The URL can be used to link to this page

Home My WebLink About5290-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTME, NT Town Clerk's Office $outhold, N. Y. Cerlificate Of Occupancy No. Z 1+~+32 Date Oct 11+ lg. 71 THIS CERTIFIES that the building located at . WZ~. PXne. $~'.e.e. B~, ....... S~eet Map No.~ ~....~ ~SBlock No ........... Lot No. ~ ~ ...... 9B~q~9~.. ~. ~ ,... conforms subst~tially to the Application for B~ldMg Permit heretofore filed ~ ~ office dated .......... J~y...$~.., 19..6~ p~su~t to wMch Build~g Permit No...52~. dated ........ ~ia~..12 ........ , 19.~1., was issued, ~d co~orms to all of the requ~ ments of ~e applicable provisio~ of ~e law. The occupancy for which ~is ce~fficate is issued ~ ... Prl~at. garage. (ac.ce ~ zn~y .BulldOg.) ............................. The ce~ificate ~ issued to ...Fre~ .~al.tarz ...... ~er ........................... (o~er, lessee or ten.t) of the aforesaid building. Suffolk County Department of Health Approval H~use ~ 3060 Pine Tree FORM 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) 5290 Z Permission is hereby granted to: .... ~. ~...~.s;.~. ....................................... ................... ~eheg~'e ....................................... at premises located at ........... W~..,~I~...~F~e.. ~ ...................................................................... ................................ lle~,~..i~.~..tet~..~..&..~ ........... ~ ................................. pursuant to application dated ........................... .,Tg,l,y..;.JlJl, ............. , 19.~l~., and approved by the Building Inspector. TOWN OF SOUTHOLD BUILDING DEPARTMENT ' . TOWN CLERK'S OFFICE ,~.Z ~ ~.,~ ,~..~/ .r._,~Y's* ,~ ,.~ SOUTHOLD, N.Y. Z~/ /~ ~ ~ ..... ...... ...... , ........... App~ ..... ~....~.~.~...~ ....... ~ ....... , 19...~.2 Pe~tt No.~..~..~..~.,~..~.'. ~ ~ ~ ,/ ~i~ ~/~ L~...~~ ......... ~ ............ ~.~.....~..~ ................................ ..................... ....... ........ " ............. ""~ ..... {Suildlng I~) ...... "';' 2 ..................... APPLICATION,FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink 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 public streets or~r~ areas, and giving a detailed description of layout of property'must be drawn on 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 this application, the Building Inspector will issue a Building Permit to the applicant. Such permitl:7 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 shell have,been granted by the Building Inspector. ' APPLICATION IS HEREBY MADEito the Building D'~pa~mi~n~F-tE~ [~iJance of a Buffding Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable L~ws, Ordinances or Regulations, for the construction o.f buildings, additions or alterations, Or for removal or demolition, as herein described. The applicant agrees to comply w~th all applicable laws, ordinances, buitdJng code, housing code, and regulations. name, if a corporation) ........ -- ~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner 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.:,~-'-~....~.~......./.../...7...~..... Lot'No.: ..-~..~.~./.....~.. Street and Number ~.~z~.~..~:~..~..~t~..~.~.~.~./...`~z~.~..~..~.~.~..~.~~;~:~ ..... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occuponcy ...... ,,~,.,,~.,/,./,,~..,,.,~, ,-- ...................................................... : ...................................... b. Intended use and occupancy ...... .-~....~..~:..!.~.....'~..;--/ ....... ; ................................................................................ 3. Nature of work (check which licable): New Building ....~. .......................... Alteration ....... ..~ ...... Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ...... ..~..~.......!...O.. .................................. Fee ...... ; ..................................................................... '. ............. (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 ......... ~ ........... 7. Dimensions of existing 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 .........../ ................... ! .......... .~.....e~.. ......... Depth ..... ~...~ ........... 8.. Dimensions of entire new construction: Front ......... .~....O.. .................. Rear z' ! Height .................... Number of Stories ....... /.. ................................ · 9. Size of lot: Front ........~..{~. ........... Rear ....... ~.~.../. ............Depth ........... *..~;'..~,.~....~ Z.~ 10. Date of Purchase ............ /...e~.~,..~ .......................... Name of Former Owner ..~.;~J~.~........C...~..~t~t~. 1 1. Zone or use district in which premises are situated .......... /~.J[.~..G~t~.~..Z~r.~.. ....................................... 12. Does proposed construction violate any zoning law, ordinance or regu at on.;) ..... ~.~ 13. Name of Owner of premises .. ~.~.~... ...... ./..~.~..~{...Address ...:../..~...~....~..,¢~..:~......~ ...... Phone No.~.~.~..-..~.~..J~.~ Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .~...~..~1~..-.~.....~...~.../..~.....~..~...~.....Address ....~...~.....~-~.....~...~...7-~....~...~,.- ..... Phone No ..................... PLOT DIAGRAM LOcate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. · . I I I above named. He is the .......................... ~...~...~ .............................................. (ContractOr, ag~t, co,rate officer, etc,) of said owner or owners, and is duly authorized to perfor~ or have performed the ~id work and to ~Ee ~d file this application; that all statements contained in this application are t~e to the best of his knowledge and belief; and that the work will be performed ~the manner set fo~h in the applicati~ filed therewith. ~om to before me this f ~ n ~ ~ -- ./ ~ ................. o, ........... ......... ............................. N~a~ ~blic, H~ARY PUBLI~, State of New York HO. 52-8225850, Suffolk County