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HomeMy WebLinkAbout5316-z FOEM NO, 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISE~S UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5316 Z Permission is hereby granted to: ......... E~...~b.~ ...... .............. .~......~.~r.~,~, .~,~...~;.,. ...... i ................. ...................... ~(~;~ ~'~ ~%~ ....... ~,,;Z.~ ........................ to ..... ~1~t .. ~.{ .. ~r,~...f~ 3,~r...~.~ 2:1~ ~g ............................................................................... pursuan¢ to application dated }~' ~'~ ~, ............................................................ , 19 ........ and approved by the Building Inspector. Fee $.~..~.".~ ........... FORM NO. 4 ,, TOWN OF SouTHoL~ BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . ~O~Or~ .~,,& ,M~O~, ~:~tStreet Map No ~'~t~t;~ Block iNTo..lgtg. .Lot No. ~...l~lt¢~]aO].ll. I~,~X, ........ conforms substantially to the Application for Building Per'mit heretofore filed in this office dated ............. ~,~r,.. ~$, 1~.~,. pursuant to whiCh Building Permit No. dated ......... lq~,3~.. ~ ......, 19~.., was issued, an~ conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is .. ?'~A.Val,~, .~¢~..~,am~ .1.~ .4Wg*l&~tlag .... ~" 'i ............................. The certificate is issued to .t~ari~ .l~o~h~l~ ....... i~ ...... : .................... (o..Wner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .~1~t~1....~1~...~.~ .t~t R, UNDk,'RWRITERS CI~RTIFICATE No. '~8~'; ......... i ............................. HO US k; N klM B 1! R. ~9,.~ ....... Street..l~Ol~.~l~a. t48.//~. ~. !~ 1~8~O~.~1 ~ P&~l~t ............... Building Inspector FORM NO. 4 TOWN OF SOUTHOLD~ BUILDING DEPARTMEL~T Town Clerk's Office Sonthoht, N. Y. Certificate Of Occupancy No. ~0~; ...... Date ...... ...:.&~ .... THIS CERTIFIES that the building located at , ~ .1~. & 't~lt~t~l'8' 1~/~Street Map No. 0~0~0~ ... Block No..1~ ....... Lot No .... ~11~...t~O[~lO~[.g[· ~.5[~ ........ conforms substantially to the Application for Building Pe~cmit heretofore filed in this office dated ............. ~},.. ~., 19.~F~. pursuant to which Building Permit No. ~¶~.. dated ......... ~1~" ' 'tS ..... , 10~¢I.., was issued, an~t conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is l;~J~,~a~tl '011~ The certificate is issued to 'FlPlItl~ 'D~' 0~o~'a~'er, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .&~.. UNDERWRITt!RS CF~RTIFICATE No..~1~ ........................................ HOUSI~ N UM BER. ~0 ....... Street..~. ~ ~. ~ '~0~)~' .............. , Building Inspector $-9 SCHD SUFFOLK COUNTY DEPARTMENT O~F HEALTH Date Bldg. Permit No. ~9~'~?,/z<' ,~-< TO WHOM IT MAY CONCERN: at The sewage disposal facilities for a structure located (Give deed l~ca~ion) have been inspected by this department and fDund to be satisfactory. Ob;,, D~s'trict Engineer FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate O[ Occupancy No.~l~. ...... Date ........... ~pl'~.... ~.~ ..... , 19. THIS CERTIFIES that the building located at . l~O~l~ .~. & ,l~el*l~. l~TM Map No. ~... Block No. ~ ....... Lot No .... ~l~[...~014. ]ll,]~e ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. 1~.. 2~['~, 19 .~/3. pursuant to which Building Permit NO: dated ......... I~y. · ~]: ..... , 19~.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .. 1~$~,~ .~..~f~,~ .dW~],l~[ ...................................... The certificate is issued to .ll~,~ .])~1~ ....... ~..~ ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .&~**~,.. ~1~. i~'~ .b~r. 1~..~&.. UNDERWRITERS CERTIFICATE No. '~'~8y' ....................................... HOUSE NUMBER.~ ....... Street. ~ .~& ~.~lJ...~]~ .~a&~l~l[ ............... l~OltM NO. ~ TOWN OF $OOTHOLD BUILDING DEPARTMI~NT TOWN CLBRK~$ OFFI¢w SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5316 Z Permission is hereby granted to: .............. .~.....~e~..&~e...ll~ ........................ ..................... ~i~-sl~l~ ....... l,,Z.~ ........................ to ..... I~d~..m..m~...t~r...d~m~ ............................................................................... at premises located at ...... ~il..~..&..l~.~e~..l~l~ll ......................................................... ................................................. ~& ........ ]!~', ........................................................................ )(IL~ ~ 19..~ and approved by the pursuan~ to application dated ............................................................ , ., Building Inspector. Fee $ .~1.~.0..t~. ........... Building Inspectorf BUILDING DEPARTMENT . . 'TOWN GLERK'S OFFICE ~,//~z ~o C. ~ ~THOLD, ~. ~. ~ ~ ~ ................................ ............. ................................................................ ~~ ........... ~ ~ ....................... ..................... ~ .................... ~ ......... .