The URL can be used to link to this page

Home My WebLink About5478-zFOR~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z... ~... Date .............. l~.r¢~l~.. ].~'..., 19..~ THIS CERTIFIES that the building located at Ol~n~' &.P~sh ..... Street Map No. ~t~O.. Block No ........... Lot No. 3~. ~ ..... ~O~ ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... .a~...2~ .... , 19~.. pursuant to which Building Permit No. ~.. dated .......... !~...26 ..... , 197].., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is . pri~.~ .c~ze..f~ly. 5~o2~. ...................................... The certificate is issued to .. A~l:~ .~ck .... ~' .............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. ~.eb.. 23. ~.:..i~y. R, .?il~a.. Building Inspec(or 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? 5478 Z Permission is hereby granted to: .~lm.e~ee..l~m~.~.....~..~..~. ............... Giree:~p~,. .......................................... at premises located at .......... J~IIIII~J~..A'..IJ~I.J~..,~ ............................................................... ................................................... (~r, elmj,~e ........... tI~Y~ .................................................................. pursuan,t to application dated .................................. A~j.....~ ......... , 19...~1, and approved by the Building Inspector. Fee $..J,O,00 .......... Building Inspector $-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date ~ ~,~- /~,~ Bldg. Permit No. ~2 ~ TO WHOM IT MAY CONCERN: at The sewage disposal facilities for a structure located (Give deed ~o~atlon) / -- have been inspected by this department and found to be satisfactory. District Engineer lt'OBM NO. I TOWN OF soUTHoLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ........................................ , 19 ........ Permit No .... Disapproved a/c ............................................. ............. (Bui~ ..... INSTRUCTIONS ¢ o. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Builc~g~ Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premlees or public streets or~ areas, and glvlng a deeailed description of layout of property must be drawn on the diagram whlch is part of thio 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 inspection throughout the progress of the wurk. e, :No building shall be occupied or used in whole or Jn port for any purpose whatever until a Certificate of Occupancy tr~ shall have been granted by the ,~uilding Inspector. APPLICATION IS HEREBY ~MF~DE to the Building Department for the issuance of a Building Permit pumuant to the Building Zone Ordinance of t~e Town of Southold, Suffolk County, New York and other applicable I.awe, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for remOVal or demolition, as herein cle~crlbed. The applicant agrees to comply with ail applJcab · aws, ordinances, bu{ ding code, hous ng code, and regulations, (Signature cf applicant, or name, If a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumbe~ or builder. ..... ,, ......... ................................................................................................................................................................. Name of owner of premises ......... ~Ll:~,~'...:~.e,e~. .............................................................. ........................ If applicant isa corporate, signature of duly authorized officer. ~/f:~--~" .............................................................................................. /= (Nome and title 'o' corporate officer) ...~..~ ..~,.~ at ~ 1. Location of 10nd on which proposed work will be done, Mop No,: .......... i ......... ? ...... L No.: .., .................... Street and Number..~...o..~..~.e.~ ..c..o...z~....e..~....~.,e.a~.~.~ ~.n...8....~l...e..n..~.o..0.~....~..,o.~8.~!....~.u..~?.~.o.~.e. .............. 2. State existing use apd occupancy of premises and intended uss and occUPancy of propoled construction: a. Existing use and occupancy ...~.u..j,l..8.j,r;g..lI.l,.q~ ................................................................................................. b. Intended use and occupon=, l~e~iclenOeltl ~l~elli.n..g 3. Nature of wmk (check which applicable): New Building ...?.,,x.,x. ........ Addition .................. Alteration .............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ...................................... 4, Estimated Cost . $25 ..-..~.30t000o - $10o00 (to be paid on filing this application) 5. If dwelling, number of dwelling units .....o..n.,.e. ................. Number of dwelling units on e~ch floor ............................ If garage, number of cars none 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 some structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... ..4..4..~. ....................... Rear .....4...4.~ ................. Depth 40 · Height....................16~ Number of Stories .....................°ne .................................................................................... ............. 9. Size of lot: Front ..[.?...5..~ ................. Rear ......]-..?...5..t. ...................... Depth ..... .]:..0...0.. i0. Date of Purchase ........................................................ Nome of Former Owner .................................................. ~,.. 11. Zone or use district in which premises are situated I[esiden%ial 12. Does proposed construction violate any zoning law, ordinance or regulation.> ....... .n.o. ............................................... 13, Name of Owner of premises ..k.?...~..h..u..~....B..e..c...k. ............. Address Hemps%eat1 -- ., 489-3506 ........................................... I~norte INa ..................... Name of Architect ................. .°....~]....e.T. ......................... Address ............................................ Phone No ..................... Name of Contractor .....C..,....?.......?..o..?..e..]..[ .................... Address .g...r..e.~l~.O.~ ....................... Phone No. ~..?..?..-...0..9..9...5.. 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 shaw street names and indicate whether interior or comer lot. I STATE OF NEV~O~,,~ COUN~ OF .............. ~..-'E~ .................................... being duly sworn, d~es and says t~t he is the applicant (Name of individual signing application) a~ve named. He Js the ....... ~ ................................................................. ';~ ....................................................... (Contractor, ag~t, co~r~e officer, ~c.) of said owner or owners, and is duly authoriz~ to perform or have pe~0~ed the ~id work and to ~ke ~d file this a~licotion; that..all statements contained in this application are tm~. to the ~st of his kn~l~ge a~ belief; and that the work will be performed in the manner set fo~h in th~ applic~i~ filed t~r~ith. Swam t~re me this ~ ~, . ..... ........ ,,..., · & ff lA.._ .... ................................ : ........... ~ No. 52-8125850, Suffolk County . . ~ Term Expires March 30,