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Home My WebLink About4879-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificale Of Occupancy THIS CERTIFIES that the building located at . W/.~. Faator~..Ave ......... Street Map No...~. ......... Block No....~. ...... Lot No...~.....!~..t.t.~..t.~..k. ~. ~,.~ ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ Jttl~... 31, 19.~0. pursuant to which Building Pemit No. ~8~... dated ............ Ju]3~....~.$, 19.70, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .l~,~ate..one. f~3~..d¥ll3.~n~ ....................................... The certificate is issued to . .~..e..ll~... F.~..~...~.1..~.? ...... . .(~.. ?. ....................... (oyster, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval House 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) l l? 879 Z Permission is hereby granted to: at premises located at .......~illl~....~ll~.&ql~ .............................................................................. ..................................................... I~'elm~ ........ ![~ .................................................................. pursucm¢ to application dated .......................... ~1~--.~ ...... '3~ ........... , 19...~1~ and approved by the Building Inspector. Fee $..~e,~ ............ Building Inspector TOWN OF sOUTHoLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved .~'""L ........ '., ........ , 19Z~... Permit No ..... ...~.....~...7..~..~.. Disapproved a/c ........................ ~ ..................................................... APPLICATION FOR BUILDING FERM|'I' Date ........ ,T1;L~y 31 19. *7.0. INSTRUCTIONS '~ a. This application must be completely filled in by typewriter or in ink and submitted In duplicate to the BuildingS, Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship ,to adjo n ~g premi~ec or public streets or areas, and giving a detailed description of layout of property must be drawn on the d.agram which Is part of this 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 Issue a Building Permit to the applicant. Such permit shall be kept on the premises available for ir~pection 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 Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ssuance of a Bud ng Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Law~, Ordinances or Regulations, for the construction of buildings, additions or alterations or for removo or demolition, al herein described. The applicant agrees to comply with all applicab e laws, ordinances, building code, housing code, and regulations. Stanley Sepke ' (Signature cf applicant, or name, If a carperotlon) Mattituck (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (;on~:ractoz' Name of owner of premises ........ ~.~tI~.7...~.~'.~.~q.~,~....,T..~. ..................................................................................................... If applicant Is a corporate, signature of duly authorized officer. h Locat on of__and on Which proposed work w be done Ma No.' .,~r, .......... I~ ~ ~ Municipality State existing use and occupancy of premises and Intended uss and occupancy of proposed construction: a. Existing use and occupancy ..... (tYe~l.~g, .......................................................................................................... b. Intended use and occuponcu. ................................................................................................................................ 3. Nature of work (check which applicable): New Building ~ ................. Addition ..~:~ ........ Alteration ~ ............ Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ......... ~00. .............................. ; ....... Fee ........ ~.~0J~ ........................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... O~el ............... :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~ ................ Pear ............... .1~ ........ Depth .....2Q .............. Height .................... Number of Stories .......... ~ .................................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ....... .". A. .". . ?l ~ t, .......................................................................... 12. Does prpposed construction violate any zoning law, ordinance or regulation? ......... ~O. ............................................. Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .~.,..~l~.~]r~ ............................... Address ...... g&t,.l~:L~u~ ................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and Indicate all set-hock dimensions from property lines. Give street and block number or description according to deed, and show street names and Indicate whether interior or comer lot. STATE OF NEW YORK, tee COUNTY OF ...~l~'-~-c~r. ........... $°'~' .................................. ~t~n~t'~,r~.Ol~,~]gl~ ............................... being duly tv~rn, depose sayj~hot h~ is the applicant (Name of I~dlv-l-d~a'l~lgnP'n~ application) above named. He is the. ....................... C~tr&~.t,O,T.. ................. ~ i~'~ ........................ (Contractor, , 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 f, Jled therewith. Swam to before me this .............. MARION A. REGEN1 NOTARy PUBLIC, State of New Y~, , No. 52-3233120 Suffolk Coun~ Term Expires March 30, 19