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Home My WebLink About5570-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. z~106 ...... Date ............. ~.pri! .... 2~ ·., 19.7{~ THIS CERTIFIES that the building located at . ~o .trod-./P~e. & .14tdc}la. Ro&dStreet Map No.. x,x ........ Block No..~x ....... Lot No. ~r~.~.. iviai;l;~.t~(~k.. I{.,5[ o ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... Oat; .....18.., 19.7]. pursuant to which Building Permit No...~70~. dated .......... Qq~ ..... ]8..., 19.7.1., 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 . .]~.~a:D;toa. s .blLtlding...-. restaurant ................................. The certificate is issued to . .Gab~.e]... Kou$ou~eu~ ...... 0~rae~, ................... (owner, lessee or tenant) of the aforesaid building. Suffolk County ~Department of Health Approval · .N oR~ .............................. UNDERWRITERS CERTIFICATE No... I~.o.R, .......................................... ttOUSE NUMBER.~}09.~ ....... Street .... ~Oll:lld - ~,~'~, .................................. Building Inspector FORM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, FI. Y. BUILDING PERMIT (THIS 15ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION oF THE WORK AUTHORIZED) No. 5570 Z Permission is ereby granted to: to Ju.~ ..e,~.. o~d.,t t.~a...ea..~~...ir,~Lues, s ...l~ta,l&tntl ........................................ at premises located at ...... ~tRill~..~LVe..~,-~4J~cL],e--~.-.(.gJ~) ............................................. ......................................................... ;~t,;t~a~ ................................................................................. pursucm4' to application dated .......................... JJlJ~ ....... Jj~.....~4~lt~, 19 ........ , and approved by the Building Inspector. Fee $...~.aJ~ ........... Disapproved a/c ............................................................................................ TOWN OF'SOUTHOLD ~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. t ui lng nspector] / APPLICATION FOR BUILDING PERMIT 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 location of lot and of buildings on premises, relationship to adjoinigg 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 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 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 MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable L~ws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein descJibed. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Sign_~a~/q~ applicant, or name, if o corporation) · ............................... State whether appl~ant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .~.~.....Z~ ' . ............................... ~ If applicant is a corporate, signature of duly authorized officer. ~ .................. i ' ......... Location o and on which proposed y/ark will be done.~ Mg_~ I~.: ..................................~ NoJ~,.;...'. .... Street and Number ...... ~..~....~ ........ ..~.....Z~....~...~.. .......· ..~.-.-..~iJJJ[[[i[i Municipality State existing use and occupancy of~remises and intended use and occu_j~ag,cy~r------~'~}l~;~ed cor~truction: a. Exisiting use a~ ~cupancy(~..~.~....~. .......... ~...~~.~...C ...... Z .................. b. Intended use and ~cupancy ....... ~......~.~~ ..................................................... 3. Nature of work (check which applicable): New Building .................. ,A4~clition..................~' A'~lt ion Repair .................. R~emoval .................. Demolition ............ ,..,.r~Ot~er Work (Describe) ..... ;.....~ ........................... 4. Estimated Cost ..................... ~ ................................ Fee ...r.~.. ..................................................... , ............................ (to be paid on filing this app~c'ation) 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. D mensions of ex sting structures, if any: Front ..... ...~L..~.'. ........ Rear .~..~. ........................ Depth ?..O.. ............. Height ........................ Number of Stories ....~ ..................................................................... Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of 3tories ................................ 8. Dimensions of entire new construction: Front /..~..... ~ / ~- Depth-~..~. ................. Height Number of Stories ~ ..... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date afl Purchase ........................................................ ~l~e of Former Owner ................................................. 11. Zone or use district n wh ch prem ses are s tuated .. ~.l .~...~ ..... 12. Does proposed construction violate an.y, zonina law, ordinance or regulati~e,~...~...~. ............................................... 13. Name of Owner of premises ..'~:)l~,J.~..~...~.....~.~,i~clress ....... .~~ ......... 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 dimensions from property lines. Give street and block number or description' according to deed, and show street names and indicate whether interior or corner lot. STATE, I~ COUNTY OF being duly swam, deposes and says that he is the applicant tividual signin~q~pl: _ above named. He is t~.....~...~ ............................................................................................... ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, ancl is duly au-~herized 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 therewith. ty~,g~g,~ ~" ature of applicant) ...........