~L...., ~.Z~. ....... o. This opplic*tion mu*t be completely {ill~ in b~ ~pewriter or in ink ond submitted in duplicate to th* Buildin~ Inspactor. b. ~lot plon showino I~ofion o{ lot ond o{ buildinos on premises, rolotionship to ~djoinino premise~ or public ~re~s, ~nd ~ivino a dot, lied d~cription of layout ofprope~ must bo drown on tho dioorom which is c. The work covered by this opplic*tion m~y not be comme~od b~fore issuance o{ Buildino P~rmit. d. ~pon opprovol of this ~pplic~tion, the Buildin~ Insp*ctor will issue o Buildino Permit to th~ ~pplicont. sh~ll be kept on th~ pr~m ses ~voi ~b e for in~poction throughout the pr~re~ of th* work. '1 e. ~o buildin~ sh~ll be ~cupiod or used in whole or in pa~ for ~ny pu~ose whot*ver until ~ C~i{ic~t* sh~ll h*v$ been ~r~ntod by the Buildino Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of a Building Permitpursuant to thet~- 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 demolition, os herein describec~N'~Jk The applicant agrees to comply with all applicable laws, ordi nonces, building cdde, housing code, and regulations. · ESw. Tebia & Sen (Signature of applicant, or name, if a corporation) 1+0 Gerar8 Ave E. Malvern L.I. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. CSntracter Frn~ Denahue 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.: ....... ~ ........................... Lot No .......... ~ ........ Street and Number .......... .~.~.~. He~to~ La & ~/..$ lvla~ors Path S®uthoZcl ~'1--- 775'0 Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...l[t~,~a,13,~.i.],~lD,~ .............................................. b. Intended use and occupancy .......... ~eL..:~a~l:l,l,~..~we,],~,l~ ........................................................................ 3. Nature of work (check which applicable): New B,~i~ing .... ~ ...... Addition .................. Alteration .................. Repair .................. I~moval .................. Demolition .................. Other Work (Describe) ........................................ 20 · 000 + "" 4. Estimated Cost ~v,vv ...................... ~ ................................. Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... .~.e. ................ Number of dwelling units on each floor ....: ....................... If garage, number of cars ........ I~z).eL....(~lz~l~Z'...~La~l.-~e.) .......................................................................................... 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 ................................ 8. Dimensions of entire new construction: Front ~' ' Rear ...........~.~.. ............ Depth 28-6 Height .................... Number of Stories ....................... ~.D,e ......................................... 9. Size of lot: Front ..... .~.Q0 ................ Rear ........ .1.0~r. .................... Depth ......... .~.~.6.~.../....~.~.~ 10. Date of Purchase ........................................................ Name of Former Owner .......... .0.~,~.~.OZ~. ............................ # # 11. Zone or use district in which premises are situated ......... ~,.....0,~,S~ ....... 12. Does proposed construction violate any zoning law, ordinance or regulation? .............. Z).I ......................................... 13. Name of Owner of premises~...~.~......~...e.~..~....~.,e. ....... Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ....~/.~..~,®~'L&.~.S .............. Add ;ss ...~..~.~..e.~.T~ .................. Phone No ..................... ~icate all, set-back dimensions from .'cording to deed,~n icate PLOT DIAG[ Locate clearly and distinctly all buildings, whether existing property lines. Give street and block number or description whether interior or corner lot. STATE OF N~O~ ~-- COUN OF ........... ................................................................................................. being duly ~orn, d~o~s and says t~ he is the applicant (Name of individual signing application) above named. He is the ................. C~[~[~ ................................................................................................. (Contractor, agar, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or h~e perfo~ed the said work and to ~ke and file this application; that all statements contained in this applicati~ ~re t~e to the best of his knowledge and belief; and that the work will be performed in the manner Swam to before me this ................. ............................ ......... , _. x / ............... Nota~ Public,~~~ ...... ~.~Coun~ (Sig~a~re of ap~[ica~ ........................ ~ JUDITH ~. ~ol~r~ ~ J~ ~JlJl 0J New York Ho. 5~(~3~4g63. Suf/olk Cou~ty ~mmiss~, ~s March ~ ~/~ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. ~,,.~/~' .~'~ TO WHOM IT at ! MAY CONCERN: The sewage disposal facilities for a structure located (Give deed 1Bcation) 0 have been inspected by this department and found to be satisfactory. District Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL File No .................................................................. Date .............. ~..---~. .............. ../.~ ............. / .~.~...~~...~ ............................ PL~SE T~ NOTICE that your application dated ....... ~.....f..~ ............... ..... ~...~.m~....~.....~....~., ............... ~~~~ ........... .......................................