The URL can be used to link to this page

Home My WebLink About6515-z· O~ NO. & TOWI~ OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z?.29.8. ..... Date .......... ~;..'[.~ ..... , 19. ~l~ THIS CERTIFIES that the building located at . I~/1t. 1~$1~. Roaa..~..~.°.~.~et Map No... X~ ....... Block No.. ,X~ ..... Lot No~... 01'~enpo~t ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ AI~' ~619- · ?9~l~rsuant to which Building Permit No. 6~1 ~'~- · dated ...... Ap~' . ~ ..., 19 73., was issued, and conforms to all of the req,,b-e- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . ¢o~tra.e.tor~. Yard..with. storage, tanks. & .office. tr~lle~, ...... '~~he certificate is issued to . Pa~], .GO~aXx~bli .&. H(~ls. In~ .... OMlaers. ............ of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant) UNDERWRITERS CERTIFICATE No. I~,R* ...................................... HOUSE NUMBER ...67~O... Street . M~n. Ro~d.. ~eenpo~t ................ ...... . , . . / Building Inspector FOR~ NO. ~ TO~N O~ $O~TSOLD BUILDING DEPARTMENT TOWN GLERK'S OFFICE SOUTHOLD, N; Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON 'THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6515 Z Permission is hereby granted to: ~.~...~......a..,o.~ ~.,~...~..,, ..a... ~.o.~... ;I;~ ..................... " ........... ~.e..~..o.r.~ .............................................. pursuant to application dated ............... .~.~.~..~.......~.,~. .................... 19.~.,~.., and approved by the Building Inspector. Fee :j..~..e....Og, .. ............. Building Inspector .BUILDING DEPARTMEN TOWN CLERK'S OFFICE ~OUTHOLD, N. Y. .............. , Approved ............. .~.~.....~...~ ................. , 19.?.~... Pemit No...,..~....~..../...~..~ ......... Application No ............................... . . APPLICATION FOR BUILDING PERMIT ~,~-~ Date ..... ....................... t.~ . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triPlicate to the Building Inspector, witJ~ ~3 sets of plans, aCCurate plot plan to scale. Fee according to schedule. .<- b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, affd ,giving a detailed description of layout of property must be drawn on diagram which is pert 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 :.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 shall have been 'granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depai~ment for the-issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffoik County, New York, and other applicable Laws, Ordina[jces or Regulations, for the.construction oJ buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with ell applicable law~ ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ~4.~ ~ ~-~L/~ ~(~ ~ ~- .... i~i~~.~rporatJoni~ ~- .... ~.e3~...C~.~£~,..~..$~j~,.];d~e .......... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ............ ~t~;L..Ck~a~z~.~aJ,..&..Se,~a..~, ....................................................................... * ..... Builder s License No ..... ~ .................................................... Plumber's Licen~ No ......................................................... Elemrician's Licen~ No ........................................... Other Trade's Licen~ No ................................................... 1. Location of land on which propomd work will bedone. Map Nm; ...................... ~ ..................... Lot No ......................... Street and Numar .......... ~e...~..~ .................................... ~...~o~..~.~ ....................................... Municipali~ 2. State exi~ing u~ and occupancy of premi~ and intended use and ~cupancy of pro~d-con~ruction: a. Exi~ing use and ~cupancy .................. ~.~,~.~.~ ....................................................................... b. Intended u~ and o~upancy ........... ~,~q, ............................................................................................................. ' 3. Nature of won< (check which applicable): New Building ....................... Addition ,....;,.~, ......... ~.. Alteration., ........ Re r ................... Removal ......................... Demolition ...................... .~ Other Wdrk ................................... pal ...... ~ . .. (Description) 4. Estimated Cost ...................................... .. .. . ... . 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, commemial or mixed occuDaneV,'sp~ifY nature and extent of each type of use ..................................... 7. Dimensions of existing stnJctures, 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 constnJction: Front ......................... Rear .......... , .................. Depth ................................. Height ................................................. Number of Stories ......................................................................................... 9. Size of lot: Front ...................................... Rear .......................................... Depth .................................................. 10. Data of Purchase ..................................... N.a. me of Forryr~O~fl[er ............................................................................ ~1. Zone or use district in which premises are situated....... __..~...."...~.~.....~ .............................................. 12. Does ,roposad construction vi~late any z°ninglaw' ordinance Or regulatiOn: ....... iii..~ ....................................... 13. Will lot be regraded ................................... Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises ........................................................................................................ ..... · · ........... · ... · .-- · (Address) (Phone No.) Name of Amhitect ..................................................................................................................................................... (Address) (Phone No.) Neme of Contractor ................................................................................................................................................... (Address) (Phone No.) PLOT DIAG RAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all 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 Int. STATE OF NEW YOR/J~ ~,~ ) SS COUNTY OF ........... ~'~:~.%~ ................. , /-- .......................................................................................................... being duly sworn, deposes and says that he is the applicant above named; (Name of indiv'.t4uat signing contr~tY~ (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 h~s knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. ............... y ....... .................. ///// / / -. , / ' in Itolk County