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Home My WebLink About5131-z~O~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..~.~.~89. · · Date .......... ltal'elt...l~, 19 . ~2 THIS CERTIFIES that the bnilding located at .. It;/t~ l~ltddle ReaCt (CR27~treet Map No. ~ .... Block No..XXX .... Lot No. Yt~XX. .Peeonic .I~,~, ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... Feb ..... '3 ', 19.7t. pursuant to which Building Permit No. ~]3]Z dated ........... FeD -.3 , 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 I/,~ Blxsiae~$ · b~Idlt/g 'W~th' apar~me~at .cm- 2nd. ft~o~' .... The certificate is issued to -- ~Olllr~tt~ lla~a ....... Ovlae~ ........... (owner, lessee or tenant) of the aforesaid building. Suffolk Cotmty Department of Health Approval · ~re~ex~ating 'pools & well · · ' 1/ ......f. ...... ''~ ~ Building Inspect~ TOWN OF SOUTHOLD .BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. 'BUILDING FERMff fiNiS PERJ~AIT MUST BE KEPT~ ON THE PREMISES UNTIL FULL COMPLETION OF ~I~IE W~)RK AUTHORIZED) ~N? 5131 Z Permission is hereby granted to: ........ ~...!i~t..~[~.,~..~ ..................... to .... ~j~.,. ~.~...L~jI~.~..~.~.,..~...~ [~.~l~j[....~..e..Cl...e....J~4J~Jj~...~.1~....J~.]~.j~J~J ........................ ............... .(~t ..~.tl~..~.t :.~..~,...~l ......................................................................... at premises located ot ............ ::'.~JjJ.,:~;~J~.~...~l~.:~[.~.~J~.J ................................................... ..................................... t~eJ~..:.~.~;~., ................ .: ....................................................................... pursua~ to application dated ......................... .JJ..~t ....... ~ .................. , 1~.~...., and approved by the Building Inspector. ~ Building Inspector J NO. I Approved ~TOWN OF sOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19 ........ Permit No ............................. Application No......'~../....~...~ ....... Disapproved a/c ............................................................. APPLICATION FOR BUILDING PEIU~rI' Date ......................... ~..e.? .......... .~. ............... , 19.?/.! ..... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Butldin.~ Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o, areas, and giving a detailed description of layout of property must be drawn an 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 th,s application, the Building Inspector will issue a Building Permit to the applicant, Such permil shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whale or in part for any purpose whatever until a Certificate of Occupanc~ 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 Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other oppliceble Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described The applicant agrees to comply with oil applicable laws, ordinances, building.code, housiDg code., and regulations. (Signature c applicant, or name, If a corporation) Pecenic N.Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ............................................. Osc~er,...-....b~iZ~er. ............................................................................................................... Name of owner of premises ..... ..~..e....]~..~.~.....~.~..~.~ .................................................................................................................... If applicant is a co~orate, signature of duly authorized officer. (Name and title'of corporate officer) 1. L~ation of land on which proposed work will be dane. Map No.: ........ ~ ........................... Lot No.: ..~ ................ Stree and Number ...~Z.~...~l~..Sg~...q.,~.,...~.2 ......... ~e.c.e~lc.....~.,Z, ................................................ 2. State existing use and occu~ncy of premises and intended use and occupancy of propos~ construction: a. ~isting use and ~cupancy ..~.~...~Q~...~~ .................................................................................... b intended use and ~cuFen~, ..~.. ~.~..~..~...e~..~.,~oo~ ........................................... Nature ,.~f wo~k {check which apphcabie') New Bu~dmg ............ Addition ..... ~ ...... Alterahoa .....:~... 3 Repair ........ RemoYaI ............. Demolition ..............Other Work (Describe) ............... 4 Estm-ated Cost .... -~ y OO(~...~'. ................................. Fee .......~.:.90. ................................................... (to be paid on fl'lng th~s applicahon) 5 I~ dwelling, number of dwelhng un,ts ....~J~tJll ................. Number of dwelling un,ts on each floor ....... If garage, number of cars ........................................................................................................................................ 6 If business, comme-c,al or mixed occupancy, specify nature and extent of each type of use .~.~.~...]). ........... 7 Dim, ens~en_¢ of exlst,ng slructures, Jf any' F~onl ....................... Rear ............................. Depth ................ Height ..................... Number of Stor~es ................................................................................................. D:mensions of same structure with alter(~lOnS or additions' Front .................................. Rear ............... Depth .............................. H-*~ght ......................... Number of Stories ........................ 8 D~mcns~ons of enhru n£w constrtJchon: Front .................................... Rear .......................... Depth ............... Height ................... Number of Stories ............................................................. 9 S,ze of lot: Front ........ ..2..0..Q .......... ~.ear .........::).0...0 ................. Depth ..... ~.Q.0...+. .... 10 Date of Purchase ................................................... Name of Former Owner .... q.~...~l~.~.a..~.~. ......................... J'i. Zone or use d,strlct ,n which prom,sos ore situated ..... .~..~..n....~.~..S..~ ......... ~..~..?..q..' ..... ..12...S..e..). ............................... 12 Does proposed construct,on ~mlate any zoning law, ordinance or regulahon? .... ll~ ......................................... 13 Name of Owner of prom:sos ..... ..~..o.....]~.....S..s. ................. Address ....~...e..c..o..~..i...o. .................. Phone No ............... Nome of Architect .................................................. Address ...........................................Phone No ................ Nome of Contractor ........... Cj[l~.fl ............................... Address ...................................... Phone No ................ PLOT DIAGRAM I_ocote clearly and d~stmctly oll buildings, whether exist,ng or proposed, and indicate oil set-back d~mens~ons fro property hnes. Give otreet and block .qumber or description according to deed, and s~ow street names and indlca whether ,nterior or corner lot See attached plan STATE OF NEW YORK. I. S $ COUNTY OF .~f.c. lk ............. J -- .................................... ~;[~;l~l,t..J::[az.$ ............. being duly sworn, deposes and says that he ~s the apphc~ (F,lame of indwldual signing apphcahon) above named. He ,s the ............................ .O.~.e.~....-....~...~..:Jr...l~..e.~.. ................................................................................... (Contractor, agent, corporate officer, etc.) of so~d owner or owners, and ~s duly outhorJzed to perform or have performed the sa,d work and to make and this appJicohon; tk. at alt statements contained m th~s opphcahon are true to the best of hm knowledge and behef; c tl*.ar the work will be performed in the manner set forth in the application f~led therewith. Sworn to before me this ~ /' // / ,~ // ............. ......... ........... .................... ~ otor'/ Public,. ................................................... Count~ (Signature o~l~ii~'~')" "