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Home My WebLink About5640-zNO, 4 TOWN OF SOUTHOLD BUW.DING DEPARTMENT Town Cle~k'~ Office Southokl, N. Y. Certificate Of Occupancy No. Z63~6 ..... Date ............ Marok..13 ..... , 192~. THIS CERTIFIES that the buiMi,~g located at P.~ne. ~ee. &. Ba.y..Ave ..... Street Map No. N&ss,. 1,~, Block No ........... Lot No.. -3 ...... CutchoL'u~.. l~.,.~ o ...... conforms substantially to the Application for Bufl~i,~ Permit heretofore fried in this office dated ............Iiov. · .23.., 19.71. pursuant to which BuiMing Permit No. ~f~0~ · · dated ........E~.. 2t~ ......, 19.7.1., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which tht~ certificate is issued is ... ~iva.~e. cfm .fa~l~. d~e11~... ~.~.th. an .&d~$tio,~ ............. The certificate is Lasued to . .~oh~ .L. & .Ro~el~ar~e. ~&vo~ ....... .u~mers .......... (owner, lessee or tenant) of the ~foresn~d building. Suffolk County Depez~ment of Health Approval NcR, ................................ UNDEBWRITEBS CEBTIFICATE No..penfl~.~g ......... ' ........ HOUSE NUMBER .... 827.% .....Street .. ~y. ~e. (. ~ .La) ................. Building Inspectorl FOI{,~ NO, ~ TOWN OF SOUTNOLD 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? 5640 Z Permission is hereby granted to: at premises located at ....... ~l~.....~l~li4~.~&3g~. ......................................................................... .................................... ~ta~ ..~. &...l~a,e-..~eee.. ae~ ......... C~tet~ate .................................. pursuan~ to application dated ........................ ~lltll~ ....... ~ ................ , 19.~..., and approved by the Building Inspector. }Zee $...-~*00 .......... Building lnspecttr TOWN OF SOUTHOLD..~ ,~.~' /-/.~/~, ~,~Y-- 7fa//-- ~, BUILDING DEPARTMEN~ .... ~.~ ~ -~ ~~ TOWN CLERK'S OFFICE ~~ -/ _ ~--- ~ ~ SOUTHOLD, N.Y. ~' ~ ~ ~~ ~ ~ / ~pfic~tion No....~.~'~ ................ Examined ...... ~......~.....~..~ ...... 19 Approved .................. t.~. ........ ~..~. ........ , 19...'..~.'.. PemitNo.......~...~.....~....0......~:......?.,.-. '~-'~1:~-'- ~ ~ ...................................................................................................................... , ............ (Building I nsp~ ~* .~PPLICATION FOR BUILDING PE~IT ........... , ...... :NS UC ONS ~. This opplicotion must be compl~tel~ filled in b~ ~powriter or in ink ond submitted in duplicot~ to the Buildin~ Inspoctor. b. ~lot plon showino location o{ lot ond of building, on premises, r~l~tionship to adjoinino pr~mi~e~ or public ~tre~t~ or ~re~s, ond ~ivino o detoil~ description o{ I~out ofprop*r~ must be drawn on tho dio~rom which i~ p~ o{ c. The work covered by this ~pplicotion m~y not b~ comme~ed b~fore issuance of Buildino Permit. d. Upon ~pprov~l o{ this opplicotion, th~ ~uildino Inspector will issue , guildin~ ~rmit to th~ ~plic~nt. Such p~rm sh~ll be kept on the promises owilobl~ {or insp~ti~ throughout the pr~r~s o{ th~ work. e. No buildin~ sholl b~ ~cupied or u~ed in whole or in po~ {or ~n~ purpos~ whomever until ~ Co~i{ic~t~ A~klCATIO~ IS HfiRfiBY ~D~ t° the Buildin~ D~p~rtment for the issuonc* o~ ~ ~uildin~ P~it pumu~nt to th~ Buildin~ Zone Ordinonco of tho Town o{ Southold, Suffolk County, ~w York, ond other opplic~bl~ ~w~, Ordin~n~, or Rooulatiohs, for the construction o~ buildings, oddifion* 0r ~Itor~tions, or for romovol or domolifion, ~, h~r~in d~ribed. The opplicont oorees to comply with ~11 opplicable ~aws, ordi nonces, buildin~ c~e, hou~in~ c~, and r~oulatio~. --. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder; · '" , ............................................ ." Name of owne~ of premises . ~1~q~~K~/~y~ ...~ .............. , ........... i ..... If applicant is o corporate, signature of duly authorized officer. ,~,¢~ o ~ ~ , ,~ (Name and title of corporate officer) Location of land on which proposed work will be done. Map No.: Lot No.,~ ..................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Exisiting b. Intended use and occupancy ............................ ~. ......................... ~. ............ ~:*'*''r***~ ..................................... 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 t~pe of use ............................ ' 7. Dimensions of existing structures, if any: Front ....... .~'..~.,~....: ....... Rear ....... ..~....~.:..e..: ............. Depth ..~..~.~.~'..~. ...... Height ..../..~.;..K.,.~. ....... Number of Stories ./.~. ............................... Dimensions of same structure with alterations or additions: Front ....... .~..,,~.¢.~...; ............... Rear ...?.,/.:.z~.../. ............ Depth ....... ~..~'..~'..~ ............ Height ......... ./..~.'..~.. ......... ~ Number of Stories ...... ./.~./' ................... 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height Number of Stories 9. Size of lot: Front ....... /.~..~.t.~. ......... Rear ......... ,/..~..o.:.,~..~ ........... Depth .......~....?"..~.:.~..~ .......... 10. Date of Purchase ......... ~/...~.Z.~...~. ............... Nome of Former Ow, er ~...~.~9..~....~..~..~...r'..e'....~....~. ................... 11. Zone or use district in which premises are situated ~ .................. l~. .................................. 12. Does proposed construct on v o ate any zon ng aw, ord hence or reau at on;~ Y'~ ~' ; ........................................ 13. Name of Owner ~!~prem~ses ..X~.~.$.~..X~.~'~....~:. .......... ~c~ress ...... .~.. ..................... ...'~.~...~.~.~.. Phone No.~..~...~..Z...~.....~... Name of Architect '.; .. . Address ~ //~'K~ Phone No. Name of Contractor .~.~..~...~..., ..~.~'..~.4~ .~. ................. Address ............... ...~.~.'.~.~. ................ Phone No....,r~...~',~?....~.. ..... 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, COUNTY OF ............................ ................ op, (Name of individual signing application) above named. He is the ........... K.~.~...~'..~..~. ~ ~ ~ ~. ~ .................... ' (~ntmctor, ag~t, corporate officer, ~c.) of said ~ner or owners, and iS'duly authorized to perform or have performed the said work and to ~ke and file this application; that all statements contoin~ in this appliC~ion am tree to the best of his ~owledge and belief; and that the work will ~ performed in the manner set fo~h in the ~plic~im filed ther~ith. Sworn to before me this ~ B / ........ Nota~ Pub iE~/..~,~~ .... Coun~ ~ (Siana~re of applicant)