The URL can be used to link to this page

Home My WebLink About5779-z FORK NO. A TOWN OF SOUTHOLD .BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Zb04+. . . . . . Date . . . . . . . . . . . . . . Aug. . . .9. . . . ., 1974. . THIS CERTIFIES that the building located at .XAvgi!k4 .DriV*. . . . . . . . , , . Street Map No. . .xx . . . . . . . Block No. ? . . . . . . .Lot Nom. . . 4tt i "4. . 11*Y.o. . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . 4?. . .31. ., 19.79. pursuant to which Building Permit No. . .5779A dated . . . . . . . . . . . Mar. . .31 . . ., 19.7?., 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 .PTt.V4t*. DA9. AaRtly. .4V0jj.US.11jtA.4LA .44iUt$9A . . . . . . . . . . . . . . . . . . The certificate is issued to ft6l" . . owner. . . . . . . . . . . . . . . . . . . . .. . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval 1!a! . . . . . . . . . . . . . I . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . :.1�!. . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . HOUSE NUMBER . . . . 16.0 _ . . . Street . . . . �t!u�l�s.DTi�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector FOR. M NO. ') TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP. EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5779 Z Permission is hereby gronted to: ............... M~%. ~i't~ek.....J ~.,. ............................ ~o ...~u.i&&-a~..a~3&~ti~..~..e~i.~t .d~..dwtt.~n~ ............................................................. at premises located at ..... [~.~.....~,.~..~a'~g~e~..9~ ................................................................. .............................................. Km;'t I%'ue'~ ............................................................................................ pursuant to application dated .................... I~'.......~.~ ................... , 19..'7~0.., and approved by the Building Inspector. Fee $..~.~.(~). .......... Budding Inspec7 TOWN OF SOUTHOLD BUILDING DEPARTMEN~ ~'~" ? ~ TOWN CLERK'S OFFK:E/ , ~,~ .......... :~.~.~ ....... . J~ ~ ~.. ,~sT.u~,o~s ~ a. ~is amlicatim must be completely fill~ in by ~pewriter or in ink and submitted in d~l~ate to the Buil~g~ Ins~tor. ~ b. Plot plan showing I~ation of lot and of buildings ~ premises, relationship to odjo n ng premiss or pub ic stree~ or areas, and giVing a detailed de~ription of layout ofpr~e~ must be drown on the diagram which is ~ of this applicon. c. The work c~er~ by this a~lication may not be comme~ before issuance of Building Permit. ~ d. Upon appr~al of this application, the Building Ins~tor will issue a Building Permit t0 the. oppli~L.~ch permit shall be ~pt ~ the premises available for ink,ion thr~g~ut the p~ress of the work. e. No building shall be ~cupied or used in ~ole or in part for any pu~ose whoever until a Ce~ificote of ~cupancy~ shall have ~en granted by the Building In~ector. ~ APPLICATI~ IS HEREBY ~DE to the Building Depadment for the issuance of a Building Permit pumuant to the Building Zone Ordinance of the Town of ~uthold, Suffolk COunt, New York, and other applicable ~ws, O~i~ or R~ulations, for the co~truction of buildings, additions or al~rations, Or for mm~al or demoliti~, as heroin describe. The applicant agrees to comply with all applicable I~s, ordinances, building c~e, housing c~e, a~ ~ulati~s, ............. ............. (si~tu~ of ~p.~t, ? ~me, if ~ ~o~';;~;~f ........ · .. ....... ............. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............. ~.~..~.~..~....-.......c....~..~.~.~.~ ........... _ . .................... ~;..~=....~T.~'. ......................................................... If applicant is a co~omte, signature of duly out~orized officer. ..... ~..~ 1. k~tion o{ I~nd on which propo~d work will b~ don~. ~g ~o.: ~ ..~[ot ~o .... Strut and ~um~r ............................ ~ ~ * ~ ...Z~.~....~/ ................................. ~ ~.~...~ ~¢.~'j~l~.~ '"'~ 2. St~t~ ~i~tin~ u~* and occu~nc~ o{ pmmi~ ~nd intend~d_u~ and ~upanc~ of p~o*~ ~: ~.' N~ture of work (check which applicable): New 'Building .................. Addition .................. Alteration Repair ................. ./l~emoval .................. Demolition ....... ~, .....Other Work (Describe) ........................................ 4. Estimated Cost ............................................................ e .......................................................................................... (to be paid on filing this opplicotio~n) 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 n~ture and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ...... ..~.....~....x. .......... Rear ........ ~,.~. ................ Depth ...,~ ............. Height . ..~... ................ Number of Stories ....... ~ ................................................ .~ .................................................... Dimensions of same structure with alterations,or additions: Front ........... .~.~......t. ............. Rear ....... .~.~..../. ........... Depth .....~.~.. ................... Height ......... ~....O...?....~.....Number of Stories ....... ~ ................... ......... · ~./...~.. ........... Depth 8. Dimensions of entire new construction: Front ......... .~....~. .................... Rear / ....~.....~... ............ Height ..~...~ ....... Number of Stories ........................................................................... ~ 9. Size of lot: Front ...~,..-~.....~'..:...~..... Rear ~ ~ ~ ~' ~ ~'~ .~i ~' ~' ~ ~'' ~ P,,~hn<~ -~--.~. /~/' .-~.. ~ /~.~ ~.. I~om,, ,~f Former r~,ner ..~.~- 10. Date ................................. ~. ............................................................................... I1. Zone or use district in which premises are situated .....~..c...~.~..!......~...../..~.~.~../....~.~ .......... ~.. ..................................... 12. Does proposed construction violate any zoning law,, ordinance or regulation? ~.....~...~...,.....:, ................................... 13. Name of Owner of premises ..... U..l.~.C>.......~...?..~./.!.~...Address ........ ../~..~......~....~...~...k....~...../~/J~ne No. 2~'..'...~..~.?.? Name of Architect ........ .%....Z ..................................... 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-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 lot. STATE OF NEW' ~"~P~..~ .,./. ! c c COUNTY OF ...~f~..J'~'" (Nam~;~i~'~'l"~i~ ning application) ...... being duly sworn, deposes and says that he is the applicant above named. He is the ......................................................................................................................................................... (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 are 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 this ~ of .................... ./? m. ;-J' ,/.' ,' ................................ ............................... Notary Public, .~~-~u~.~:~nt¥ (Signature of ~l~plicant) ' {~J Nolary Public, State of N~w York No. 52~0~44968 Suffolk County Commission Expires March 30, I~..~ ~o?YC, '"-I