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Home My WebLink About6561-zFORM NO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ~arb.c~r. Lights..l~r$.v.~ ..... Street Map No. ~.~ .~ ... Block No .... ~...Lot No..~ ..... 3o~tho~d...~ ~... ......... co~or~ substanti~ly to the Application for B~ding Permit heretofore ffl~ ~ t~ office ~r 6~Z dated .... $~ .~.-...- ..... , 19~ p~u~t to ~hich B~ Pemit No... ~.~ Ma~ 10 ~973 dated ............ J~. 6 .... , 19.2~, ~as issued, ~d confoms ~ ~ of ~he r~ men~s of the applicable pro~s~o~ of ~e law. The occup~c~ for ~ch ~h~ ce~ica~ ~ The ce~fficate is ~sued to .8~.9~$..~ ........ ~9~ ............................ (o~er, lessee or ~n~t) of the Mores~d b~ding. S~olk Co~W Dep~tment of He~th Approv& ~,K, ............................... U~ITERS CERT~ICATE No. ~. ........................................ HOUSE ~ER ...gQ~ ....... S~t. ~r~r .~$~t~. ~ ..................... ~ Brig~t~e D~ ' ....~q ~ · ..... ~g Inspector FORM NO. ~- TOWN OF SOUTHOLD BUILDING DEPARTMENT T~OWN CLERK'S OFFICE SOl/TI'fOLD, N. Y. BUILDING PEILMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL ~CO~PLETION OF THE WORK AUTHORIZED) 6561 Z Date ...................... ...)~..~. ............ 2..0. .......... 197..~... Permission is hereby granted to: ............. .~,.~..~...~;.,....~...~r. ............................... ..................... .~..~¢..~.o.!4 ........................................ at premises located at ........[~0~.-,~,..~ ...... ~z~boz~..Ligh~..][s.t; .................................................. ....................................... Ha~.b~..~ Ehts..~ ............ Sau~ol~ ................................................. pursuant to application dated .............. : ............. ~t~l~.....J~ ....... , 19..~,~., and approved by the Building Inspector. Fee $.....1 .~.~...C~.. · ....... FOI~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined Approved ............ ..~..?..~..~.'..'~....!.?..#, /T /, ~-,r'' 19~ .~';.:. Pemit No..~..?~....~..~...~...-~T... ............. Disapproved a/c ..... .~..~.~.~.~/......~......~/..~.~....i..i.~.~__ ..................... ....... .......... .............. ........................................ ~'")~u~'~ ~ ~ ~ .... .................... (Budding; Insp;~;~i ................................. ~/~ ~ ~e~"~ APPLICATION FOR BUILDING PERMIT ~ ' r ;~' ~ -~hISTRUCTIONS March 8 73 Date ................................................ , 19 ..... a. Th~s apphcatlon must be completely filled ~n by typewmter or ~n ~nk and submitted in tmphcate to the Budding Inspector~w 3 sets of plans, accurate plot plan to~ scale. Fee according to schedule b. Plot plan showing Io[cat~qn. lq~,lot and of b,q~!~l).n~.,on p.r.~m~se~,relat~.p~z~t?c~..ac~n_k'zga~qremmes or pubhc streets or area s~"deta~led g~vmg a descmpt~on of layout of property must be drawn on dmgram which is part of th~s apphcat~on. c. The work covered by th~s apphcat~on may not be commenced before issuance of Budding Permit. d. Upon ~pproval of th~s apphcat~on, the Budding Inspector wdl msue a Budding Permit to the apphcant Such permit ,shall be kept the premmes a~aflab~e for inspection throughout the work. e. No budding shall be occupied or used m whole or ~n part for any purpose whatever untd a Cert~hcate of Occupancy shall have~ granted by tile Budding Inspector ' APPLICATION IS HEREBY MADE to the Budding Department for the ~ssuance of a Budding Permit pursuant to the Budding Z, Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the constructed buddings, ad(htmns or alterations, or for removal or demoht~on, as hereto described The apphcant agrees to comply with all applicable la ordinances, building code, housing code, and regulations, and to admit authomzed ~nspectors on premises and m buddings for necessary inspectio (S,gnature of applicant, or name, if a corporation) (Address of apphcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build o~:o. er Name of owner of premises .... ,R_o,,b,,e,~..,~,:...,~,,e,v,,y.. ............................................................................................................. If applicant ils a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................................................... Plumber's License No ......................................................... Electrician's L~cense No ..................................................... Location of land on which proposed work will be done· Map No.