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Home My WebLink About5186-zFOI~M NO. $ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..2;.b¢.~ ..... Date ......... re.b . . .h, .... , 1972. THIS CERTIFIES that the building located at ~lakomt.~a .Road ....... Street Map No..~ ...... Block No...Xlt ..... Lot No... ;~:I:.. ,Sottthold, N,M,... conforms substantially to the Application for Building Permit heretofore filed in ~is office dated ....... g[~qg. ~..., 19 ~3, p~suant to which Building Permit No.. 5}8.~ dated ........ F~rch. 29, 19 7~ , was issued, and conforms to ali of the require- ments of the applicable provisions of the law. The occupancy for which this ee~ificate is issued is . .pr.irate .acc.ss~r~ b~.td~g (Lo~ ~.ed.) ....................... The certificate is ~sued to .~R~9Y9 EV~ ....... ~gY ............ (owner, lessee or tenant) of the afores~d building. Suffolk Co~ty Department of Health Approval . N..R. ................... Building Inspector TOWN _OF SOUTHOLD TOWN CL~ERK's OFFIGE SO'HOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ........................... ~ ......... ~J., 19..~.J.. to ..... ~J"~"~mcew~r~..~:ea~er.ta.~ .......................................................................... at premises located at ............. ,~..]J~l~Jli~..J~ ................ J,~l,~..jj&f~el~j. .................. ............................... :..~ ...................... ~~ ................................................................................ pu~uan~ to application dated ............................ ~ ......... J~l .......... , jj~ ........ , and approved by the Building Inspector. FORM NO. I 'TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No .............. Disapproved a/c .............................................................................................. App,cation No. ................................. (Building Inspect~~ ............. APPLICATION FOR BUILDING PERMIT Date ....................... .~....f....~.........~.......?. ......... ,! 9...?...(.. INSTRUCTIONS a. This apphcation must be completely filled in by typewriter or in ink and submitted in duplicate to the Build/, Inspector. b. Plot plan showing Iocahan of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this applicatio c. The work covered by this application may nat 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 pert, shall be kept on the premises available for inspechon 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 Occupan. shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to t~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as here~n describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, (Signature cf applicant, o? name, If a corporation) ........ "'r'" ' ....... / J (Addres~ of applicant)-- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work wJJ, be done Map No.: ............... Z~..~.~ ............ Lot No,: .... ~, ............ Street and Number.....~.,.~¢.. N. a. Existing use and occupancy .... U....T..%..'~'~ ' ~J/" ....... ~ .................................................................................................... b Intended use and occupan:, .....Zq*. / ...... J,...~.~..~..~'. ...... %. ..................................................................... 3 Nature of walk (check which aoplicable) New Building . ~ ........ Addlhon .............. Alterat~or .... Re ar ' ~ . .. P' ............ 'J~4':' Remora ................Demolman ................. ~Other Work (D.scnbe) ............ 4 Eshmated Cost ...~/2.0. .............................................. Fee .....~.. ......................................................... (to be paid on fi'lng th~s apphcat~on) 5 It dwe[llng, number of dwelhng un,ts ..........................Number of dwelhng umts on each floor .. If garage, number of cars ................................................................................................................................ 6. If bus,ness, comme-c~al or m~×ed occupancy, spec.ff.y nature and extent of each type of use ..... .,) ......... 7 Dimensmns of exist,ng structures, if any: From .... .~'.. .............. Rear ......~ ...................... Depth ..... Height ....~...! ............. Number of Stones ...... / ............................................................................ Dimensions of same structure with alterations or addmons: Front ................................. Rear .................. Depth ............................... Height ...................... Number of Stories ..................... 8 Dimensions of enhre new construction: Front .................................... Rear ........................... Depth ........... Height ................... Number of Stories ................................................................... ! 1. Zone or use district in ~hlch premises are situated .......... ..~.. .......... ~ ................................................. 12 Does proposed construct,on ~,ol~te any ~oning law, ordinance o.1:. regulation ..... ~... 13 Name of Owrer of premises ./.~..~...O.......~....~...t~..~c~.l./~'~ddress ..~.~../7..~...~..4.~ ................. Phone No ....... Name of Architect .................................................. Address .......................................... Phone No ................. Nome of Contractor .......... ~...~ ............ Address ............................... Phone No ............ PLOT DIAGRAM Locate clearly and dishnctly all buddings, whether existing or proposed, and Indmate all set-back d~mensions fr~ property lines. Give '.treet and block number or descript, on according to deed, and show street names and ind,c~ ,vhether interior or ccrner lot. (Name of indiwdual signing apphcc/t~ll~h) , '' -- '"--'~//] (~.ontroctor, agent, corporate officer, etc ) of said owner or owners, and is duly authorized to p~'rforrn or have performed the said work and to make and this application; that all stotements contained in this applicahon are true to the best of his knowledge and behef, . that the work w~Jl be performed in the rnanner set forth in the apphcatJon filed therewith.! ~o 52-B~25BSI), Suffolk Count~ Term Exp~r~s rffarch 30, 1