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Home My WebLink About5828-zNO. 4 : TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, BI. Y. Certificate Of Occupancy No......Z~'~? ..... .. Date 0etobel' 18t 19 73 THIS CERTIFIES that the building located at . E../.3 .Bq.~.s.s.e..a.u..A.v.e..... Street Map No. XX Block No. XX ..... Lot No. X~ 5outho].d, conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... .Ap.r.~..1..2.~ ..... , 19.7.2.. pursuant to which Building Pemit No. _ ~.../-~/dated~.~ ...... .Ap.r.~..1..2.~ ...... , 19..7.2, 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 ...~.~..v.a.t.q..(.a.c.q .e.s.s.o.~.y..b..uS..]..d..i~g.)...&..f. en??. ........................... The certificate is issued to Frederick l~eh (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... N,R, UBIDER~ITERS CERTIFICATE ~o ............................................. 300 Bo:Lsse&u Ave. HOUSE NUMBER .............. Street .......................................... 8outho].d Building Inspectbr FORM NO. 2 TOWN 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? 5828 Z Permission is hereby granted to: ....... ]l~'~.~:Le, k... ,a:LeJa ...................................... ................... 8 ~i'~Jle ].d~ ......................................... ~o ....... ~...~...a...e..e...e.~..~..e...~....L ~..t..e. ~..a. Le. )...~..~l.a..J~,r ........................................................... at premises located at ......... ~!L~:Le.~oal~.A.~e..~..&/...~.,I. og,~q~ .......................................... ..... pursuont to application doted .......................... ~t~.:[.~ .......... ~1..., 19...~'~., and approved by the Building Inspector. Fee $. ~...?..O..R..O~... .... Building I nspec~or [ ·oml No., TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ..... ~ ....... [ ............. , 19.7....~.. Approved c,, ,, 3 ...'~. ~ ........................................ , 19.. Pemit No. ~*-~c~.h_~- Appli¢ofion No ................................. Disapproved a/c .......... ~~.._...._ ............... ~:~.~.. {Buildin~ In~l:~ctor) APPLICATION FOR BUILDING PERMIT ~ D. April 2~ 72 ~ ate ................................................ , 19 ............ INSTRUCTIONS ~ a. This applic~ion must be completely filled in by typewriter or in ink and submitted in triplicate to the Bud ng nspector, with J~J 3 sets of plans, accurate plot plan to scale. Fee according ~b schedule. .b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and~ giwng a detailed description of layout of property mpst be drawn on 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 work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shell have been`][;> granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit purs~iant to the Buitding Zone Ordinance of the Town of Southold, Suffotk County, New York, and other applicable Laws, Ordinances or Regulations, for the oonstruction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all al~Olicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. Frederick Rich (Signature of applicant, or name, if a corporation) Southold N .Y. State whether applicant is owner, levee, a~ent, architect, engineer, ~eneral contractor, electrician, plumber or builder. owner If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Map No ...................... Lot No .............................................. 1. Location of land on which proposed work will be done. · bar E.~.. Boisseau Ave S~.~hQl~ ~.~ ...................... Street and Num ........................................................................................................ 3 00 Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: °ccu pancy '""'~'~e ll i~'g ............................................. 7" ~' ........ i .............. a. Existing use and ................................................. b. Intended use and occupancy .......... sa.me..~th..~.c~.es~o~'.~..~lc]d~ ........................................................... f.~. 3.o Natom of work (check which applicable): New Building ....... ~ ........... Addition ..................... Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) 4. Estimated Cost ............................................... Fee .......... 0~.(~). ............................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ....~..~.~.e. ..... 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 usa ..................................... 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 ...... I.G .............. Rear ....... 1D ................ Depth ......1.0 ....................... Height ................................................. Number of Stories ...........D,T),fl ....................................................................... 9. Size of lot: Front ........'~0~ ...................... Rear ......... ~.2...~. .......................... Depth ......2.~..~,~.~ .......................... Height .................................................... Number of Stories ...................................................................................... 10. Date of Purchasa ..................................... Name of Former Owner ............................................................................ . _lU 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposad construction violate any zoning law, ordinance or regulation: ............. .~...o. .......................................... 13. Will lot be regraded .,~--zzo ....................... Will excess fill he removed from premisas: [ ] Yes [ ] ~--6~.~,., 14. Name of Owner of premises ff.~.q.~fLT.~.~..~i.l~ .............................................................................................. (Address) (Phone No.) Name of Architect ..................................................................................................................................................... (Address) (Phone No.) Name of Contractor .............~,.~R.(~ ............................................................................................................................. (Address) (Phone No.) PLOT DIAG RAM Locate clearly and distinctly all buildings, whether existing or proposad, and indicate ell sat-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. see filed plot plan STATE OF NEW YORK, ) SS COUNTYOF....~I~D~}.~C .............................. ) ............................................. ..~...~..e.~.e...z'..~.,,~..~....~.,~.c..h ..................... being duly sworn, deposes and says that he is the applicant above named. (Name of individual signing contract} 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 end belief; and that the work will be performed in the manner set forth in ~the application filed therewith. of ........................ .............. No~ Public ...................................................................... ~ounty ................................................ (Signature of applicant) -4