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Home My WebLink About5384-zF~'~' NO. 4 TOWN OF SOUTHOLD BUILDING DEPAHTTIF. NT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.. Z.~90 ..... , Date ..jxl~r. 2~ ................. ,19.73. THIS CERTIFIES that the building located at .. ~.2.~ .I//l, .F~'~ .t/Qad ..... Street Map No ............. Block No ...........Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....Jg,l~ .2 ........... , 197.~.. pursuant to which Building Permit No.. dated ....JU,l~ .2 ............ , 19.7.$ ., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is ..... l>z'~.~at& .One. F.m~I.~L~ .Dw~.3A~g ................................... The certificate is issued to ....... R;Lah&x~ .B&h¢o~i~ .............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ....... l{.tl~, ........................ UNDERWRITERS CERTIFICATE No ................. P.e..~.d../~g. .................... HOUSE NUMBER .. 3.g..~ ........ Street ...l/de. 27~z~ ~to~Ut ....................... FOI~! NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENI~ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 53~ Z Dote ........ ~.~.?....~....~ ........ .~.... ............... , 19.?..! Permission is hereby granted-to: --- ....g..:.~.~.~.~:~LL..O~....5:... ............ C..~.:(..~..~..~..~.~:?. ........ ~ .................. at premises Iocoted at ....t,; ................................. ~..x...:.,.: ...................................................................... ............................ .~.,g..~.Z.~L~..?2 ................................................................................... Building Inspector. Fee $..,..'.~.. ................ Exnmin~,H ~,~, ~ o, SoUT.oLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~TH~D, ,. Y. Disapproved a/c ......................................... APPLICATION FO. BUILDING PERMI, ............................ . .... Dote INSTRUCTIONS . a. This application must be completely filled in by typeWriter or in ink und submitted in duplicate to the Bud r~' Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premisas or public streets o..~ areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this opplicatio~ 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 Department for the issuance of a Building Permit pursuant to tl~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable 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. ............ (Signature cf applicant, or name, if a corporation) .............................. ~)/~o~'-~0-~-- ~-'~ ~-,~-~ ( ~' (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .......................................... ~ ................................. If applicant is a corporate, si nature of dui authorized officer ~r~'~'- ~'~ 4) g Y . , / (Name and title 'o, corporate officer) /~"1~ ~ ~~ ~/'~ ~ n n ,4-7" / ..,-, / / ~. Locaro of ~a d on Which proposed wo~ w.,~ be dane. ~ap No.: ~./.~ ....... Lot ~o.: ......':~... ............. Stree,.nd .um .r .................... .................. ,~ ~ .--~/~ Municipality 2. State existing use apd occupancy of premis,~ and intended use and occupancy of proposed construction: a. Existing use and occupancy ..., ............ ~ ....................... .~ .......................................... , ~...~? ,. t.//-~- .~/~ ......... b. ntended use and occupanc · ................. ~:...~ .............. ~.......~...~. ~,~ .~...~...7......~... 3. Nature of work (check which applicable): New Building ................. Addition / Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ..................... ~.~./,:'/~2.~..f:~. .............. Fee .......................................................................................... (to be paid on fi!lng 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 an~i Front ........... .~....~. .......... Rear .~'....~........................... ~ Depth ......-~.....~..../.. .... Height ...... /~...x.. Nbmber of Stories / Dimensions of same structure with alterations or additions: Front .......... ~ ..................... Rear ....'~...~.. ................. Depth .......... .z./...~../. ............. Height .......... ../~...~.. ........... Number of Stories .............. ./.. .............. 8. Dimensions of entire new construction: Front .......... .~..~.....~. .............. Rear .....~..~,...~. ........... Depth ....~....x~...../. ....... Height ...... /...~'..../. ..... Number of Stories ............./..... ~ .............................. 9. Size of lot: Front ....... /..~..~..~.~.. ..... Rear //~4-- / .~ .................................... Depth ......... .~...~.....-~.....-~. ...... 10. Date of Purchase ......... . .............................................. Name of Former Owner ................ ~. ................................... 11. Zone or use district in which premises are situated ........................ ..~,,..~ ................................ 12. Does proposed construction violate any zoning aw, ordnance or regu at on> 13. Name of Owner of premises · ..Address . ...-..x,.~. .... Phone No ..................... Name of Architect .~, ....... ;.~~.~...Address ........................................... ~- Phone No ..................... Name of Contractor ~'./-,/Z~..L-.:..~......Address .~/....~.~ .~. ..... Phone No~.~..~...'~'..~'...~.p PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer Jot. 14/' STATE OF NEW YORK ...... ~;~-;..~~~......: ............................. ~ing duly .orn, d~o~s and says t~ he is the applicant ~m ot mnamvmaual s~gnmg applicati~) a~ve named. He is the ........................................... ~..~ .................... 'iL ................... '. "j (~ntmctor, ag~t, co~mte officer, ~c.) of said owner or owners, and is duly authoriz~ to pe~orm or have perfo~ed the said work a~ to ~ke ~d file this application; that all statements contain~ in this application am tree to ~e ~ of his ~l~ge a~ belief; and that the work will be performed in the manner ~t fo~h in the applicati~ fil~ ~ith. Swam ~ ~fom me ~is ......... .......... .............. ....... .... .... .... · ................ 3'~bte~ Public, Stote of New Yo~ Residing in Suffelk County No 52-7]35315 Commission Expires A~arch