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Home My WebLink About5231-zTOWN OF SOUTHOLD B~m.F)ING DEPARTM~T Town Clerk's OEice Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the builctin~ located at .R,0.,I/,. N/~. RtVoh. PA ...... Street Map l~o./Cagt. K~dd. Block No ........... Lot No,l~ll~.. l/att~,tuck..~'.Z, ......... conforms substantially to the Application for Building Permit heretofore ~ed in thi~ office dated .........Apr:Lt.. l.~.., 197~. · pursuant to which BuildinI Permit No.. ~231Z. dated ........... Ipr. il...1.~., 197.1.., was issued, and conforms to all o! the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is. Pr~.va~a .one..£a~lly. chmllin$..viih .addition .................... The certificate is issued to IJarz~r .Vl, eeland ....... ~hene~ .......................... (owner, lessee or tenant) of the aforesaid bui]dlng. Suffolk County Department of Health Approval .]~,~, .............................. UNDERWRITERS CERTIFICATE No. pending .................................... HOUSE NUMBER .... ~ ...... Street L~nda. Rd ................................ FO~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5231 Z Permission is hereby granted to: ..... ~-.ii~,~-.-.~'e-.~.-~z~e-~m~-- to ....... ~,~t~;..~l~.. ~l~t ~,~,~i.. ~l~tc..li~l;:l~:~i~..i,sti~,~liil~ ...................................................... ot premises located at ...... .]~/;~O.~,lt~.~...l~,~.Cefl~jl~l[~..~l~,..~g..~$~li..~ll~ ....... ~l~)~..Cg~..~:~i~[&.... ............................................. lgllt;t,X~g¢~ .......... lt~Zi;'': ....................................................................... pursucm¢ to application dated ............................... ~L~rs .......~....., 19~t., and approved by the Buildir~g Inspector. Building Inspector TOWN OF $OUTHOLD ~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam,ned ........ , ,97.( .... App,,cotion ................... ,Approved 'k " .~Z..~ / ........................................ , 19 ........ Pemit No ..................................... Disapproved o/c ...................................................................... ~ '~""--' "-~uilding Inspector) 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, re ationsh p to adjoining premises or public streets or~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application/'~ c. The work covered by this application may not be commer~ed 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 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 th~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described, The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. liebert .H. ~.a.~t ..... (Signature of applicant, or name, Jfa corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................................................ c.e~t,=~c J~e= .............................................................................................................. .'~ Nome of owner of premises ......~..&...~.~.~...~.~.q.~.~.~J~j .............................................................................................................. ~.~' If applicant is a corporate, signature of duly authorized officer. ~ .................. ......... Location of land on which proposed work will be done. Map No.: .....~.~.~....~.,.a.~,t....,~..~.... Lot No ......................... Street and Number ....... ~.~..~t~,~ .............. ~tl~J~ ..~[=Y.*. ........ . ........ I'~,.~-.~ LI/V'Z)~ ~O~ Municipali~ State existing use and occupancy of premises and intended use and ~cu~ncy of pr~ed construction: o. Exisiting use a~ ~cupancy ...... ~.~ ....................................................................................................... b. Intended use and occupancy ......... ~e...~t~.~~..~..~.C~ ............................................. ,' "3. Nature of work (check which applicable): New Building .................. A~dition .......~[ ..... Alteration .Z31: .......... .Repmr .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4.' Estimated Cost ..................... J.t~O0..:i...:... .......... :....;.Fee .. .'... ... ~.li. ..(~. ....................................................................... (to be paid on filing this ~pplication)... §. if dwelling, number of dwelling units ...... ~lJe ............... Number of dwelling units on each floor ........................... If garage, number of c~rs ........................................................................................................................................... 6. If business, commerci(~l or mixed occupancy, specify nature and extent Of~'edch typo'of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ....................... [' Iqumber of Stories ......................... : ....................................................................................... Dimensions of same structure with alte~¥{ons or additions: Front .................................... Rear ............................ Depth ................................ Height .......... ~ ................. Numbe~' bf~Stories ................................ 8. Dimensions~f entire negi'Cbtis?riii:tion: ~'~ront ................ :.~ ................. 'Rear ............................ Depth ........................ H~/ight .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone ~r ,ae.disttic;t i~.whjch premises are situated ................ .~..~..~.....~..~.~...~. ........................................ .~ ........................ 12. Doe's proposed construction violate any zoning law, ordinance or regulation? ........ IB~...: ................ : .......................... 13. 'Name of Owner of premises ..R~...~2~ee~aJ~...:..~...Acklress ..~.e..9..~..~..?...~.. .................... Phone. No ..................... Nam~ of Architect ...................................................... Address ............................................ Phone No ..................... · Name of Contractor [ .......~...l~r~..~; ......................... Address ............ ~I,t~IML~II. ............ Phone No ..................... PLOT DIAGRAM Locate clearly and .distinctly all buildings, whether existing or proposed, and indicate qll set-back dimensions from property lin.es. Give street and block number or descriptio~ according to deed, and shoW street names and Indicate ~hether interior or comer lot. / ' STATE OF NEW YgRK,_ t c c (Nome ot inaiviaum signi.ng applicatiom (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.contoined, in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. ELIZABETH ANN NEVILLE NOTARY PUBLIC, State 'of New Yerk No. 52-8125850, Suffolk Coun~ Term ~ March 30. ~_ ~,~