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Home My WebLink About5749-zTOWN OF SOUTHOLD BUFLnING DF, PARTM'~IT Town Clerk's Office Southold, lq. Y. Certificate Of Occupancy No. Z6702 ...... Date ..............Sept... alt..., 19.'~5. THIS CERTIFIES that the building located at .~/a. ~4ain. ~lo~l ............ Street 1F3, 1~-'%, 1F5' Map No. l:,~c · ~a.y .~,$ t~'~ No ........... Lot No, 200 ~. 2(~1 t. 202....~re~upor.t.. II conforms substantially to the Application for Building Permit heretofore filed in this office Ear 16 72 3/1 dated ...........?/.$6/?.3 .... , 19 .... , was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which thi.~ certificate is The certificate is issued to . .G.~.o.:..L....P.e..n.ny...I.l.l. ..... 0?.n.~I' ........................ (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval . .. ~ ,~: ............................ UNDEBWBITERS CERTIFICATE No. ~ :it .. ....................................... HOUSE NUMBER .... 6.?.~ ....Street ...... ~.ln. ~tcaql ......................... Building InspectOr FORM NO. ~ 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? 57 9 Z Dote ........................... ~ ....... ]6...., 19..~.. Permission is hereby granted to: .... at premises located at ....................... ~/~"~" ~1~ ............ &~lt~lll~llilUl~l~ ............................. ............................................ O~enp~t~' ............. ~'~'~ ...................................................................... pursuan¢ to application doted ................................... ~lgl~ ...... ..~.~.,' 19......~,., and approved by the Building Inspector. TOWN OF $OUTHOLD ~/-~.~ . · 'J/ BUILDING DEPARTMENT ~ ,c:~.~,~ TOWN CLERK S OFFICE ~~ ~ ,. Y. D ~ rov~ o ~ ...... ~ ...... ~ ..................... .......................... ...................... .............................................................................................................. ..... X ...................... ........ ~. lhi* o~lieation mu~t b~ completely fill~d in b~ ~p~writ~r or in ink ~nd ~ubmitt~ in ~licat~ to th~ In*~ctor. b. Plot plan sh~in~ I~ation o{ lot ond of buildinfl~ on pr~mise*, relationship to odloinin~ pramise~ or public ~reo~, ond oivinfl ~ ~t~il~ d*~cription o~ I~out o{pr~*~ mu*t be drown on th~ die, ram which c. ~ work cov*r~ by th~ o~lication mo~ not b~ comm~m~d before i~uanc~ o{ 8uildino ~rmit. d. Hpon opprov~l o~ thi~ opplication, th~ 8uildin~ In,p~tor will issue o Buildinfl ~rmil to th~ ~licont $~h ~holl be k,pt ~ th~ premise~ ~vailabl~ for in~p~tion three,ut th. pr~r~ o{ th~ work. ~. ~o buildino ~h~ll b~ ~cupi~d or u~d in whol* or in p~ ~or ~ny pu~ose wh~er until ~ ~ific~ o{ ~h*ll hay* b~n ~rent~ by th~ Buildino In~p~tor. APPLICATION IS HEREBY MADE to the Building Department, for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, S~folk CoUnty, New York, and other applicable Loews, Ordir~nces or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with oil applicable lows, ordinances, building code, housing code, and regulations. (Signature of applicant, or name, if a corporation) .Main.. RoAd.,...C~eenp. or.t ,... ~tew...~.~r}~ ....................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buil~. Name of owner of premises ............ Ge. or~e...T,.....P~nny.,...ITT ........................................ ~ · If applicant is a corporate, signature of duly authorized officer.~, (Name and title of corporate officer) 1. Location of land on which proposed work will be done· Mop No.: ........... XZZ ..................... Lot No..~'~. ............... Street and Number ......... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed comtruction: a. Exisiting use and occupancy ...... h~t,~ia.es.s..l~ui.].ding. ............................................. ~ .................................. b. Intended use and occupancy ...... ~a~e...w~,t~..&c[c].i.tJ.o~ .............................................................................. Nature of work (check which applicable): New Building .................. A~ldition .................. Alteration .................. Repair .................. Remgval .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .......... ~l..~r.~....(~D........C~..!,..~ .................. Fee .......................................................................................... (to be paid on filing 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 t,/pe of use .~...~....~......~...~J~-~ 7. Dimensions of existing structures; if any: Front .........~..~ .......... Rear ........ .,~..¢;~ ............. Depth ....~..(~. ....... Height .....~..~.l. ....... iL Number of Stories ......... J ....................................................................................................... D,mens,ons of _s~me structure w,th alterations or additions: Front ........ .~..~ ................... Rear .....k;:z..~.. ............................ Number of Depth .......'~1"-~'- ................ Height '-~,-C~ ! Stories ......... ~ ............. 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ........ /.-,-~.~.~ ........ Rear .................................... Depth .................... ~ ........... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated 12. Does proposed construction violate an~ zoning law_,.,w_~:.o,~, Jnance or regulation? ............................................................ 13. Name of Owner of premise~..t...~.../...~...~....~....~Address...L~....~.~...J..~.....~...C-.~.C.... Phone N~. ~....~.i..~..~'...~...~..~ Name of Architect ...................................................... 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 i~terior or comer lot. STATE OF NEW~YO~,,. ~.~ COUN~F OF .~,~../~.....~ ....... ........ ~....4~.....~,...~ ...................... being duly sworn, d~o~s and says that he is the applicant (Na~e of individua~igni~ application) a~ve named. He is the ............................... ~ ...................................................................................................... (Contractor, agar, corporate officer, etc.) of ~id ~ner or owners, and is duly authorized to perform or have performed the said work and to ~ke ~d file this application; that all statements contained in this application are true to the best of his knowledge and belief; and t~at the/?r~willb~,~rformed in the manner ~t fo~h in the applicati~ filed therewith~ bWO mto ~tole meTnls ...... .......... .