be done Map No.: .... ~ ................ Lot No ' .3cZ /G3o ................................. Street and Number ......... ~./..S_.~.~.(~,~.....~I,......(..C..~..~.~.~ ..C..u..~.~..o.g,.u...e. ................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............... ~.e..~..~...~..~ ............................................................................................... b. Intended use and occupant,' .................... cma e.. m Zct;b ................. 3. Nature of wo~k (check which applicable): New Building ..... ~.w.~ ...... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ............................................................ Fee ....,~.~0D; ............................................................................ (to be paid on fi!lng this application) 5. If dwelllng, 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 ....A.g.Q~.$.$..q.~..~'.... 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 ............. ~. .................... Rear ......... ~. ................ Depth ...... .8.. ............... Height .................... Number of Stories ......... ~ ............................... 9. ' Size of lot: Front ...... .I.Q0 ............... Rear .................................... Depth ................................ 10. Date uf Purchase ........................................................ Name of Former Owner ........................................................ 1 1. Zone or use district in which premises are situated ..................A.....c14.,~t; .................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation.;' ........... a43 ............................................ Name of Architect ...................................................... Address ............................................ Phone No ..................... Nome of Contractor ........ s~ .................................. Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly oll buildings, whether existing or proposed, and indicate all set-back dimensions fram property lines. Give street and block number or description according to deed, and show street names and indica/'e whether interior or corner lot. STATE OF NEV~ Y..O3K,,. IS.S. COUNTY Of ...~.~..~..9.J,$. ............. R~.12,er t Hubbard · ............................................................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ............................ Ol~r4~e,~'. ..... ~1~;~,~($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 thor the work will be performed in the manner set forth in the application filed therewith. Swam to before me this 28 70 ........................ day of .......... //