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Home My WebLink About5527-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, BI. Y. Certificnte Of Occupnncy No .... Z..~.~.~.0.... Date October 17, 19.73 THIS CERTIFIES that the building located at ...3..t~..s.e.t...W.a.y. ............. Street Map No..~.0 ......... Block No.Z~.. ........ Lot No. ].62 conJ~oms substantially to the Application for Building Permit heretofore filed in this office dated ........ .3.e.p.t. :..2.7. .... , 19.7.~. pursuant to which Building Pemit No..~.~..2.7.Z.. dated ........ .~.e.p.t. :..2.?t .... , 19.~'..., 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 Private (accessory)storage buil~ing The certificate is issued to .... .J.o..h~l...P.;..(~...~...e.y. ................................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. ~ ............................... UNDERWRITERS CERTIFICATE No.. ~ ........................................ HOUSE NUMBER ....~..0. ....... Street $'ffil~e~; Way Southol4 Building Inspec~r FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5527 Z Permission is hereby granted to: to ~1,~.~ ' ' ~tt~' "1[~'~ ,'ii lil~Z'?' "~li..'L~d~l~ ..................................................................................... at premises located at ..... ),~l)..Ijl...~....~,~d~.t, .~®&el~..P~'il; ...................................................... ........................................... ~ilmmmel) ..W~ ~.....$e~ime %4 ......... ~,%o ............................................... pursuan¢ to application dated ............................... ~&D~ ...... ~%~. ...... , 19...~..~, and approved by the Building Inspector. Fee $..-.~[,*00 .......... lt'OB~l ' NO. 1 1'OWN OF souTHoLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. mined ........................................ ,19 ........ Approved ........................................ , I9 ........ Permit No ............................. 7 Application No ............................. APPLICATION FOR 'UILDING/~ '. '~ pete, ..... ...... .......................... ;.... ,9..'J...I ..... INSTRUCTIONS a. This applicotion must be completely filled in by typewriter or in ink und submitted In duplicate to the Building~, Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premieal or public streets or areal, and giving a detailed description of layout of property must be drown on the diagram wh~:h It part of ~hll application. c. The work covered by this application may not be commenced before iuuanee of Building Permit. d. Upon approval of this application, the Building Inspector will I#ue a Building Permit to the applicant. Such permiL-; shall be kept on the premises available for inspection throughout the pragre~s of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of C~¢upancy shall have been granted by the Building In,patter. ,..A, ,P. PLI.CATIO_N.!S HEREB. Y MA_DE to the Building Department for the issuance of a Building Permit pumuam to the ~uua~n.g, :one. urn. manta et ~e town of Southold, Suffolk Count, New York, and other appll~ble I.awl, Ordlnanoe, ar _~.egumT~ons, tar the construction of buildings, additions or al.terahons, or for remora ar derr~lltiml, al heroin d~:r bed ~ne applicant agrees to comply with all applicable laws, ordinances, building cod_e, housing code, and regulatlonl. State whether applicant is owner, lelsee, agent, architect, englnalr, general contractor, electr!¢!afl, plumber or builder. : If applicant Is a corporate, signature of duly authorized officer. 2. State existing use a,nd occupancy of premi~e~,. ,0 ~/,..~ ^and Intended~$e and occupancy of prapoeed comtmctlon: a. Existing US~ Nature of wo~k (check, which applicable): New Building / Addition .................. Alteration epair ......... ~ ..... Removal .................. Demolition .................. Other Work (Describe) ........... ~ ......................... Estimated Cost~ i..1~ ..1~ R ..~..~. .......................................... Fee .............. ~ ......................................................................... (to be paid on fi*.ing 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 ..~. C/L ....... 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 ............. I.'~.*. ................ I Rear ..... ~ ...~. ................ Depth ......~....'. ........... Height ...~...u~.. ........ Number of Stories ...~L~. ......................................... .: ....... · ....................................... ' I ~'~ ~ / 9. Szeof at Front.~,~).. Rear I~..O. r~nth I 5 0 10. Date of Purchase .~~ .... .I--?t..~.~'~ ................... 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 ........................................ Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No..C....' ........... ~. ~'~ Name of Contractor .................................................... Address ............................................ Phone No .................... 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 show street names and indicate whether'interior or comer lot. STATE OF NEW('~'O~jI~, · A ! S.S ' COUN'n'o ........ · . (Name of individual signing applicafid'n) above named. He is the ................................ ~.....[~...~.l~.~. .......................................... , ....................................................... (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 th,erew th. ....... NO. 52-8125850, Suffolk Term Expires March 30,