~.3,,6..2. ...................................... Lot No. 8 Street and Number ....... ..~..a.~.b.,o.~...~.t.?.,h..t...s....D.~.t..v..e. .............. .S..o..u..t..h.o...1,d..;..~.e,?....~..o.~?. ......................................................... Municipality 2. State existing use and occupancy of premises and ~ntended use and occupancy of proposed construction: Rest dent ia 1 a. ~xisting use and occupancy .................................... , .............................................................................................. b. Intended use and occupancy ....R..e..s.~.d..e..n.~[~.l. .............. .~...&.. ........................................................................ o Nature of work (check which ap le): New Building ....................... A n ..................... Alteration ............. Repair ......................... Removal ......................... Demolition .................. Z..,. Other Work ............ (Description) 4. Estimated Cost .......§.5. x.0..0..0. ............................ Fee ................................................................................................ (to be pa~d on flhng this apphcat~on) 5. If dwelling, number of dwelling units .................Number of dwelling units on each floor ....................................... 2 If garage, number of cars ........................................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................................... 7. Dimensions of existing structures, if any: Fron1~ ...... .4..3. ........... Rear ...4.3. .................... Depth ....... .3.,8. ....................... 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 2z~ 24 .............. :~'~ ..................... ......................... Rear ............................ Depth ............................... Height ................................................. Number of Stories ............. .l; ................................... ~J74 ............................... 9. Size of lot: Front ~.33 t04 ...................................... Rear .......................................... Depth ............................................... 1967 10. Date of Purchase ..................................... Name of Former Owner .......................................................................... 11. Zone or use district in which premises are situated ................................................................................................... 12. Does proposed construction violate any zoning ~aw, ordinance or regulation: ...~..e.s. ................................................. 13. Will~otberegraded ....... ~.o. ........................ Will excess fill be removed from premises: [ ] Yes [~j No ~9.h~& ~ L~.v.I Harbor Lib. his Drive , 14. Name of Owner of premises ................................................................................. .7. .6. .5. ~. .5. .4. .3. .3. .................. (Address) (Phone No.) Nam,~- of Architect .................................................................................................................................................... (Address) (Phone No.) Name of Contractor Ba~e Construction Co. Inc. Southold 765-1681 .................................................................. [~,~1'~;~') ................................................................. (Phone No.) PLOT DIAGRAM Locate clearlv and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro property lines. Give street and block number or description according to deed, and show street names and indicate whet er interior or corner lot. tot STATE OF NEW YORK, ~: r'~ COUNTY OF .. S...~.~...~.O...L~, ............. ) Robert E. Levy " .............................................. being duly sworn, deposes and says that he ~s the apphcant above name, /Name of individual szgmng contract) He ~s the ...... Owner (Contractor, agent, corporate officer, etc,) of smd owner or owners, and ~s duly authorized to perform or have performed the smd work and to make and file th~s apphcation; that statements co.ta,ned m th,s apphcaBon are true to the best of h,s knowledge and Bb~;f~,t~[~vork w,II be performed In the man, set forth m the apphcat~on hied therewith ~O?~Y PUgL[~ Et=re ol New York 'L I L r ] L__'] 7-0 7-0 ,I cL05 L IV IN 6-'~ n'l 2;0: $"