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Home My WebLink About5547-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at gO~2Boaol~ .Ro~di ........ Street Map No.~d&~' .]~0h .PP~lock No ........... Lot No. ~2 .... ~Otl~O~d.. 1~ ~][, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... 0~t ..... 1,..., 19.71. pursuant to which Building Permit No. ~ dated ........... 00~, .... ~..., 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 .. P~.~.vat,~ .&oeossoz'~r. (l~o~age). bldg ................................ The certificate is issued to . .DI'.o..It,. B.ul'lr~ ..... .t~ll®l, ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...ll.°l;lo ............................ UNDERWRITERS CERTIFICATE No.. N.°.R. ? ........................................... ttousE NUMBER.. ~.60 ....... Street..CeCl~l~ .B®&ah.Road ............................ Building Inspector FO~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERJ~IT (TI~tlS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5547 Z Permission is hereby granted to: at premises located at ......... J~li{,.~j~.,.,Gli~.&~...~l~jr~j3....l~ ........................................................... .................... ...................... ~,~ ....... ~.z., ............................................... pursuantc to application dated ................................. ~, .........J~ ....... , 19...~.J., and approved by the Building Inspector. ~/~'--~'~'~ ~. ~'1 BUILDING DEPARTMENT ~,~ Ir ....... TOWN OF SOUTHOLD ~ ~ ~ ~ ~ , TO~N CLERK'S OFFICE k ~ SOUTHOLD, H.Y. r-/ ~proved ........................................ , 19 ........ P~it N ......... APPLICATION FOR BUILDING PERMIT Date .................... , ...... INSTRUCTIONS 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 Iocotian of lot and of buildings on premises, relationship to adioining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. c. The work covered by this opplication 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 work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY N~DE to the Building Department for the issuance of a Building Permit pursuant to the~ Bud ng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. ..................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................ ........ ................................................................................................. Name of owner of premises ...J~..~,......~-.,.....~'..(~...-'~./..~...? .~.. .......................................................................................... If applicant is a co,orate, signature of duly authorized officer. ~/~[ ~/' ~'& ~ ~ ~ ..................................................................... · (Name and title of co,orate officer) 1. L~ation of la~ on which pro osedwor' will e done Ma No' ~~~No ~ ~ici~li~ 2. State existing use end ~c~y of premiss end intended use end ~cu~ncy of pr~s~ c~structi~: o. ~isiting use end ~c~ency ........ ~ .................................................................................................... b, Intended use and ~cu~y .......... ~..~.~.~.~.~ .................................................................................... · 3. Nature of work (check which applicable): New Building ................. Addition ......~. ......Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ............................................................ Fee .......... ..~../.~,..~..~.~.....~... .................................................. (to be paid on filing 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 str~ctures, i~ any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. ! Dimensions of same structure with a teratioj~ or additions: Front .......... ~......~2,.l. ......Rear Depth ........ ~.. .................. Height .......... ~.,. ............ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories .......................................................... ~ 9. Size of lot: Front ............................ Rear Depth 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 I. Zone or use district in which premises are situated ............................................................................................ 12. Does propos~l construction violate any zoning law, ordinance or regulation? ....................................................... .~.... 13. Name of Owner of premises .,. &/.~.~.../~ ........ Address ..~..... Phone No ....... :;:::: ........ : Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .-~'...~4~..~..~.~J..C-.. ........... Address .....~.6~/...~'.~../~./.~. ...... 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 YORK, COUNT~OF .~ ................. ~ .......... $ · ' ' signing application) a~ve named. He is the ................................................... ~.~-~..~..C.~.~..C~ ............................................... (Contractor, agent, co~orate officer, etc.) of said ~ner or ~ners, and is duly authorized to perform or have performed the said work and to ~ke and file this application; that all statements contained in this application are true to the best of his ~owledge and belief; and thar. t~ work will ~ performed in the manner set fo~h in the application filed therewith. No. 52-81258~, Suffolk Te~m Expires March 30,