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Home My WebLink About5297-zTOWN OF SOUTHOLD BUILDING DEPARTMI~.NT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy THIS CERTIFIES that the building located at . Crescent .~,va ............ Street Map No.. Y~ ........ Block No.. XY, X ..... Lot No..L~ .. F-~-$her~ .t sta.nd. · ~,,¥ ,.. conforms substantially to the Application for Building Pemit heretofore fried in this office dated ......... l~2a.y... 1 .~ ..... , 19 .~.%. pursuant to which Building Femit No.. dated ......... b~ay .... j.b,..-, 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.r.f~va.to · one..£am.~..ly, due 1].&rig. ....................................... The certificate is issued to . ~.o. ber.t..~slutxhe12. ....... .~fianer ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Building Inspector / FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT fi'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5297 Z Permission is hereby granted to: ~.,T.,~e, le....r..,~t.i~...l'.n®..&/~.-Relme~.....C~mpbell ...... F$~.~.~"'~'~.~ ........................................ to · ~Bu.t,~..ma...ml~.$ ~.$o~..~..ex~s ~rt~.. ~e~,1-~.:I~$- ............................................................ at ~remises located at ............ ~..CF~"&~ ......................................................................... ..................................................... ~l-shv~":I~.and ............ t~Y~ ................................................... pursuar~t to application dated .............................. ~*'~7 ....... ~'3 ........... , 19....~ and approved by the Building Inspector. Fee $..~4.0~ ............ FO~ NO. I TOWN OF soUTHOLD RUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ^l:~raved .......................... .; ............ , '~.?.... Permit "o......~..~.f.Z.~ Disapproved a/c ................................................................................ APPLICATION FOR BUILDING PERMI'I' 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 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 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 port 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 purauant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ~nd other opplicoble 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. ng Thc. . T ohn.. ad, e.. Jo ,o ...... (Signature cf applicant, or name, if a corporation) ,~O ~ ~ ~ .l~..~.~..h...~...a....l..s. land~ Sew York 06390 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................................................. ener l...Cont actoz: ........................................................................................ Name of owner of premises ....,~f)~J~A~...CJtIIIJJ]g~I 3, ........................................................................................................... If applicant is a corporate, signature of duly authorized officer. '· ............. UName onat~t~e'ot corporate otr~cer) 1. Location of land on which proposed work will be done. Map No.: ..J~l~2 ............................ Lot No.: .~nml..~l .... Street and Number ....... ~.e~.cJ~lat;..A¥.elx1Ae. ................................... .E:L~J3.~'~I...~I3,~331;1,~..~..~¢i~ ........... Municipality 2. State existing use apd occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... ,l::~;J,I;1,eD,~ ......................................... b. Intended use and occupant', re$ide~ce ~, ' 3. Nature of walk (check which applicable): New Building .................. Addition .....~.. ........... Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ...~q.l~,~.0g.D,..(J0. ................................ Fee ~..5..~...0...0. ............................................................ (to be paid on fi!lng this application) 5: If dwelling, number of dwelling units ......... :J, ................. 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 ...... .4'.0. ................. Rear .......J.g. ..................... Depth ....3D. ........... Height ..~.1~. ................. Number of Stories 1 . . D~mensions of same structure with a,lterations or additions: Front ......... 2~1 ...................... Rear ........ 7.8. ............... Depth ...~.0 ........................ Height ......][~ .................. Number of Stories ..........~. .................... 8. Dhnensions of entire new construction: Front ....~J.~..". ......................... Rear ....... ~.1~..". .............. Depth ....~..6.." .............. Height ..~...g. .......... Number of Stories ....... ~, ...................... . 9. Size of lot: Front .~,.l~5.,.~J~. ............ Rear ..~,.~5~*.5.0. ................... Depth ...~.0~.8....-...~.~,.~.e.87 10. Date of Parchase ........................................................ Name of Former Owner (~ikl~,J.#~...,~.e....g.~.~l.1..1.. .......... 11. Zone or use district in which premises are situated ............. /ZWliI.~4.1~.~-.~.q~ ............. 12. Does proposed construction vi~late any zoning law, ordinance or regulation? ...ilO. ................................................... 13. Name of Owner of premises RoJ~z'.L.Ca~j)~e11...Address ~'J.~l~e~'~l..TILJ.&n~l .......... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Nome of Contractor ~..~...GlllXt,...CDX~,.~l:,.Address ~'.~B~l~..~l...Zl~,l,s~D,4 .......... Phone No. ~..8..8...-.7..2.3..1.. 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 corner Jot. See enclosed Plot Plan STATE OF NEW YORK, *Ice COUNTY OF ................................ )' ~"~' ........ .,~..~nTID~D...~J.~,J~.iR,~..~..~.e ......................... i ..................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ......... .Y.;I,.~CL~.g'.~RI,~.~3.t;.. .................................................... :L ....................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and ti,ar the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .... ......... day of ..... ..................... . Noto P.b,ic, : .......... ._-- ..County .........i ........... ........................ ~ ~t~lJbJJc, State of New York JJeiliding in Suffolk Co. Off. No. 52-6439000 ~ommission Expires IV~'cb 30~ J ~'~2~- ,~, 8 5-"- o,,'- 4 o'!,¢-. 8's.5