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Home My WebLink About5526-zNO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMRNT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No.. ~ ..... Date Ju.~y 26 19 73 THIS CERTIFIES that the building located at 32~i~ ~ia:LI$ ltoad Street Map No ............. Block No ...........Lot No .................................. conforms substantially to the Application for Building Permit heretofore fried in this office dated September 27 ~1 ~26Z ...................... , 19 .... pursuant to which Building Permit No ......... dated 19.t.~. was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is Bus~.n®ss issued is ........................................................................ Daniel Kael~l~ The certificate is issued to ........................................................ (owner, lessee or tenant) of the aforesaid buil~i,g. Suffolk County Department of Health Approval .................................... UNDERWRITERS CERTIFICATE No ............................................. HOUSE NUMBER ~9~1~ Street ~ Ro&d! Cut~hogue! 9g Cox Lane, Cutelmgue, .... ............. Building Impee~r FO~ NO. ~ 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? 5526 Z Permission is hereby granted to: to ...IretA,..~..~.~..ea..e~l~l..lm~aee~..ImlA&l~e ...................................... pursuan¢ to application doted ............................... ~l~p~'""~ ......... , 19...1~J,, and approved by the Building Inspector. Fee $...5,.~. .......... Building ~nspect&r / T~,WN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOt. D, N. Y. APPLICATION FOP, BUILDING PERMIT,,,~ ote ........... ....... . '~.~NSTRUCTIONS a. This application must be completely filled, in by typewriter or in .ink. and~ submitted.in duplicate to the Buildirl~ Inspector. .. b. Plot plan sh~ng..Io~atJon of lot and of build. ~i~.' en I~emTses, relationship to adjoining premises or public streets or areas, and giving c~d~r~lle~descrJption of layout ofl~11raj~erty mdet be drawn on the diagmm.~hich is part of this applicetion. c. The wo.rk~ C?ered by this application may not be commm~ced before issuance of BUilding Permit. d. Upon approval of this application~ the BUilding Inspector will issue a Building Permit t~ the al~lieanf. Such ~e~.~it shall be kept on the premises available.~r Inspection throughout the. progress of the work. e. No building shall be occupied or u~led in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. Building Zone Ordinance of the Tow~ of Southo~, Suffa/k CountyX,,N~ ew York, and other applicable Laws, Ordinances or ~ Regulations, for the cOmtructlon of bUildings, addttlene or a!teratloi~'Q.r, for re~oyal or demolition, os herein described. ~? The applicant agrees to comply with all applicable laws, ordinances, building code, housing cooke, and regulations. '" - ......... (Signature of applicant, or name, if a corporation) ............ ~ ..~:):....!N.'.S. ~ItVlC~; CE.N. TEI] ~, ........... ', ............. rD ~,.,..~,~,. _ ' '~ i~u~ ~'~'~_i~;~) ......... .,.~i./.'.~.r applicant is owner, lessee, agent, a~h t~t~t, .nginee~',~jene~a, contractor, electrician, plumber or builder. .:.~.,....~.~s,,.~ ................... ~..~..:.~.~;:..~:;{~,~....~ ............................................................................. · L,~.~,uz~.... n '~-~' Name of. owner of prom. Sos ........ ~,4r..~.~,e,~a.,~.~....~.~-~..~ ................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ' 1. Location of ...................................... land on which, proposed work will be done. Map No.: Lot No ......................... ~ and occupancy of ~ ¢omtrta:tion: 2... State existing use and occupancy of pmmiees, end. in~ended use a. Ex~,ng ~, ond o~u;a,w ~..t!l~...~ausee~.~4,..aa~.t~......~.~.~...~t .................................. b. Intended use and occupancy ......................... .,~.~.l~.~m .......... :;., ....................................................................... 3. Nature of work (check which applicable): New Building .................. Addition ...... ~ ..... Alteration .....~... ......... Repair .................. Removal .................. Demolition ........ ; ......... Other Work (Describe) ........................................ 4. Estimated Cost ............. ~..~....~ ....... i ..................... Fee ~ (to b· paid on filing this application) 5. If dwelling, number of dwelling units ............................ Numbe~'~0f dwelling units on each floor ............................ If garage, number of cars ................................................................................................. ~.~.~-...-..j.~ ........... 6. If business, commercial or mixed occupancy, specify r~ature and extent of each type--V~r' ,VV~of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... I-leight~'. ..................... :. 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 ...~.~' ~ Height ....f.~!. ......... 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 ..................................................................................................... 12. DOes proposed construction violate any zoning law, ordinance or regulation? ............................................................ 13. Name of Owner of premises ........................................ Address ............................................ Phone No ..................... Name of~"~ '~e~;:t ..'.~., .~...~...~....~...~..~..~..~.......i...i ........ Address ~..~1.~..~..~...~..'~...~'. ......Phone Name of Contractor .................................................... Address ............................................ Phone No ............. ~ ....... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-beck dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether i~terior or corner lot. STATE OF Nk-~")YQP~K~,~ COUNTY ~ ~. ......... $~'~ ........... ~'~' (N~me of indivi~__. _.~...~ m~'c '~"~n ........ .... unl ~i'ni'g app ~'"'~~ duly sworn, d,oses and soys t~t he is t~ applicant being a~ve named. He is the ............................ ~ ...................................................................................................... (Contractor, ag~t, co~orate officer, etc.) of said ~ner or owners, and is duly authorized to perform or have per~ormed the said work and to ~ke and f~le this application; that all statements contoin~ in this application are true to the best of his ~owledge and belief; and tha~ tbe ~rk will be performed in the manner Set fo~h in the applicati~ fil~ ther~with~ Swam to before me this ..... o, _ [ Z_ · ............................................. ELIZgSETH ANN ~EV~LLE NOTARy PUDLI0, Stnte of New York No, 52-8~258~, Suffolk Term