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Home My WebLink About5531-zFO~M NO. 4 TOWN OF $OUTHOLD BUILDING DEPA_RTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy Nc~l ........ Date ...... 0~;ob~ · 17.1~ ........ , 19.7.3. THIS CERTIFIES that the building located at M~at .Way ................ Street Map No.. 90. ........ Block No...X~ ..... Lot No. 16]. ..... ~ou, t, hol.~l .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Sept;, .28~., 19.71- pursuant to which Building Permit No...~.~.~12, dated ........... Sept;, .28~.., 1971.., was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . Pr;~vate..stQrage. ~aaee~sory ). bull .~E~I~[ ............................ The certificate is issued to .l~hl.~.$p. 1~,..Pf~f-£er ................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..NR. ................................. UNDERWRITERS CERTIFICATE No..P..e.n~..i..~. ................................... HOUSE NUMBER .... 3.7.0. ......Street ..... S..~..S.e.t...W.a.y. ......................... Southold ........ ........... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE $OUTHOLD, N. Y. BUILDING PER, iT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 5531 Z o~ .............................. ~)'-'~'""~/~'~", ~7't' Permission is hereby granted to: .......... ....... ........ o, premises Iocoted ot ............................ ..~..~.~ ....... ~:~ .~./s4-.~,.-.~. ....... L.e~.A~~.~. ............................ ................................................................................. ,~O.~..T..~o.~..~.;...~...~ ......................... .................... '~v- ............ ~'~) ....... "-~' '""'~'~'~ ....................................................................... pursuo~n~c to apphcotion dated ................................. .~..~, 19.~/., and approved by the Building Inspector. IN~B~ ' NO. I 'TOWN OF soUTHoLD BUILDING DEPARTMENT TOWN CLERK'S OFFI(:E SOUTHOLD, No Y. ... ..... Approved ........................ ....~......., 19...Z/Permit No ............................. Disapproved (Building Inspector) Application No .................... ~ ........ APPLI~,ATION FOR BUILDING PERMIT ~ Date ........ ~.'......, .......~..! ........................ , 19..~./. ..... INSTRUCTIONS (J~ a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building ~ Inspector. b. Plot plan showing location of. lot and of buildings on premises, relotionsh p to adjoining premises or public streets or ~ areas, and giving a detailed descriphon of layout of property must be drawn on the diagram 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 Bud ng Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. 'shalle' haveN° bulldingbeen gmntedshall bybe the°CCUpiedBuilding°r usedlnspector.in whole or in part for any purpose whatever until a Certificate of Occupancy -~ B APPLICATION IS HEREBY MADE to the Bu ding Department for the issuance of a Building Permit pursuant to the uilding Zone Ordinance of the Town of Southold, Suffo k County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of build ngs, additions or a terat OhS, or for removal or demolition, as herein.descr bed The applicant agrees to compl? with all applicable laws, ordinol~r, es, building code, h~usinc~,cod, e, and regulahons. - /,(Si![nature cr opplicar)t, or/nafne, if a corporatipn) "~ ~_~ ~ -' , -"'"'""' , (^dd;'""~g;~L'~'~ii~;~i ............... '~'- ............. State whether a- cant s owner essee nt ' 'I . , age , architect, engineer, general contractor, electrcian, pusher or builder. ....................................................... .................... .............................................................................. Name of owner of -rem se ./'~...~..//..//9 p s ...................... ~ ........... .. .......................................... If apphcant ~s a corporate, s~gnature 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.: ...../.~.~../.. ........... Street and Number .. ../~...~.~'~Z .......... ./.-~...7~.....Z.~.. .............................................. --~ 7 ~ ~ '~ ' ~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use,',nd occupancy ................................................. £ ....... )....~: ............................ , ............... ~ .......................... , ........... 3. Nature of work (check which applicable): New Building ~ ................. Addition .................. Alteration ................. Repair .................. Re, moval .................. Demolition .................. Other Work (Describe~....~....~...~.~...~..?...~..~ 4. Estimated Cost ......~../.~...~.. .......................................... 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, Jf 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 ...... /~2...~. ..................... Rear ...... /..~ ................... Depth .../~... ............... ! Height ....~..! .......... Number of Stories .................... ~ ................................................................................................. 9. Size of lot: Frant ...... /.~..1~. ............. Rear ........ ~...~..~.. .................. Depth ......... /:'~......./. ............ 10. Date of Purchase ....~.~/.~.~......~.~..~'..~.~ ---- ........................ Nome of Former Owner ~?~.~.~..~.-~ ................................... ! 1. Zone or use district in which premises are situated .................................................................................................... .._?. 12. .Does proposed construction violpte any zoning law, ordinance or regulation? ....,~/O. ................................................. 13. Name of Owner of premmes .y...'.'..~.....~.~.......~.~..~...~cldress ~_,,~c~.,~Z~.....~..~. .......... Phone No. Name of Architect ...............: ...................................... Address ............................................ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensioh~fl~m~ proper'n/ lines. Give street and block number or description according to deed, and sh~ street names'ee~.Ln*dieate whether interior or comer lot. STATE OF NEW YORK, lee COUNTY OF .... ~S~:~3.,~. .......... )' ~'~' .......................... ~,~.~,~-~p..~-f,e,f,~-e~. ..................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ......................................... (~MD,~. ........................................... ~ ....................................................... (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 tha~ the work will be performed in the manner set forth in the application filed therewith. Swam to before me this: ; . ........... 2.~Y-~....~Jav of ..6.e~t~il~ez: ........... ....... 192.1... pu , ._ ',FI...:,9/L ............... .............................. Notarybl'c~~,,~.,,~d~,~~Count~ o~ ~u~e~]~ (SIgnature'of ~pplicant) (,/ ELIZABETH ANPt NFj~ILLE NOTARY PUBLIC, State o? New Yor~ ' No. 52-8~2§850, Suflolk COLL~ Term Expires March 30, 19