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Home My WebLink About5197-zFOF, M NO. 4 TOWBI OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, BI. Y. Certificnte Of Occupnncy THIS CERTIFIES that the building located at . 14ar .l~a~. D~ .............. Street Map No..XX ......... Block No..~ ....... Lot No.. ~.. ~tt~.t~k. · .li,X,. ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... Mai'Oh..S.S., 19..~J pursuant to which Building Permit No .... dated .......... ~ar,...~..., 19.?.~., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is . .l~;l, vate .gar~le. (. acee~sory. B~,dg} ................................ The certificate is issued to . .C ,. I~,O~&Clki ..... 0~ner .............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County D~epartment of Health Approval ..... Il,R. .......................... /./ c ....... ,---- .. - Building Inspector l~O]ll~[ NO. ~- TOWN OF SOUTHOLD 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) Permission is hereby granted to: ............ .J~t ~.~ .......... ~ ............................. at premises located at ...... ]JlJ~..~JlI.T~[,;J,lte...][J~ ................................................................................... ............... ~ ............................... ~tt~Lt~e~ ...... ~.,,,T,**.: ........................................................................ pursuar~t to application dated ..................... .~.~eJ~ .......9% ............ , 19...~.~., and approved by the Building Inspector. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ,, ,, ,~ ,, o-,/ ~Z.z... ^l~roved ........................................ , ........ Permtt No ............................ Dis~ppr~ed o1¢ .............................................................................................. t Application No.....~.....(-,~....Z., APPLICATION FOR BUILDING PERMIT ~o,, ......... ~.~..B. .......... ~..! ................ , ,o..~ .... INSTRUCTIONS a This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Butldir Inspector. b. Plot plan showing location 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 an the diagram which is part of this applicatio c. The work covered by this application may not be commenced before issuance of Buildir~g Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such pert,- 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 Occupan, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit puniuant to tl 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 demolihon, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Signature cf applicant, o~.name, if a carnation) (Address of a~pllcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build: Name ofowner of premises ....~. ......... ; ~' ' ........................................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title 'of corporate officer) 1. Location of land on which proposed work will be done Map No.: ........................................ Lot No.: .....~....~... ........ Streot ond Number ............................................................... [ ...................................................................... ~/' '-- c~ ~ ~ ~ Municl~li~ 2, State existing use and occupancy of premises and intended use and occupancy of propas~ construction: a Ex st n use an ~cu an ~~' ~ . g a p cy ................................. ,~ ............... ~ .......................................................................... ~. ,.,e.~e~ ~,e ~.~ o~u~... ,,. ~.~ ~,~.~ ...... ~~....; .................. 3 Nature of wo~k (check which applicable) New Budding ~(' Addition Alterat,on Repair .................. Re~ova~ .................Demoht~on ............... ;. Other Work (Describe) .............. 4 Estimated Cost ............ m~....,~ ..?~....0...0. ............................. Fee ........................................................................ (to be po~d on filing th;s application) 5 If dwelling, number of dwelhng umts ........ ~ ............. Number of dwelhng umts on each floor . . If garage, number of cars ................................................................................................................... 6. If business, commercial or m~xed occupancy, specify nature and extent of each type of use ..~ .......... 7 Dimensions of exist,ng structures, if any: FmW ........................... Rear .............................. Depth. / .... Height ....................... Number of Stones ....................................................................................... D:mensions of same structure with alterations or additions' Front ................................... Rear .............. Depth ............................... Height ........................ Number of Stones ........................... 8 Dimensions of entire new construchon: Front ............. ~,~.~ .......... Rear .......... .~.~......~... ...... Depth .....~.,...~... .... Height ................... Number of Stones ........ ~ ........................................... 9. Size of lot: Front ........................... Rear ................................. Depth ................. 10 Date of Purchase ................................................... l'game of. Former Owner .................................................... 11. Zone or use district in which premises are situated .... ./~.'~...~ ................................................................... proposed construct,on ~olate ar~ zoning law,~ordmance or regulatJ.a~ .~ ./1~...~..~ ................................... 12 Does Name of Owe, er of remises .~..' ~ ,e~ Address ~.O-:~ Phone o 13 , p .................................................................. N Name of Architect ................................................... ~, ~-~. ~, J/'_~ Address.i~,~i~i ~ciSj ........ Phone No ............... Name of Contractor ...... ~..:.'...~e~w~,~1 ..... ..~....~.. ......... Address .'........... __. ...................... Phone No .................. PLOT DIAGRAM Locate clearly and distinctly all buddings, whether ex~sting or proposed, and red,cate all set-back d~mensions fro property lines. Give street and block number or descript*on according to deed and show street names and ind~ca ,vhether interior or corner Jot. STATE OF NEW~'OP, Jc~/~/ tS$ "'"'"""'".'"-..".....~.~.Z.....~..l~"'"k"4f'~:¥'..'~.?I. ............. being duly sworn, deposes and says that he ,s the apphc~ (Name of individual signing apph,~g,t~on] above named. He ~s the ............................ ...r~.....)~.....-ff~...~.:..'5~ ........................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sa,d work and to make and this application; that all statements contained ~n th~s application are true to the best of h~s knowledge and behef: tha~ the work will be performed in the manner set forth m the application filed therewith Sworn to before me this .................. · .~.../day of ............ ~ '" '." ............ NO,^I~¥ ,u~;c. Stae of ~I ~ ¥or, ~ Cou,~~ (Signatur( of applica¢ ............ ~rm Expires ~afc~ 30,