HomeMy WebLinkAbout5439-zFO~ NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
THIS CERTIFIES that the building located at E~. I,X-ttt® -Neck .RomS... Street
Map No..1~ ......... Block No...~ ..... Lot No. ~... C. II~;ehogu®...N.Y. ........
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ......... J. ul~y .... 1 ~.., 19].. pursuant to which Building Permit No..~'~.
dated .......... .~..ug .... ~ ...., 197.'[.., 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 .P~'.X.~at~-.sto~age. b~$1d.t~g ..........................................
The certificate is issued to~oseph .l~a~'l~t~ .... O.~.ner .............................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval
House ~ 330
· .N~ .............................
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/ / , :
...... · l. yj> ~ ~, ......... ~ ...... ~ .] ........
' - Building Inspector ~
FOI~M NO. 2
T(hVN OF SOUTHOLD
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)
N? 5439 Z
Permission is hereby granted to'.
.............. ~..e.~.,.~.~..~ ................................
...... .~,.tt ....~'~1~.. ~..1~ .....................................
................ I...~ .......
to .... ~..mm...~,~.e..~...~.~.......~'e~....~..~......l~. ...................................................................
at premises located at ...~.....Z~.t,~dlI...~I~K..~II4L ......................................................................
........................................... Gll~ho~m .......... ~Xs ........................... :....: ............................................
pursuan¢ to application dated ............................... ,T~. .......~,~ ....... , 19...~.~., and approved by the
Building Inspector.
Fee $....~*.QO ...........
Building Inspector
TOWN OF sOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
.~ SOUTHOLD, No 1'.
Examined .......... .....~...~.~ 19.....~... Permit No. '~ 3 ~ ~
ARoroved ........................................ , ............................
Disapproved o/c ................................................................ " ~
(Building I nspecto/~
APPLICATION FOR BUILDING FERMrT
INSTRUCTIONS
This application must be completelY filled in by t~ewriter or in ink und submitted in duplicate to the Building
Inspector.
b. Plat plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or ~
areas, and giving a detailed description of layout of property must be drawn an the diagram which Is part of thie application. ~
c. The work covered by this application may not be commenced before issuance of Building Permit. r~
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 Bulldiag Permit pursuant to the ~
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable I.awl, Ordinances or
Regulations, for the construction of buildings, additions or al.terations or for removal or demolition, al herein described.
The app leant agrees to comply with all applicable lows, ordinances, building code, housing code, and regulations.
Jeseoh Barbate
(Signature cf applicant, or name, If a corporation)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Owner - builSer
Jes ~lt.h Barbat~ ...............................................
Name of o~ner of premises ..................................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Nome and title 'of corporate officer)
1. Location of land on which proposed work will be done. Map No.: ................ ~ ................... Lot No.: ...'......:~... ..........
E S Litt· Nec R~a4 C c o .Y
Street and Number ...... /. ................. 1 ............ ~.. ........... a ....... .~.~...~..~.~......~......~. ...................................................
.~ ~_~ Municipality
2.State existing use and occupancy of premises and intended use and occupancy of proposed cor~tructlon:
a. Existing use and occupancy Taca~l;
b. Intended use and occupan:', .....~::LT. nl:e...a:b~z'~,~e,..~l.L-L~8.t.~ ..................................................................
3. Nature of walk (check which applicable): New Building .~[. ........... Addition .................. Alteration .............
Repair .................. Remora Demo tion .......... Other Work (Describe) ' .
· Es '..oted Cost ............. ~ .............................................. Fee ...... ~,,O0 .........................................................................
(to be paid on fi!lng this application)
.5. If dwelllng, number of dwelling units ....~..O..~..?. ................ 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.....1::~'~; ....... i~;$Z'&~e................
7. Dimensions of existing structures, if any: Front' ............................ Rear ................................ Depth ...........
Height ........................ Number of Stories ...............................................................................................
Dimensions of saree structure with alterations or additions: Front ....................................Rear ...........................
Depth ................................ Height ............................ Number of Stories ................................
8. Dimensions of entire new construction: Front ........ [~. ....................... Rear ........ ............... Depth .......... .1..2.. .........
Height .................... Number of Stories ........... SZte ....................................................................................................
Size of lot: Front ...l.0J~e f't...9:: ...... Rear ....1.0.Q ........................ Depth ........... 2~*.bc..e...~.~....+
Date of Purchase ........................................................ Nome of Former Owner .......................................................
Zone or use district in which premises ore situated ...~.A..I.I....~...~..s...~. ...............................................................................
Does prOPosed construction violate any zoning law, ordinance or regulation? ....... [1~ ................................................
Name of Owner of premises ~.a.e...~..~.~..TA.a:.~.~. ........... Address .~.:...~...~.?..~...b..~..e..~..t,.. ............. Phone No .....................
Name of Architect ...................................................... Address ............................................ Phone No .....................
Name of Contractor ..... ,qamll ...................................... Address ............................................ Phone No ....................
10.
11.
PLOT DIAGRAM
Locate clearly and distinctly oll buildings, whether existing or proposed, and indicate oil set-beck dimensions from
property lines. Give street and block number or description according to deed, and show street names and indical'e
whether interior or comer lot.
ST, A'T'E OF NEWo~,,,_ ! S.--
TY Of . o
~~ ........................... being duly sworn, deposes and says that he is the applicant
///'~<~ ~tN, am,7 o.f i?,dividual signing application) .
~oove named. He is the ............................... .(~/~.~.~. ....... ~1~,~1,~'. ............................ ~ .......................................................
(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 contained in this application ore 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.
Swam to before me tl~a~"~- j..iL ~-0.~
................. , .............................
,TARY PUBLIC State at NewLV~
~0. ~g'26744~0, Suffolk
. ~'g~'m EXpires March 30~