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Home My WebLink About5593-ZFOKM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMI~,NT Town Clerk's Office Southold, N. Y. Certificnte Of Occupancy No.. z5320 ..... Date ... lullr. 27 ................ , 19. THIS CERTIFIES that the building located at . .2.~.~.0...B.ay...a.v.e.~..u.e ......... Street Map No ............. Block No ...........Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed, in this office dated . .0..c.t.o.b.e..r..2.~. ........ , 19..~.~. pursuant to which Building Permit No..~.~.9.~.~.. dated . .0..c.t.o.b.?.r..2.8. ......... , 19...7.~, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ..... !.l..u~..t.~.p.l.e...R.e.s.~.d..e~.e..$T.M.o.t..~' ..... ~ ................ . ................ The certificate is issued to ...... .H.e...rj~....B..1.u~.. .................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... Pending UNDERWRITERS CERTIFICATE No ............................................. HOUSE NUMBER 21~0 Street Bay Avenue, FO~ 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? 5593 Z Permission is hereby granted to: ................. ................. I~'c'c~:t'uek ......................................... to ..... ~ff~t~' .alt.. e~t~t~'... &-. F~ke.. ette~&.t ~ea~..ale-. e~..1111~1~ ........ .................. [.?..llat~t~ek. Jlet~Z?...~..ImZld3~ ....... [..mpa~a..a~..~..~ ~) at premises located at ................ ~..~h~..31~Ve ....... l~l~t,~ue, Jl~....~e- ..................................... pursuan$ to application dated ............................. (~l~.t, ...... ,.~. ......... , 19..;~.~., and approved by the Building Inspector. Fee $.~,,~:~1 ............. FO]ElM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ................... t.~......~.). ........ , 19.2.!.. Pemit No... ~ ............................ 3 7--- Disapproved a/c ......... ~ INSTRUCTIONS Application No.....~....~..Z..'~..~......~ Date 0..~..~'...~.~...~... ~!.~.; 7 .............................. ,, ........... , 19..../.. ..... a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on'premises, relationship to adjoining premises or public streets areas, and giving a detailed description of layout ofproperty ?ust be drawn on the 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 In~p~;for 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. . . . .. A PLIC^TION IS HEREBY MADE to the Building Depa*r,tment for the issuance of o Building Permit'pursuont to the Building Zone Ordinance of the Town of Southold, Suffolk, County, New York., and other applicable bows, Ordinances or Rogulotions, for the construction of buildings, additions qr ~lterotions, or for removal or demolition, os herein described The applicant agrees to comply with all applicable Iows,.ordinonces, building code, housing cod~, and regulations. , (Signature of applicant, or nome, if a corporation) State whether applicant is owner, lessee, agent~ ~rchitect, engineer, general contractor, electrician, plumber dr builder.~[ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work w. il! be done. Map No.: ...... .................................. Lot No.I...~...~.~...T.~..e.¥.~.;~/* Street and Number ...,~J~......~.~..~,~...~.......~..~.~ ."Z~..~..~..~...,.~...C....'~f...,~.~l~.s~. ................................ : .............. ~3e ~ ~/~ . Municipali~ State existing use and occupancy of premises and intended use and ~cu~ncy of proposed construction: a. ~isiting use a~ occupancy ......... ~.~.~.~_ ................................... ~ b. Intended use and ~cupancy ....... ~.~.~.~....~~....~.~...~...(~'"'""'~'~ ~ '~'"'"'"'"'"""'"" ' 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration Repair .................. Removal .................. DemolJtior .................. Other Work (Describe) ........................................ 4. Estimated Cost ...........~.~...j...O...0...O..,j~ ........................ 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 .L ....................................... , ................................................................................................... 6. If business, commercial or mixed occupancy, specify, nature and extent of e~ch type of De.th ........... 7. Dimensions of existing structures, if any: Front ........... ";;; ........... Rear ..~.~i~. ................. Height ..... ;~l.../ ........... Number of Stories ........ ~'. ..................................................................................................... Dimension, j o~f ~me structure with alterations or additions: Front ....................... Rear ..j..~,~J..:. ......... Depth ....~r.~....*'. ................ Height ........ ../..~..~ ............. Number of Stories ..........Z~ ................... 8. Dimensions of entire new construction: Front .................................... Rear ............... Depth ....~...... ........... Height ....../~. ......... Number of Stories ........................................... ~ ..................................................... 9. S,ze of lot: Fro t ....~ ...~. ....... Rear .~,,J.~. .......................... Depth ....~..~.~'.,.~ ................ . 10. Date of Purchase .............. l./....~.J.../.~.~.. .................. ~Name of Former Owner~J~....~~ 11. Zone or use district in which premises are situated ...~..~..~..~....~ ............................ ~.. ........................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? .../~....O. ................................. 13. Name of Owner of premises~J~'..~..V.~J;~/~..c~.~Address ..~.~..,~...~...-. ............. Phone No.~.~.~;...~.~/..~. 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 descriptlo~ according to deed, and shaw street names and indicate whether interior or comer lot. STATE OF N~(4'~_ I~'_ .~.,~ J S S ' COUNTY OF ~_......._..,...f ' '~'~t~,. ~ J : .J ............... y;.....t..~~ ....... ~~.~ ......... ~ing duly ~om, d~s and says t~ he is the applicant [ma~e bf indivjdua~igning a~lication) above named. He is the ......... ~ ............. ~ ................................................................................... ~.~... (~ntmctor, agar, co~mte officer, ~c.) of said owner or owners, and is duly authorized to perform or h~e peffo~ed the ~id work and to ~ke and file this application; that all statemen~ contained 'in this applic~ion am tm~ to the best of his ~owledge and belief; and that the work will be perfo~ed in the manner ~t fo~h in the ~pllc~i~. fil~ ther~ith. ~~r.~ me this~,a~' ~j ~ [ ' ......................... :.. o, .........