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Home My WebLink About5261-zFOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 5..h:3~8. .... Date ............. &lag ...... a~..., 19. THIS CERTIFIES that the building located at ..... Pae.~.f:l(~. S~;. & .I,e~.gon Street Map No...~ ........ Block No. ~ ....... Lot No.. Xl~:... l~la~;.t.ttuek..}L,k% ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... April,...26., 19..7] pursuant to which Building Permit No. dated .......... .¢prt.]....2(~.., 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~:&Va~;e..garaga. (aeaec~so~,y. I~UJL],¢I ir~g ) ........................... The certificate is issued to . .~¢avAey. t4a~lg¢~ .... .0,~me:r ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...... ~,R, ......................... e goa ¥ .... -i..':..../. ............... Building Inspector FOtLM NO. 2 TOWN OF $OUTHOLD 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? 5261 Z A~$1 2~ Permission is hereby granted to: .................. .~......~.~.~i~.~..~,./,~.....~.~.?:..?~ at premises located at .......... .~.i~.~.;ie,..,~.l~..~,...~,,~.;~.~/.b..~14~ .......................................................... .................................................. ~,,-.~. t;, .:~¢~ .................. pursuan¢ to application dated .............................. {~.,~ ........~,~......, 19....~ and approved by the Building Inspector. Examined e\ Approved ........................................ , FOII~ NO. 1 TOWN OF SouTHOLD BUILDING' DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19 ........ 19 ........Pemit No ......................... p,,cat,on No ...... ......... Disapproved a/c ........................................................... ~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ~ a. This application must be completely filled in by typewriter or n nk and submitted in duplicate to the Building Inspector. · =, b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or ublic streets or~ P areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application, in c. The work covered by this application may not be commenced before issuance of Building Permit. -,I d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit 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 Occupancy 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 Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. Jllti tll (Signature of applicant, or name, if a corporatiOn) ................. ........................................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................................ ................................................................................................................... Name of owner of premises ..... .~.1;.~¢l~...~.1~.~0 .............................................................................................................. applicant is a corporate, signature of duly authorized officer. If .................. i ' ......... 1. Location of land on which proposed work will be done. Map No.: ............ ~ ...................... Lot No ..... Street and Number ............... j~e.:~.~.~..,~tr.ljl:...j~.l.~el~..&V. ............ ~j~t~.~nlcl~,q~i[~' ...................................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy&~.(,~j.lla~Z?...j~j~.~, ................................................................................................. b. Intended use and occupancy ............ JLJ...~,.t~..~lt..~d~:Lt,~ol~ ............................................................ , .... 3. Nature of work (check which applicable): New Building .................. Addition .....~ ..... Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ....................... ~O0.._~h ........................ Fee ........ F~,00 .................................................... .................... (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 type of use ...~01~,~:~... 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of some structure with alteratiOns or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ....... .1.~ ........................ Rear ....~.~ .................... Depth ...~ ................. Height .................... Number of Stories .............~ ................................................................................................. 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Dote of Purchase ........................................................ N~3rne of Former Owner ........................................................ 11. Zone or use district in which premises are situated ....&..~)~.G~ .................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation.;) ....... M ................................................ 13. Name of Owner of premises ....~...~&~,~e ...................Address ............................................ Phone No ..................... Nome of Architect ...~.~ ............................................. Address ............................................ Phone No ..................... Name of Contractor "&'&'"~l~.:~. .......................... Address ......... ~1~.~.~;.~,.~.~{~ ............. Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and 'ndicote oll setJ~3ck dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. d STATE OF NEW YORK, t S S COUNTY OF ....... t~lZ_~o'l'~ ........ ~' ' ............... · -..:..~ .............. ~ ......... ~..~lt~,[[..... .................. being duly SWorn, deposes and says that he is the applicant (Nome of individual signing application) above named. He is the ................................. C.~.t,Z'~,O.~g~ ................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to rn~ke and file this application; that all statements contained in this application are tru~y~9 the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the applicotiorr,file~l therew th. Sworn to before me this / / _ .................. · ................... · ~ JU~tTH T. ~ ¥o.~ __ _~ cant. No. 5~*0344963 Suffoll~ CeUnt~. f~.,~ Comm;sslull [xpi~s March 30~ I~ ~