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Home My WebLink About5116-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at .. 'Vi~E/~g®' La ............. Street Map No..xX ........ Block No ..... ~...Lot No ...... X~;....0I~,en~..~t~.Y.: ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... J~..12 ......... , 19.7.~. pursuant to which Building Permit No..~116Z · dated .......... Jan... 12 , 19. ?.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 . P.F. iv&.te, ac~esso~.~. Bu:Llding..(.Greenhou.s.e .addn) .................. The certificate is issued to ... Cyril .Luke~a~. & .'~ifa ..... Owners ................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . ...~.:.R., ............................ House ~ I~O]IU~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5116 Z Permission is hereby granted to: ............ .g~.t1.,~..~..~ .~.... ................... ............ .~J.11sg~..**~ ........................................... .................... 0~ ............................................. to ~..~a,.~sO~,.~;i~m..~.~zts.t,t~..ac~ sse,v~..]~ ~ ~ ~rg..ff, gr.~..~ .a.. pursuon~* to opplicotion dated ........................... ~ ....... ~j~ ............. , 19,...~[~ ond approved by the Building Inspector. re~ $....~t~ .......... 'rOaN OF sOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFI(~! $OUTHOLD, N. Y. Examined .~,....../.i.~.~......, 19.~...1... ...................................... .... p. mlt No. Dl=appraved a/c ..................................................................... ........................... ~" '~{'~/ii~/i;'~"i;~i};;[';g;i ................ ~ ........... APPLICATION FOR BUILDING FERMIT Date ....~.~A~..~.,...~.?.Z~ ......................... ,19 ........... INSTRUCTIONS a. This application must be completely filled In by typewriter or In Ink und submitted In duplicate to the Bulldin: Inspector. b. Plot plan showing location of lot and of bu.lldings on premises, relationship to adjoining premlees or public streets o areas, and giving a detailed description of layout of property must be drawn on the diagram wk~ch Is part of thio applicatlo,- c. The work covered by this application may nat 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 portal shall be kept on the premlees 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 o Certificate of Oocupanc shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department f~r the Issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lowl, Ordinances o Regulations, for the construction of buildings, additions ar alterations, or for removal or demolition, al heroin describe. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and rtgulatlonl. (Signature cf applicant, o~ name, If a COrl~mtlon) State whether applicant I~ owner, lel~ee, agent, architect, engineer, general contractor, electrician, I~lumber o~ bullde, ........... ,~,~,~,~, ....................................................................................................................................................................... If applicant Is a corporate, signature of duly authorized officer. (Name and title 'of corporate officer) 1. Location of land on which prapmed work will be~ne. Ma~ No.: ........................................ Lot No.: ...................... Street and Number 500 Village Lane, Orient ~' Municipality 2. State exletlng use and occupancy of premllel and Intended use and occupancy of propped comtructlon: House and Barn a. Existing use and occupancy b. Intended use and occupant,' House and Barn w~ C-,z'.ee~ouse 3. Nature of work (check which applicable). New Building .................. Addition ...~, ............ Alteration ............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................................... 4. Estimated Cast ............ .~...,~.Q.0.,..Q.(~. ............................ Fee .............. $.~.,0~ ........................................................... (to be pa~d an filing th~s application) 5 If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ......................... If garage, number of cars .......................................................................................................................................... 6. If business, commerc,al or mixed occupancy, speci_fy nature and extent of each type of use .......... .... '24~ 7. Dimensions of e~istfng structures, if 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 24 t Rear 24 t Depth 10 t Height ......... .~..I. ...... Number of Stories 0I~ 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ...................................................... 11. Zone or use district in which premises are situated ................................................................................................... 12 Does proposed construct;on ~iolate any zoning law, ordinance ar regulation? .... .~..9. .................................................. 13 Name of Owner of premises ....C.....~.......~...~.~I.~..~..I.~ ........ Address ~...0..0.....V..~.~..]..~j~..e...~.~.e. ..... Phone No.~.~.~...~..7..~... Name of Architect ...................................................... Address ............................................ Phone No .................... Name of Contractor .................................................... Address ............................................ Phone No .................... PLOT DIAGRAM Locate clearly and distmctly all buildings, whether existing or proposed, and indicclte all set-b~ck dimensions fron property lines. Give street and block number or description according to deed, and show street names and indicat: whether interior or corner Jot. ,1' STATE OF NEW YORK, '~. ~ COUNTY OF ................................ )' '~"~' .................... ..C.~.~.~....~.,:....~,...L~,...e.,~..~.,.~. ...................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ................................. ~ .............................................. ' ......................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to rr,:ke and file this application; that oil statements contained in this application ore 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. Sworn to before me this ......... ......... .......... .,, z/ , ................... u ( g otur, o opp.cont) Yorl~ No 52-8125850, Suffolk Term £xp~res March 30,