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Home My WebLink About5332-zFORM NO. 4 TOWN OF SOUTHOLD BUff,nlN(~ DEPARTMENT Tow~n Clerk's Office Southold, N. Y. Certific; te Of Occupancy No..Z.~.2.?? ...... Date .. J.~]~. 2~ ............ v .... , 19. THIS CERTIFIES that the building located at . .0.r.~.e..~.t.a.~...A.v.e.n..u.e...F,~[.,.. Street Map No ............. Block No ...........Lot No .................................. conforms substantially to the Application for Building Permit heretofore fried in this office dated June 1 19. ?l pursuant to which Building Permit No.. dated June 2 19 ?l , 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 Accessory Bulldimg The certificate is issued to ...1~..e....]~l~J,lp. 1~, .. l~a.~.J, ery ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ........ ~ .......................... UNDERWRITERS CERTIFICATE No. NR HOUSE NUMBER .............. Street...0.r.~. e.?.t.a.~...A.v.e.?.u.e.,..F..~.s.h.e.r..s..~.s.]...~..d... FOI~M NO. 2 TOWN OF SOUTHOLD ~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5332 Z Permission is hereby granted to: ...... Wm,...~2a, uX~..~/C,..~qat~,~..r, aX3,o~t .................. ~..:t?~ ........................... .................. .................... ~.~,'~s...~,],a.~l. ....... b5~. 9~ ...... to .~u.~.~t-..ne~..~va~e-..~a~a~e-..~ e~ ~e~:..~) ...................................................... at premises located at ..J~,.G~..m~LQ[..,]~ ......... O~.~.~t~]....~ ............................................ pursuan,t to application dated .............................. ~a~'"'"~' .......~,.,.., 19..~.~.., and approved by the ~uilding Inspector. Fee $1~.QO ............... 'TOWN OF SOUTHOLD ; ~ ~ ~- ~/~-~ , BUILDING DEfARTMENT TOWN CLERK'S ~FICE ~TH~D, N. Y. ....... L.... ...... D~pp~ a/c .................... ~ "~ "" ' ' '(Budding~ APPLIGATION FOR BUILDING PERMI'~ 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 adjo ning promises 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 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 Deportment for the issuance of a Buildina Permit aursuont to Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other app ic-ab e Lows', Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees comply to with all applicable laws, ordinances, building code, housing code, and regulations. 0, ........ t ~,~- (Address of applicant) Stote whether oppllcont is owner, lessee, ogent, orchitect, engin~r, generol controctor, electricion, plumber or builder. General Contractor rem se~ ~'. Phili]~ la,. M~llor~ Name of owner of p .................................................................................................. If applicant is a corporate,~ignature of duly authorized officer. (N;me and ~:i" t ;;;~rate officer) ..... 1. Location of land on which proposed work will be done. Map'No.: Blook 3~ Lot No.: .i Street and Number ~) ~ t CT~J 'T ~ ~ ~ U ~ ~1 ~ ~ e ~S ~ . . Munici~li~ State ex~stmg use and ~cu~ncy of premiss and intend~ ~?nd ~cu~ of pr~ construction: a. Ex~stmg me and ~cup~ .................................. , ........ ~.....[~.[ ..................... : ............................................ b. Intend~ use and u n- ~ 8~O~e 7 3. Nature of wark (check which applicable): New Building ....... [ ......... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ .(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 ................................ 8. Dimensions of entire new construction: Front ............ ~.~ ................... Rear ........ 2.~ ............... Depth ....... ~ ............ Height ........ .~...~. ....... Number of Stories .................. .~.. ................................................................................................. 10. Date of Purchase ........................................................ Name of Farmer Owner ........................................................ 11. Zone or use district in which premises are situated ........... ]Jl.l~.lJll:l,~/~J, .............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ....l~..~.. .................................................. 13. Name of Owner of premises~.e~.....JJll.~l~ ............ Address~J,~JlJl~m..~J~lllJe..JJ~l~hone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck dimensions from property lines. Give street and block number or description according to deed, and show street names and indk~ate whether interior or comer lot. STATE Of NEW Y~JRK,//. COUNTY Of ...~....~.. .... ....~/-~.~;~/J.;~/~--t~ ..................... being duly sworn, deposes and says that he is the applicant (Name of irl~vidual si/~g ar.~pp~on above named. He is the ....... /...~....:....~....v.~.~.~,..~..~_.,~.. ..................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and lis ·duly auth°ri~.d;t0 perform o~ have performed the said work and to make and file this application; that all statements contait~ed in :this epplice{ti.on are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth i~ ~he application filed therewith. Swam to, before me this "~ / ....... d of .......... .0., ,/ ,/ . YJ ee ......................... Notary Publicr~......~./~.~.._//~.f, cgC/f.?.~_.~/r~:ounty Z~EIi. E:E:t~ C~. W.A,t:.~_~ture of applicant) // Notary p~blic, State ot NeW-t'or · ~ t,4~. 52-9.509185 ' C~ali)ied in Suffolk CoualW~ lerm E~h. es Ma. ch 30, 19 /,.