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Home My WebLink About5399-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte O~ Occupnncy THIS CERTIFIES that the building located at . .W//~ .//tar~ .P& ............ Street Map No... xXx ...... Block Nc~xX ........ Lot No.~.. Eaji;. Ear~.~.. ]~...]/, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Jut-y - - -34, 19.7.4- pursuant to which Building Permit No.. ~3~)Z. dated ........... JUly. · .%3., 19. '7~, was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is P~.ivat~ .aceossor~ · ( s.torage)..bultd.$ng ............................. The certificate is issued to .. Peter' Fru~entl' · '0~er ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approvai ....... N.,Ro ........................ ' ......... / Building Inspector/ ~0~ NO. ~ TO~N OF SOUTSOLD 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) iiiiiZ;/~//~...-~-........iii~.~...................· ........... .i........~-.~iii to ............................................ ~...~ ........ ~::~.'...:~.~~ .................................................. to application dated ................. .~/.../....:..,~ ....... !....'~... ........ , 19...~..~.., and approved by the pursuant Building inspector. Fee $.. '~.. ................. 1PO,BM NO. I TOWN OF soUTHoLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y~ Exom .ed... t f Approved ......................... ~ ........... , " ...~'.~. c~ c~ ~ 19 ........Permit No .......................... Disapproved a/c ................................. /.~ ..................... Application No....~.....~....~..~.. .......... 5" .~ 7 ~. APFLICATION FOR BUILDING ,ERMIT i/~ ~) ~ INSTRUCTIONS ~ a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building~'t Inspector. b. PIo, t .pi.an showing location of lot and of buildings on premises, relationship to adjoining premlees or public streets or areas, ana g~wng o detailed description of layout of properb/must be drawn an the diagram which II I~rt of thle appllcation.,~ 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 wil ssue 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 I-~EREBY MADE to the Building Department for the issuance of a Building Permit pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Law~, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demo t on, al here n descr bed The applicant agrees to comply with all applicable laws, ordinance~buildJng code, housing code, and regulations. State.whether applicant is owner, lessee, agent, architect, eng Ineer, general contractor, electrician, plumber or builder. Name of owner of premises ............................ ~ .......................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title 'of corporate officer) 1. Locat on of and on wh ch. proposed work w I be done Ma No ' .. · I~n ~-~' ~'~ . · P .................................. at .._.: ....................... Street and Number ~.. ~. /7/~L'3' .................... .:.~........~...~.~,, .......................... Municipality 2. State existing use and. occupancy of premises and intended use and occupancy of proposed construction: Existing use and occu n ~ ' ' a. pa cy .................................................................................................................................. b. Intended use and occupan:., 3. Nature of wink (check which applicable): New Building ..... ~..~..~. ...... Addition .................. Alteration .............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ...................................... 4. Estimated Cost ............................................................ Fee ....: ..................................................................................... (to ~e .paid on filing this application) 5. If dwelJ!ng, number of dwelling units ............................ Number of 'dwell~j 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 ............................ '~' .... .~....~...! .................. Depth 30' 7. Dimensions of existing structures, if any: Front ......~ .................... Rear .................... 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 / ~'/ .. Height /~'~? Number of Stories .. ! .................... 9. Size of lot: Front ...... .,~....~... ............. Rear .................................... Depth / ,~o i 10. Dete of Purchase ........................................................ Nome of Former Owner ..... ~...-. .................................. 11. Zone or use district in-which premises are situated ..................................................................................................... 12. Does proposed Construc;[on vi~ate any zoning law, ordinance or regulation? ......-?......: .............................................. 13. Name of Owner of premises~..~-~....~......~..:.T.:...~..:.~;: ........ Address .............................. , ............. Phone No .......T: ............ Name of Architect ...............2.~ ......................... Address ............................................ Phone No ..................... Name of Contractor .......................... ~ .................. Address ............................................ Phone No. 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 or comer interior lot. 70 STATE OF NEW .y~)J~J~',/~, ~' ] t e~ COUNTY OF-.~..)''''~'~ _y. ~-~. ~- ................... ..~1~,~.-..'~..~~. ........................... being duly sworn, deposes and says that he is the applicant CName of individua above named. He is the ............ ../~....~;.;.:~z~c-- ....................................................................... '~ ....................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or ha~e 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 thaz the work will be performed inAhe manner set forth in the application filed therewith. Sworn t~e~ rne this~ .~.~..,...~.. ~ (/ 19 .~.~.... - .................................. ..................................... Natary Public, ....~.J~.EN~:~..~ CoMntv~/ ,/2 (Signature of applicant) ~;/S~O~ic, Slate of New York No. 52-0344963 Suffolk County. s. Commission ~xpire~ March 30~